Kalain Ho­sein

With 1,068 COVID-19 cas­es, Trinidad and To­ba­go broke its record for dai­ly con­firmed COVID-19 cas­es yes­ter­day, beat­ing the pre­vi­ous record of 984 cas­es re­port­ed on De­cem­ber 3, 2021.

Yes­ter­day’s count was the first time for the pan­dem­ic to date the Min­istry of Health had con­firmed and re­port­ed to the pub­lic over 1,000 cas­es in a day. On No­vem­ber 15, 2021, Tech­ni­cal Di­rec­tor, Epi­demi­ol­o­gy, Dr Av­ery Hinds, had said if the then-cur­rent rate of in­fec­tions con­tin­ued, T&T would record 1,000 new cas­es in a day.

In the last 24 hours, the min­istry al­so re­port­ed that 18 more peo­ple had died to COVID-19, two of whom were young adults and four of whom had no un­der­ly­ing health con­di­tions. There were al­so eight el­der­ly males, two el­der­ly fe­males and six mid­dle-aged pa­tients among the deaths.

As of yes­ter­day, there were 17,349 ac­tive COVID-19 cas­es, the high­est for the pan­dem­ic to date, ac­count­ing for one in every 80 peo­ple in the coun­try. Staff at coun­ty health of­fices re­spon­si­ble for con­tact­ing these pa­tients will be put un­der fur­ther strain as ac­tive cas­es in­crease, po­ten­tial­ly re­sult­ing in fur­ther de­lays of re­port­ing test re­sults and a lack of check-ins from min­istry per­son­nel.

The al­ready ex­haust­ed hos­pi­tal sys­tem will be put un­der fur­ther pres­sure as cas­es in­crease. Se­vere COVID-19 cas­es con­tin­ue to over­whelm in­ten­sive care units (ICUs) with an oc­cu­pan­cy av­er­ag­ing near 89 per cent, mean­ing nine out of ten beds across the na­tion’s ICUs are filled. Over­all hos­pi­tal oc­cu­pan­cy as of yes­ter­day stood near 60 per cent.

COVID-19 dai­ly cas­es can be count­ed based on the date when some­one is swabbed or sam­ple col­lec­tion, and it is al­so mea­sured based on when those sam­ples test pos­i­tive. In T&T, the lat­ter is pub­lished by the Min­istry of Health dai­ly, while the for­mer is col­lect­ed by epi­demi­ol­o­gists and re­port­ed by Dr Hinds at the COVID-19 me­dia brief­in­gs. While not out­right­ly re­port­ed by the min­istry’s dai­ly sta­tis­tics, this would be T&T’s sec­ond time cross­ing 1,000 cas­es in a day.

Around No­vem­ber 28, 2021, T&T crossed this record­ed 1,000-cas­es-a-day mile­stone based on the date of sam­ple col­lec­tion, ver­i­fy­ing Hinds’ pre­dic­tions. How­ev­er, Jan­u­ary 20, 2022, now holds the record for the high­est re­port­ed dai­ly cas­es for the pan­dem­ic to date.

Based on the cur­rent pos­i­tiv­i­ty, though, the worst still may be yet to come. Yes­ter­day’s case fig­ures came from sam­ples col­lect­ed from Jan­u­ary 13 through 19, while Wednes­day’s 918 cas­es were from sam­ples tak­en from Jan­u­ary 11 through 18.

In the last 20 days, 43,173 sam­ples have been sub­mit­ted for test­ing at pri­vate and pub­lic lab­o­ra­to­ries, av­er­ag­ing 2,158 sam­ples sub­mit­ted for test­ing per day. This fig­ure ex­ceeds the pub­lic test­ing ca­pac­i­ty of ap­prox­i­mate­ly 1,200 sam­ples be­ing processed per day. As of Jan­u­ary 17, 2022, this month’s pos­i­tiv­i­ty rate stands over 70 per cent.

On Jan­u­ary 10, both the Chief Med­ical Of­fi­cer Dr Roshan Paras­ram and Dr Hinds in­di­cat­ed that the coun­try is in the em­bry­on­ic stages of com­mu­ni­ty spread of Omi­cron.

“So we are look­ing at ear­ly com­mu­ni­ty or lo­cal spread for sure and it will on­ly be a mat­ter of time be­fore we get what has hap­pened in the oth­er coun­tries.”

Paras­ram said then the min­istry es­ti­mat­ed there could be an in­crease in COVID-19 cas­es with­in two weeks.

“We are wait­ing to see that in­crease, at least com­ing out of the sam­ples,” he said.

The coun­try has record­ed 28 cas­es of the Omi­cron vari­ants of con­cern. How­ev­er, ac­cord­ing to Dr Hinds, eight of these were found with­in the com­mu­ni­ty and are still un­der in­ves­ti­ga­tion.

He said, “As we are con­tin­u­ing the epi­demi­o­log­i­cal in­ves­ti­ga­tions and the ob­ser­va­tions of what’s go­ing on in the pop­u­la­tion, we are see­ing where there are in­creas­ing pro­por­tions of these cas­es that don’t seem to be linked to im­por­ta­tion and are there­fore linked to what we call hid­den chains of trans­mis­sion.”

With just three Omi­cron cas­es in To­ba­go, Dr Tiffany Hoyte, act­ing Coun­ty Med­ical Of­fi­cer of Health, said, “We have on­go­ing com­mu­ni­ty spread.”

To­ba­go’s first Omi­cron case had no links to trav­el or a COVID-19 pos­i­tive in­di­vid­ual, while the sec­ond was an un­vac­ci­nat­ed mi­nor who re­turned to To­ba­go af­ter tran­sit­ing through Trinidad. De­tails on the third case have not been re­leased at this time.

In­fec­tious dis­ease spe­cial­ist Dr Nathaniel Duke, dur­ing Wednes­day’s To­ba­go House of As­sem­bly’s post-Ex­ec­u­tive Coun­cil me­dia brief­ing, said, “So this vari­ant, which is now cir­cu­lat­ing in the To­ba­go space, as of to­day they have record­ed three, so epi­demi­o­log­i­cal­ly, we can mul­ti­ply that by 100 and that will prob­a­bly be the amount of Omi­cron-pos­i­tive pa­tients cir­cu­lat­ing in our so­ci­ety. So, there­fore, a surge is about to come, so we have to be pre­pared for that surge that is on our doorstep.”

Based on the lat­est ge­net­ic se­quenc­ing da­ta from the Min­istry of Health and the Uni­ver­si­ty of the West In­dies, Omi­cron ac­count­ed for ap­prox­i­mate­ly 25 per cent of sam­ples sub­mit­ted for se­quenc­ing, with Delta ac­count­ing for the oth­er 75 per cent. How­ev­er, da­ta and es­ti­mates from GI­SAID show that Omi­cron may al­ready be the dom­i­nant strain.

Gen­er­al­ly, hos­pi­tal­i­sa­tions spike with­in days of a surge in cas­es, but deaths lag up to two weeks af­ter. How­ev­er, vac­ci­na­tions are ex­pect­ed to stem the tide of hos­pi­tal­i­sa­tions and deaths, as not­ed by glob­al da­ta. Epi­demi­ol­o­gist Dr Hinds has said the death rate lo­cal­ly is 15.6 times high­er among the un­vac­ci­nat­ed than the vac­ci­nat­ed. As of Jan­u­ary 19, 2022, 2,659 of the 3,256 COVID-19 deaths were amongst the not-ful­ly-vac­ci­nat­ed pop­u­la­tion.