Covid-19 is certainly not the first outbreak of disease we have had in T&T but it is the first where we have had such government control of the facts by government doctors and politicians and such little input from independent medical practitioners to the point that, after almost four months we have yet to hear anything from the Trinidad & Tobago Medical Association, whether that was a statement of commiseration for an anxious public and medical practitioners or medical advice.
The Minister of Health (MoH)has become accustomed to make statement after statement without independent analysis. A case in point is his recent comment on children taking part in outdoor youth sport competition before September: “with the evidence of the changing epidemiology and how children under five are now dying, are you prepared to take that risk with your child?” I think the Minister is guilty of fear tactics here. He should be asked to produce the evidence that “children under five are now dying.” This is simply not happening even with the occasional case of severe Covid-19 in children.
CDC reports that between February 1 and June 6 there were 42 deaths attributed to Covid-19 among children under age 15 in the USA. Data from China, Italy, Spain and the UK pain shows similar patterns with also no deaths in the under fives.
The CMO and others, who advise the Minister, should tell us where they is getting the figures about these enormous numbers of children dying, so much that they were able to persuade the Minister to make such a statement. That will not happen since the media also appear to be afraid of asking tough questions and who is to blame them when the official organisations have gone into hiding, leaving the field to the Police Commissioner who, in this instance, is quite correct to insist that children, young and old, should be allowed to play outdoor sports, official or not.
Like all countries we have a long history of disease outbreaks, mainly in Trinidad, lesser so in Tobago. Post streptococcal glomerulonephritis, which used to cause large outbreaks of kidney disease every five years among children in South Trinidad in the 70s and 80s, never existed in Tobago. Neither did rabies transmitted in T&T mainly by dogs and bats.
Rabies in Trinidad is now vampire bat-transmitted rabies and we are the only Caribbean island who has ever had this problem. Vampire bat-transmitted rabies was first recognised in Trinidad during a major outbreak reported in 1925.
Over the last century, seven notable epidemics were recorded in Trinidad with the loss of over 3,000 animals, mainly cattle. Sporadic outbreaks of bat-transmitted rabies still occur in livestock to date.
The last human case of rabies occurred in 1937, probably vampire-bat transmitted. The last confirmed case of canine-transmitted human rabies in Trinidad was in 1912. In contrast, up to 1993, canine rabies was still a significant problem in the western region of Venezuela, where a minimum of 468 cases of canine-transmitted rabies in humans occurred between 1989 and 1993 and continuing to this day and we now know how easy it is to get from Venezuela into Trinidad.
Other things get in too. Among them, malaria. Last June the MoH reported that of the seventeen cases of malaria reported so far that year, 13 were in Venezuelans. Up to now, according to the Venezuelan government there has been almost no Covid-19 in Venezuela. Perhaps that’s why they flew over here some months ago and offered us reagents for the Covid-19 test, which we refused because we also know there is no Covid-19 in T&T, unless selfish people, including Trinidadian citizens, bring it in. But not Venezuelans.
The importance of malaria as a public health problem in T&T was realised many years ago.
Early in the twentieth century, the disease was regarded as one of the main causes of death and during the period 1902-1912 constituted ten per cent of all deaths. Between 1931 and 1942 the number of cases diagnosed annually averaged over 17,000 and there was a strong correlation with cocoa growing areas.
Efforts to eliminate it in the 50s were successful but up to 1962 there were still almost 300 cases diagnosed.
For many years malaria was an unknown disease in T&T, so much so, that the Malaria Division of the MoH changed its name to Insect Vector Control Division. We need them now more than ever. For the vectors of disease, bats, mosquitos, politicians and so on, live on in Trinidad and Tobago.