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CMO: T&T may have local spread, behave like person next to you has Covid-19

Ministry of Health CMO Dr Roshan Parasram warned today that Trinidad and Tobago might now be experiencing low levels of ‘local spread’ of the novel coronavirus Covid-19 and urged persons to treat everyone in their immediate vicinity as though they were infected.

As of this morning, the twin island republic tallied 82 positive results from 539 tests with three deaths and one discharge. There are three patients at the Couva Hospital’s Intensive Care Unit—one in critical condition and two stable—with another 14 stable cases at its High Dependency Unit and 53 persons described as ‘ambulatory’ or mild cases between Couva (48) and Caura (5).

Photo: Ministry of Health CMO Dr Roshan Parasram.

An unspecified number of ‘highly suspect cases’ are awaiting swab results at Caura, which is being used as a holding bay.

“The time has come for us to behave as a society […] like the person next to us has Covid,” said Parasram, at today’s press conference.

The CMO said the spread of the virus has gone to a new phase in Trinidad and Tobago.

“Over the last 24 hours, we have received two cases [of local spread], one in Tobago and one in Trinidad—that you will have seen in our release as pending epidemiological investigation,” said Parasram. “We are still waiting for the clinicians to […] rule out completely that there was no link to a previous case or there was no history of travel or contact with a traveller… Looking at the surface of it, it seems that these two cases may be our first few cases of local spread.”

Parasram attempted to distinguish between local and community spread.

“Local spread […] meaning that somebody is unlinked, and I spoke about hidden cases meaning that you could have been expressing symptoms,” said the CMO, “left your home, gone to a supermarket and been in contact who someone you would not have known; and that person now develops symptoms.

“So I believe we may have a couple local cases … When we speak of community spread, it means that there is a large number of local cases and all of them have been […] basically spreading [the virus] amongst large segments of the community or the population.”

Photo: Members of the public practice social distancing in Manila.

Health Minister Terrence Deyalsingh also addressed the issue of exercise over the next 14 days. His cabinet colleague National Security Minister Stuart Young recently ‘ordered’ the public to exercise at home.

It provoked a clarification from Commissioner of Police Gary Griffith who pointed out that freedom of movement cannot be restricted ‘outside of a State of Emergency’ and said his lawmen cannot legally arrest anyone unless they breach the specific orders of the Public Health Ordinance. The law forbids congregations of more than 10 persons and the operation of ‘non-essential businesses’.

“There is a difference in ‘cannot’ and ‘should not’,” said Griffith. “You cannot lock up people for doing something that is not illegal.”

Notwithstanding the legal limitations of the government’s request, Deyalsingh reiterated that exercising outdoors could be dangerous.

“Don’t run around the savannah because the person 10 feet in front of you, who may have Covid, will sneeze and cough and then one second later you will run into his droplets,” said Deyalsingh. “[…] That is why we are saying to people who insist on exercising: stay … at … home.”

At present, exercise is one of the few reasons that the UK government allows citizens to leave their homes, although they are asked to avoid driving long distances to exercise, use large open spaces and maintain social distancing.

Photo: The Ministry of Health has advised persons not to exercise outside of their homes.

Advice from the UK’s Centre for Perioperative Care (CPOC):

  • Stop smoking;
  • Take exercise unless you are unwell with the virus: ideally a brisk walk, cycle or jog. Strengthening and balance exercises are also recommended;
  • Those aged over 70—considered to be at increased risk of severe illness from the virus—are allowed outside, unless they have been otherwise advised, and should keep two metres from others and not touch anything;
  • Maintain a good diet, including trying smaller portion sizes and planning ahead for meals;
  • Maintain your mental health, including getting a good night’s sleep;
  • Have alcohol-free days.

The World Health Organisation (WHO) initially suggested that Covid-19 poses minimal airborne threat:

“The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or speaks. These droplets are too heavy to hang in the air. They quickly fall on floors or surfaces.

“You can be infected by breathing in the virus if you are within 1 metre of a person who has COVID-19, or by touching a contaminated surface and then touching your eyes, nose or mouth before washing your hands.”

Photo: Members of the public are asked to wash their hands properly to help prevent the spread of Covid-19.

However, WHO is now considering ‘airborne precautions’, particularly within closed settings.

“When you do an aerosol-generating procedure like in a medical care facility, you have the possibility to what we call aerosolise these particles,” said Dr Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit, “which means they can stay in the air a little bit longer. “It’s very important that health-care workers take additional precautions when they’re working on patients and doing those procedures.”

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