Over the last four months, 498 peo­ple have died from pneu­mo­nia and res­pi­ra­to­ry ill­ness­es in T&T, ac­cord­ing to of­fi­cial fig­ures ob­tained from the Reg­istry of Births and Deaths at the Min­istry of Le­gal Af­fairs.

Based on of­fi­cial fig­ures ob­tained by Sun­day Guardian from in­sid­ers at the min­istry, from De­cem­ber 2019 to the end of March 2020--498 peo­ple from ar­eas across the coun­try died from these ill­ness­es.

In De­cem­ber, while the coun­try's bor­ders were still open, 83 peo­ple died of pneu­mo­nia and 46 from res­pi­ra­to­ry ill­ness­es, while in Jan­u­ary the fig­ure for pneu­mo­nia was 69, with 43 peo­ple dy­ing from res­pi­ra­to­ry ill­ness­es.

In Feb­ru­ary, 71 peo­ple died from pneu­mo­nia, while 39 died from res­pi­ra­to­ry caus­es.

In March, the num­ber of peo­ple who died from pneu­mo­nia rose sig­nif­i­cant­ly to 96, while deaths from res­pi­ra­to­ry ill­ness­es al­so rose in this month to 51 from the pre­vi­ous month.

Pri­or to this coun­try's de­ci­sion to start rigid test­ing for COVID-19 from March 6 this year and the coun­try record­ing its first known pos­i­tive case six days lat­er on March 12, T&T record­ed 351 deaths from pneu­mo­nia and res­pi­ra­to­ry ill­ness­es from De­cem­ber 2019 to the end of Feb­ru­ary 2020.

Dur­ing the month of March the coun­try record­ed four COVID-19 re­lat­ed deaths--March 25, 27, 28, and 31.

The first con­firmed death in T&T--on March 25--came four days af­ter Min­is­ter of Na­tion­al Se­cu­ri­ty Stu­art Young an­nounced the com­plete clo­sure of the coun­try's bor­ders and one day af­ter Prime Min­is­ter Dr Kei­th Row­ley an­nounced that the stay-at-home or­der would be­come ef­fec­tive March 30 to April 15. That or­der was lat­er ex­tend­ed to April 30.

The PM has now an­nounced that bor­ders will re­main closed un­til May 15, while stay-at home or­ders re­main in ef­fect un­til May 10.

On April 1, 2, 5, and 6 the coun­try record­ed its next four deaths. The to­tal num­ber of deaths due to COVID-19 in T&T still stands at eight.

The num­ber of peo­ple who suc­cumbed to pneu­mo­nia and res­pi­ra­to­ry dis­eases be­fore the month of March, pri­or to this coun­try test­ing for COVID-19, has raised con­cerns about whether they could have con­tract­ed COVID-19 or died from com­pli­ca­tions as­so­ci­at­ed with the virus.

COVID-19 at­tacks a per­son's res­pi­ra­to­ry tract, through the air­way of the mouth, nose, lungs, and throat. Your lungs may be­come in­flamed, mak­ing it dif­fi­cult to breathe. This can lead to pneu­mo­nia, which at­tacks your lungs, lead­ing to pos­si­ble death in some cas­es.

The COVID-19 pan­dem­ic has swept across the world since the out­break in Wuhan, Chi­na, in De­cem­ber last year. The world has record­ed over 2.5 mil­lion cas­es with over 180,000 plus deaths to date and with the fig­ure still climb­ing.

Over the last three weeks, the Sun­day Guardian reached out to Chief Med­ical Of­fi­cer (CMO) Dr Roshan Parasaram via phone and text mes­sages to shed some light on the is­sue. Paras­ram was ques­tioned on whether there was a pos­si­bil­i­ty that some of these peo­ple who died from pneu­mo­nia and res­pi­ra­to­ry ill­ness­es pri­or to March could have been as a re­sult of COVID-19.

It was ex­plained that fig­ures from De­cem­ber to March were re­lat­ed to deaths caused by pneu­mo­nia, res­pi­ra­to­ry ill­ness, can­cer, hy­per­ten­sion, and di­a­betes.

The ques­tions posed to Dr Paras­ram dealt specif­i­cal­ly with deaths from the first two ill­ness­es.

But the CMO nev­er re­spond­ed de­spite re­peat­ed phone calls and text mes­sages.

Mean­while, da­ta from the reg­istry re­vealed that hy­per­ten­sion ac­count­ed for the high­est amount of deaths in that four-month pe­ri­od--876 peo­ple died from this ail­ment.

Di­a­betes al­so ac­count­ed for the death of 789 peo­ple dur­ing the four-month pe­ri­od, while 454 peo­ple died from can­cer dur­ing that pe­ri­od.

The Sun­day Guardian sought some ex­pla­na­tion about the fig­ures on the deaths from pneu­mo­nia and res­pi­ra­to­ry ill­ness­es from a vi­rol­o­gist. Speak­ing on the con­di­tion of anonymi­ty, he was on­ly pre­pared to say, "If one looks back at deaths that have not come through the hos­pi­tal sys­tem, even go­ing back from let's say De­cem­ber to now, es­pe­cial­ly be­fore the pub­lic got sen­si­tised from COVID, maybe we could have found out that some of them could have been re­lat­ed to the coro­n­avirus and there­fore would not be in­clud­ed in the sta­tis­tics."

Oth­er med­ical ex­perts con­tact­ed were un­will­ing to speak.

The Sun­day Guardian had tried to ob­tain fig­ures on the caus­es of death dat­ing back to the be­gin­ning of Jan­u­ary 2019, but se­nior in­sid­ers at the min­istry said ob­tain­ing the in­for­ma­tion for such an ex­tend­ed pe­ri­od would be "dif­fi­cult and time-con­sum­ing," con­sid­er­ing some de­part­ments were op­er­at­ing "with skele­tal staff" due to the pan­dem­ic.

From Jan­u­ary to the end of March some 3,000 peo­ple in T&T had died of var­i­ous ill­ness­es, mur­ders, ac­ci­dents and nat­ur­al caus­es.

Ques­tions to Paras­ram:

Ques­tions sent to Paras­ram in­clud­ed:

1. Is it pos­si­ble that some of the peo­ple who died dur­ing the pe­ri­od of De­cem­ber to Feb­ru­ary from pneu­mo­nia or res­pi­ra­to­ry ill­ness­es could have died from COVID-19 even when the coun­try had not start­ed test­ing for COVID-19?

2. Do you think there might have been pos­si­ble cas­es that the med­ical fra­ter­ni­ty did not know about dur­ing this pe­ri­od?

3.Were there any doc­tors or oth­er med­ical per­son­nel rais­ing red flags about pa­tients who came in with COVID-19 re­lat­ed symp­toms who lat­er died dur­ing this pe­ri­od that you may have been aware of?

Paras­ram: No ab­nor­mal deaths in the ear­ly part of the year

The CMO, how­ev­er, had in­di­cat­ed about two weeks ago in a Min­istry of Health dai­ly press brief­ing that there were "no ab­nor­mal deaths in the ear­ly part of the year." But there was very lit­tle op­por­tu­ni­ty af­ford­ed there­after for jour­nal­ists to pose spe­cif­ic ques­tions about this mat­ter.

How­ev­er, last Wednes­day ques­tions were raised by a jour­nal­ist in re­la­tion to peo­ple who had died pri­or to March from res­pi­ra­to­ry ill­ness­es and if there was the like­li­hood they could have died from COVID-19. Health Min­is­ter Ter­rence Deyals­ingh told the jour­nal­ist that he would have to pass the in­quiry on to the CMO, who was not present at the con­fer­ence. There has been no re­sponse on the mat­ter so far.

At last Thurs­day's Min­istry of Health me­dia brief­ing, Dr Paras­ram said that the Foren­sic Sci­ence Cen­tre had re­cent­ly sub­mit­ted 70 post-mortem sam­ples to the Caribbean Pub­lic Health Agency (CARPHA) for test­ing but all had re­turned neg­a­tive. This was a clear turn­around from the CMO’s po­si­tion ear­li­er this month when he stat­ed that there would be no posthu­mous test­ing on any­one who died in the pe­ri­od even though they may have had risk fac­tors.

2 Cal­i­for­nia res­i­dents died of COVID pri­or to US Govt an­nounc­ing the first death in its coun­try

Last week Wednes­day, a CNN sto­ry re­vealed that two peo­ple from Cal­i­for­nia had died in Feb­ru­ary of COVID-19, three weeks be­fore the Unit­ed States of­fi­cial­ly re­port­ed its first case of COVID-19. The in­for­ma­tion was ob­tained af­ter a sec­ond au­top­sy was per­formed on the bod­ies of the two in­di­vid­u­als from the San­ta Clara coun­ty.

Those two Cal­i­for­ni­ans, ac­cord­ing to the coun­ty's chief med­ical of­fi­cer Dr Sara Cody, did not have any trav­el his­to­ry to Chi­na or any oth­er lo­ca­tion that would have pos­si­bly ex­posed them to the virus. Dr Cody told the me­dia she pre­sumed they may have caught the virus through com­mu­ni­ty spread.

CARPHA's warn­ing

In late Feb­ru­ary CARPHA, which is re­spon­si­ble for test­ing in this re­gion, had is­sued a me­dia re­lease on their web­site warn­ing the Caribbean that the im­por­ta­tion of the Coro­n­avirus in­to this re­gion had been up­grad­ed from low to "mod­er­ate to high."

CARPHA's ex­ec­u­tive di­rec­tor, Dr Joy St John stat­ed that they were urg­ing health au­thor­i­ties of CARPHA mem­ber states "to shift their mind­set from pre­pared­ness to readi­ness and rapid re­sponse and con­tin­ue to do all that is nec­es­sary to strength­en their ca­pac­i­ty to re­spond to pos­si­ble im­por­ta­tion of cas­es."

She al­so en­cour­aged all mem­ber states to in­crease their ca­pac­i­ty for sur­veil­lance and have a na­tion­al pan­dem­ic plan in place to deal with the evolv­ing COVID-19 sit­u­a­tion.

Prof of med­i­cine and pul­mo­nolo­gist Ter­ence Seemu­n­gal

Prof Ter­ence Seemu­n­gal com­ment­ing on the 498 deaths said:

“While in health I have learned over the years that al­most all things are pos­si­ble I think that it is ex­treme­ly un­like­ly that we had deaths due to COVID dur­ing those four months. Let me give two pieces of ev­i­dence that sup­port my po­si­tion here.

1. The first COVID-19 case in T&T was di­ag­nosed around ear­ly March. We went to lock down short­ly there­after. If we had deaths pri­or to this first case, it would have been a sure in­di­ca­tion of wide­spread dis­ease in T&T. This would have led to far more deaths than we have seen and over­load of our health fa­cil­i­ties and ICUs re­gard­less of lock­down. The fact that we have not seen this is clear ev­i­dence that we have di­ag­nosed the cas­es cor­rect­ly and locked down at the right time rel­a­tive to the first di­ag­nosed case.

2. The case of our North Amer­i­can neigh­bour. Their first case was di­ag­nosed Jan­u­ary 20 ,2020. Lat­est press re­ports have been that there were deaths in Cal­i­for­nia in ear­ly Feb which are now at­trib­uted to COVID-19 – an in­di­ca­tor of un­de­tect­ed com­mu­ni­ty spread. Look at the ex­plo­sion of cas­es there and the over­load of their health care sys­tem in spite of their lock­down. Com­pare this with our ex­pe­ri­ence. Clear­ly we did not have any par­al­lel lev­el of com­mu­ni­ty deaths or else that would have been the case here as well.

Bot­tom line, so far we have got it right! Let us hope it stays that way."

The top five cause of deaths in T&T be­tween De­cem­ber 1, 2019-March 31, 2020 from the Reg­istry of Births and Deaths

De­cem­ber 2019:

Hy­per­ten­sion-225

Di­a­betes-176

Can­cer - 95

Pneu­mo­nia -83

Res­pi­ra­to­ry -46

Jan­u­ary 2020:

Hy­per­ten­sion-215

Di­a­betes-182

Can­cer - 83

Pneu­mo­nia -69

Res­pi­ra­to­ry-43

Feb­ru­ary 2020:

Hy­per­ten­sion- 195

Di­a­betes-230

Can­cer-154

pneu­mo­nia- 71

res­pi­ra­to­ry- 39

March 2020:

Hy­per­ten­sion-241

Di­a­betes-201

Can­cer-122

Pneu­mo­nia-96

Res­pi­ra­to­ry-51

Deaths by ill­ness over a four-month pe­ri­od:

Hy­per­ten­sion-876

Di­a­betes -789

Can­cer -454

Pneu­mo­nia -319

Res­pi­ra­to­ry-179