Dear Doc­tor Roshan Paras­ram (Chief Med­ical Of­fi­cer)

CC Min­is­ter of Health Ter­rence Deyals­ingh

I write this open let­ter–a plea to you on be­half of three of this na­tions' se­nior physi­cians–pri­vate prac­ti­tion­ers who, along with thou­sands of health pro­fes­sion­als in­clud­ing nurs­es and phar­ma­cists were watch­ing with grow­ing hor­ror at the spike in cas­es, a spike in deaths rip­ping through fam­i­lies, and alarm­ing­ly through front­line work­ers.

We know of COVID in­fect­ed pa­tients dy­ing in tents, on their way to over­whelmed gov­ern­ment health fa­cil­i­ties, of the new phe­nom­e­non of in­trafam­i­ly spread as it's chal­leng­ing to quar­an­tine at home with­out spread­ing the dis­ease. They say they are re­ceiv­ing re­ports of more dy­ing at home than record­ed be­cause they are ter­ri­fied that if they test pos­i­tive, they be­come the Gov­ern­ment's prop­er­ty.

If CARPHA has a COVID pos­i­tive test in your (or any­body's) name, they have the au­thor­i­ty to send po­lice to your home, ei­ther to take you away to a state in­sti­tu­tion or make sure you are home. We've seen the men in haz­mat suits ar­rive through­out the coun­try and car­ry peo­ple off in a stretch­er. It is il­le­gal for a pri­vate in­sti­tu­tion to man­age a COVID case.

Man­ag­ing COVID-19 re­quires more than state con­trol.

Do you re­mem­ber how you felt this time last year? Then, you were a ris­ing star, an un­like­ly but sin­cere a-po­lit­i­cal hero who de­feat­ed COVID.

How lucky we are, we thought, look­ing with hor­ror and pity at the body bags, the men in haz­mat suits, the mass graves across the globe.

You fol­lowed the sci­ence. Your col­leagues in the Min­istry of Health, led by the Min­is­ter, kept our lit­tle fight against ran­dom cas­es tight and sealed. The politi­cians were the gate­keep­ers. Your cadre of su­per COVID fight­ers made up of doc­tors and nurs­es in the pub­lic hos­pi­tals, all of whom were re­quired to sign a strict con­fi­den­tial­i­ty doc­u­ment. That some were ex­haust­ed, and oth­ers were in­ex­pe­ri­enced was not the point. The war room was bolt­ed.

It was closed to thou­sands of doc­tors in pri­vate prac­tice who, be­tween them, have six or eight thou­sand years of spe­cialised and gen­er­al med­ical ex­pe­ri­ence; closed to the thou­sands of pri­vate nurs­es, and phar­ma­cists; closed to pri­vate hos­pi­tals and nurs­ing homes; closed to the pri­vate sec­tor, pre­pared to bring in the vac­cines.

Your re­in­forced COVID war room from which in­for­ma­tion is scarce opened ten­ta­tive­ly to al­low in a few pri­vate labs to do test­ing when it was clear that CARPHA wasn't do­ing the trick–and slammed shut.

This closed war room was ac­cept­able when there were just a few cas­es. But when the dis­ease over­whelmed our health sys­tem with a cru­el im­mutable quick­ness just as it does our bod­ies, we must have known that every liv­ing hu­man is a sol­dier in this war against COVID.

A closed war room does not win a war that is be­ing fought in every cor­ner, every par­lour, in every home, in every cell of cit­i­zens.

When in bat­tle, we can't stop to ar­gue amidst our­selves as to who was re­spon­si­ble for the weak de­fence, the deaths–close to 25,000 cas­es, up to 556 deaths, among the worst per capi­ta glob­al­ly. Let's agree that yes, that 'all of we' re­spon­si­ble in dif­fer­ent ways. Ral­lies, march­es, vig­ils, limes, wed­dings, prayers, fu­ner­als, sports. Every man and woman a COVID sin­ner. Right now, with so many dead, many dy­ing en route to the hos­pi­tals, many strug­gling to live at home, like a grim echo of death glob­al­ly, we don’t have the lux­u­ry to pun­ish and blame.

Look what this dis­ease has done to us, dear doc­tor. Things were tough be­fore COVID-19, with high homi­cides and falling oil and gas prices, but we didn't know what tough was un­til this dis­ease en­gulfed us, forc­ing us to close bor­ders, close busi­ness­es, leave peo­ple strug­gling to live, strug­gling to die, to pay rent, to feed them­selves and their fam­i­lies, ed­u­cate their chil­dren. It's ex­posed old vul­ner­a­bil­i­ties, our re­fusal to digi­tise, for in­stance, leave pen­sion­ers min­gling help­less­ly in long queues, spread­ing the dis­ease.

Doc­tors agree with the Gov­ern­ment that the on­ly way out is to vac­ci­nate 70 per cent of us to achieve herd im­mu­ni­ty. But at the cur­rent rate of a thou­sand vac­cines a day, skip­ping week­ends and pub­lic hol­i­days, it may take six years, or more to achieve herd im­mu­ni­ty.

You are not alone, Doc­tor Paras­ram. Last week, neigh­bour Bar­ba­dos record­ed no cas­es, no deaths. Let's take their cue to vac­ci­nate our­selves out of this.

We are about two per cent ful­ly vac­ci­nat­ed, one of the low­est in the world. But at least nine per cent of peo­ple have re­ceived their first shot. The What­sApp sys­tem is chaot­ic.

Now that more vac­cines are in the pipeline ac­ti­vate the pri­vate sec­tor.

The ini­tial vac­cines have been mopped up by those who be­lieve in them, but doc­tors wor­ry the up­take will get hard­er and hard­er.

To vac­ci­nate over 70 per cent of us be­fore the 'moth­er of all car­ni­vals' promised next year by the AG, and more im­por­tant­ly, so we don't go down the route of the eco­nom­ic dev­as­ta­tion of Venezuela, at least 4-5,000 peo­ple need to be vac­ci­nat­ed dai­ly.

Doc­tors are here, qual­i­fied, overqual­i­fied, to help. Many, if not all, will vac­ci­nate the pop­u­la­tion for free. They say if di­a­bet­ics reg­u­lar­ly in­ject them­selves, it is not hard to vac­ci­nate peo­ple. They rec­om­mend the fol­low­ing:

A) Give every will­ing doc­tor vac­cines coun­try­wide to ad­min­is­ter to pa­tients with the stip­u­la­tion they are not to charge their pa­tient for the vac­cine coun­try­wide. If 4,000 peo­ple are vac­ci­nat­ed dai­ly, we will be able to achieve 120,000 a month and 720,000 in six months.

B) Al­low pri­vate hos­pi­tals and labs to treat and test COVID-19 pa­tients.

C) The Gov­ern­ment needs to start a mass health cam­paign to counter vac­cine hes­i­tan­cy. Again, doc­tors who al­ready have the trust of their pa­tient will have a great reach, es­pe­cial­ly amongst those who are un­sure, who will de­lay herd im­mu­ni­ty and re­turn to eco­nom­ic ac­tiv­i­ty.

D) Cre­ate 24-hour sev­en days a week vac­ci­na­tion cen­tres with the help of pri­vate vol­un­teer nurs­es, phar­ma­cists, both work­ing and re­tired. This non­sense of ''No vac­ci­na­tions on a Sun­day or a pub­lic hol­i­day'' must stop.

The en­e­my has ad­vanced. Your re­in­force­ments stand ready to serve.

Yours sin­cere­ly, Ira Math­ur on be­half of three se­nior physi­cians in T&T.