Apparently, last week we had our first case of community acquired COVID-19. I say apparently because at the rate we are testing, it’s difficult to know about what is going on in the community. We are testing at a rate of about 4000 tests per million population. Barbados is at 40,000 tests per million population and Grenada at 48,000 tests per million.
For those who do not comprehend the meaning of per thousand, T&T has done a total of 6, 500 tests since March. Mauritius, another island with a similar population and much less money, has a rate of 161,400 tests per million. They have done 205,285 tests since their outbreak began around the same time. We have done 6,500 and 1533 are repeats. That means we have tested less than 5000 people!
Once a virus is introduced into a population, it is a biological impossibility for it to disappear entirely as the Ministry of Health has been triumphantly claiming. Unlike grandiose mistakes, viruses do not eliminate themselves because politicians say so. Every single virus we have ever had in T&T is still here with us, hiding in whatever host they use, appearing sporadically, disappearing again and returning whenever conditions are in their favour. The flu viruses are here. Yellow fever virus is here. Measles virus is here. Rubella. Polio! What keeps them in check are a myriad of factors including the hosts in which they hide (bats, monkeys, other animals, people who are asymptomatic carriers), climate conditions, nutritional status, co-morbid conditions and immune defences.
The most important of these is our response to vaccines. We do not see measles or polio or rubella because most of our population has vaccine acquired immunity to these viruses and that is due to the magnificent work of our public health nurses or the “ladies in brown” as the late excellent public health doctor, Dr Lennox Jordan, used to say.
I think we have the best public health nurses in the world. I will put them up against public health nurses from any country. We’ll always be in the top 3. I am not so sure about our public health doctors.
It was not surprising, then, to find out that there was someone walking around with COVID-19. Every doctor knows of half a dozen patients who has had COVID-19 symptoms including loss of smell and taste and who has been refused testing by the public health department. Why this first case caused alarm was not too surprising either.
Those dreadful daily and thankfully now, tri-weekly media circuses, have made the regular Trinidadian live in fear of COVID-19. This virus has to be respected, not feared.
The outbreak seems to be bringing out the worst in us. Daily one sees and hears people speaking out as fear, frustration, uncertainly and massive disruptions to our daily routines grow. We may soon see increases in victim blaming, intolerance, hostility, and at its very worst, violence stoked by racism and the promotion of xenophobic beliefs.
It is crucial in any crisis to provide empathy, kindness and compassion to our fellow citizens. It is probably the single most important factor in surviving the crisis. It maintains our confidence in our system by protecting the vulnerable, decreasing suffering and, above all, quickly recovering.
Public comments like “you have to assume that anybody you see around you has COVID!” is not a good thing to say. It’s bad psychology. It creates fear. We must be scared of our neighbour? Of somebody walking in the road? This is panic talk. If there ever was a time when we needed to be emotionally close to our fellow Trinidadians, it is now. Excessive caution of people creates the conditions for unease, insecurity and a return to barbarism similar to the conditions that surrounded other plagues hundreds of years ago.
What we need now is respect for the virus and respect and empathy for ourselves. This is a time when, as the late Fred Rogers, the American children TV presenter and educator, said “The deep and simple is far more essential than the shallow and complex.”
This may be becoming more and more difficult during this silly season.
I wrote on March 17, “The thing to understand is that almost everyone is going to get COVID-19 in the next 12 months. And most people, four out of five, will either be asymptomatic or will get mild symptoms and not know because we are not testing people properly.”
Nothing much has changed since then except that medicine knows a lot more about the virus and its disease. We now have experience and medication to treat it. The MOH should be making sure that medication is available, not endlessly repeating questionable stats that are up on their website.
We need to trust our hospital doctors to know what to do when someone gets seriously ill. We need to trust the MoH to get us a good supply of vaccines too. But that’s for next year. For now we need to be kind to each other.