Ira Math­ur

www.iras­room.org

iras­room@gmail.com

At this rate, Christ­mas in T&T, some 2,000 peo­ple will be dead of COVID-19 since the start of the virus. The fig­ure up to Thurs­day was 1,629. Un­til 90 per cent of us are ei­ther vac­ci­nat­ed or have got­ten COVID, the pan­dem­ic is here to stay.

We pan­ic when the mur­der rate hits 500. COVID-19 deaths are four times that num­ber. Peo­ple buy bur­glar proof­ing, put in alarms, and pro­tect them­selves from ris­ing crime. Yet pre­ventable deaths with read­i­ly avail­able vac­cines con­tin­ue un­abat­ed as peo­ple 'wait and see'–the lat­est be­ing a cou­ple with no co­mor­bidi­ties who died from the virus, leav­ing four or­phaned chil­dren.

Brazil­ian Pres­i­dent Jair Bol­sonaro is charged with crimes against hu­man­i­ty for the fail­ure to pro­tect the Brazil­ian pop­u­la­tion from the COVID-19 virus that has led to 600,000 COVID-19 deaths.

When this is all over, not just Bol­sonaro, but every sin­gle world leader will be made to ac­count for the peo­ple they serve, grilled and judged.

They will be grilled. How many died of COVID-19? What did you do to pro­tect your cit­i­zens from the virus.? Did you bat­tle dis­in­for­ma­tion? Did you equip in­ten­sive care units? Did you ac­quire suf­fi­cient vac­cines?

Health Min­is­ter, CMO ac­count to T&T

I con­duct­ed a joint in­ter­view with the Min­is­ter of Health, Ter­rence Deyals­ingh and the Chief Med­ical Of­fi­cer, Dr Roshan Paras­ram who ac­count for the Gov­ern­ment's man­age­ment of the na­tion's health dur­ing the pan­dem­ic.

Health Minister Terrence Deyalsingh.

Are our lock­downs, mask, so­cial dis­tanc­ing, cur­few and safe zones work­ing?

Min­is­ter of Health: We are do­ing bet­ter than most coun­tries, both de­vel­oped and de­vel­op­ing. For ex­am­ple, with 139,000 deaths and a pop­u­la­tion of 65 mil­lion peo­ple, the UK has a death rate of 0.2 per cent. Trinidad and To­ba­go's deaths per mil­lion peo­ple is 0.1 per cent.

Re­search has in­di­cat­ed a low risk of trans­mis­sion in open out­door spaces. Are we too cau­tious with the mask pol­i­cy and beach clo­sure, es­pe­cial­ly when more than a third of the pop­u­la­tion is ful­ly vac­ci­nat­ed? What epi­demi­o­log­i­cal con­di­tions will be need­ed to ad­just or re­move the mask man­date?

Min­is­ter of Health: Our rate of vac­ci­na­tion is not high enough to take that. Even with high vac­ci­na­tion, the UK faces an­oth­er spike in the virus af­ter re­lax­ing the mask man­date due to the Delta vari­ant, the high­er rate of un­vac­ci­nat­ed chil­dren aged 12-17 lead­ing to a 'six-fold hos­pi­tal ad­mis­sions and three-fold high­er death rate com­pared to Eu­rope'. Their health sys­tem is be­ing over­whelmed, and peo­ple are in ICU. This was re­port­ed by the BBC and CN­BC. Coun­tries like that will have to turn around and re­in­state the mask laws. Our ap­proach is cau­tious, yes, but it's keep­ing our peo­ple safe.

Can you do a vac­cine break­down for me? Who is el­i­gi­ble, who still needs to take it, and what per cent of adults are ful­ly vac­ci­nat­ed? Are you meet­ing the tar­gets set by the Prime Min­is­ter?

CMO: Some 980,000 adults in T&T are el­i­gi­ble for the vac­cine.

Some 360,000 are un­der the age of 18.

Some 260,000 are un­der the age of 12, and there is no vac­cine ap­proved for them.

Some 100,000 chil­dren be­tween 12-18 are el­i­gi­ble. Of these, 50,000 have been ful­ly vac­ci­nat­ed.

We have giv­en vac­cines to over 600,000 peo­ple in T&T.

This means, 55 per cent of adults (18 plus) have tak­en the vac­cine.

The WHO has ex­tend­ed the ex­piry date for the Pfiz­er till the end of Feb­ru­ary.

John­son and John­son have an ex­piry date of 2023. We are mov­ing to­wards meet­ing the tar­gets set by the Prime Min­is­ter.

How many close-to-ex­piry As­traZeneca vac­cines did the Min­istry of Health give away and to whom?

CMO: Cana­da gave us 84k As­traZeneca vac­cines which they didn't need. We, in turn, gave about 40k to Nicaragua and small­er amounts to Caribbean coun­tries and kept the rest for our sec­ond shots.

Are more peo­ple tak­ing the vac­cine af­ter the es­tab­lish­ment of safe zones?

It is go­ing well, with some 3,000 peo­ple tak­ing vac­cines dai­ly for over two weeks.

We be­lieve the 'wait-and-see late adopters' will al­so start tak­ing this, and once they and more school­child­ren are vac­ci­nat­ed, we will get clos­er to the PM's tar­gets.

Chief Medical Officer Dr Roshan Parasram.

GUARDIAN

Giv­en the vir­u­lence of Delta and break­through in­fec­tions will we go the way of boost­ers?

CMO: Sinopharm of­fers a third vac­cine, not a boost­er, but a pri­ma­ry dose, for peo­ple over 60. In the weeks ahead, Trinidad will de­cide on that de­ter­mi­na­tion from WHO on the third shot. It will be based on da­ta on the age groups re­quir­ing boost­ing to ac­quire fur­ther im­mu­ni­ty. There is no telling what the sit­u­a­tion evolves and new vari­ants emerge. There has been a mora­to­ri­um of boost­ers' ap­proval un­til Jan­u­ary 2022 to al­low an eq­ui­table dis­tri­b­u­tion of vac­cines from CO­V­AX to de­vel­op­ing coun­tries.

With al­most half of our peo­ple still re­fus­ing to take the vac­cine and the steady dai­ly death count, do you think the Gov­ern­ment is fail­ing to get the word out there that those vac­cines are safe and nec­es­sary to sur­vive COVID-19, es­pe­cial­ly for those with co­mor­bidi­ties? Do peo­ple know that you can get the virus even af­ter be­ing vac­ci­nat­ed, which will pre­vent them from be­com­ing hos­pi­talised or dy­ing? Why is vac­cine hes­i­tan­cy so high?

Min­is­ter of Health: Ac­cord­ing to the BBC, out of the UK, of 51,000 deaths from COVID on­ly (0.05 per cent), 256 were ful­ly vac­ci­nat­ed–most of these had se­ri­ous co­mor­bidi­ties. Those num­bers mean that the risk of dy­ing for a vac­ci­nat­ed per­son com­pared to an un­vac­ci­nat­ed per­son is one vac­ci­nat­ed per­son to 200 vac­ci­nat­ed peo­ple.

Mis­in­for­ma­tion is a glob­al prob­lem with peo­ple trust­ing un­qual­i­fied peo­ple and an­ti-vaxxers on so­cial me­dia rather than their doc­tors.

Col­in Pow­ell, the for­mer US sec­re­tary of state, re­port­ed­ly died from com­pli­ca­tions from COVID-19. He was 84 and ful­ly vac­ci­nat­ed. CNN claimed Pow­ell had mul­ti­ple myelo­ma, a can­cer of plas­ma cells that sup­press­es the body's im­mune re­sponse, and Parkin­son's dis­ease. Are you wor­ried that an­ti-vac­cine ac­tivists will seize up­on Pow­ell's death to make the claim that vac­cines don't work?

CMO: I can­not de­ny or af­firm Col­in Pow­ell's per­son­al med­ical in­for­ma­tion out in the me­dia. What I have to say about Pow­ell is this, if it is claimed Pow­ell was 84 years old, be­ing treat­ed for can­cer, and had Parkin­son's dis­ease with a re­duced im­mune sys­tem, his risk of suc­cumb­ing to in­fec­tion would have been high.

What is the pop­u­la­tion to take away from the ful­ly vac­ci­nat­ed el­der­ly gen­tle­man who died af­ter tak­ing the vac­cine?

CMO: I don't want to spec­u­late or breach con­fi­den­tial­i­ty, but the ful­ly vac­ci­nat­ed old­er gen­tle­man passed away from an­oth­er dis­ease, not COVID-19 or the vac­cine. The me­dia con­stant­ly re­port the ex­cep­tion, not the rule, which pan­ics the pop­u­la­tion and cre­ates greater vac­cine hes­i­tan­cy. 98 per cent of the peo­ple who trag­i­cal­ly died of COVID-19 in T&T were not vac­ci­nat­ed, and on­ly two per cent were par­tial­ly vac­ci­nat­ed.

94.5 of hos­pi­talised peo­ple are not vac­ci­nat­ed, and we have be­gun to put that in our up­dates. We need me­dia to help fo­cus on the fact that un­vac­ci­nat­ed peo­ple are dy­ing and have died. The two per cent of ful­ly vac­ci­nat­ed peo­ple who died were very ill from co­mor­bidi­ties, and the virus weak­ened them. To re­peat.

Al­most every­one who died from COVID-19–that is, 98 per cent of peo­ple–were not vac­ci­nat­ed, re­flect­ing glob­al num­bers.

Can you mod­i­fy the Min­istry of Health's COVID-19 dash­board to clar­i­fy the num­ber of dai­ly deaths? And is it pos­si­ble with­out com­pro­mis­ing pa­tient con­fi­den­tial­i­ty to let us know the co­mor­bidi­ties of the peo­ple who died of COVID?

CMO: Yes, we can and will change that to make it more straight­for­ward, and we will an­nounce co­mor­bidi­ties al­most im­me­di­ate­ly with­out com­pro­mis­ing pa­tient con­fi­den­tial­i­ty.

This woman buys water from a vendor at the corner of Frederick and Independence Square, Port-of-Spain, while people wearing their masks make their way along the sidewalk.

NICOLE DRAYTON

How does the Min­istry of Health plan to en­gage with stake­hold­ers to launch an en­tire cross-me­dia vac­ci­na­tion hes­i­tan­cy cam­paign, with tar­get­ed out­comes?

Min­ster of Health: We are man­ag­ing a glob­al pan­dem­ic to the best of our abil­i­ty.

Out­side of three con­fer­ences per week held or ro­tat­ed by Dr Hinds, Dr Paras­ram and I, we have ten doc­tors who rou­tine­ly en­gage on ra­dio sta­tions coun­try­wide deal­ing with peo­ple’s con­cerns about vac­ci­na­tion and dis­pelling mis­in­for­ma­tion. I went in per­son­al­ly to speak on prison ra­dio to take ques­tions from in­mates in stud­ies and an­swer all their ques­tions. We have an out­reach coun­try­wide to ed­u­cate peo­ple about vac­cines, in­clud­ing ra­dio ads, so­cial me­dia, out­reach ac­tiv­i­ties, com­pa­nies, church­es, mosques, mandirs, and busi­ness com­mit­tees. We dis­sem­i­nate in­for­ma­tion in re­mote com­mu­ni­ties, health care cen­tres, and mass vac­cine sites to en­cour­age the pop­u­la­tion to make in­formed de­ci­sions. We have trained prac­ti­tion­ers to coun­sel pa­tients. We have a FAQ for all the vac­cines and train prac­ti­tion­ers to ad­vise pa­tients.

How is the Min­istry of Health han­dling the cur­rent chick­en­pox out­break in the Port-of-Spain Prison?

CMO: The pris­ons med­ical sys­tems are in­de­pen­dent of the Min­istry of Health and are mon­i­tored by the Pris­ons Au­thor­i­ty. Pris­ons are prone to high num­bers of in­fec­tions due to prox­im­i­ty and lim­it­ed air­flow. There is a chick­en­pox out­break cur­rent­ly 15-20 per­sons. It's a high­ly con­ta­gious vi­ral ill­ness. There are many such out­breaks in a giv­en year, and it is well un­der con­trol by prison med­ical of­fi­cers who con­tin­ue to mon­i­tor it.

When can we ex­pect the roll­out of the digi­ti­sa­tion of vac­cine cards?

Min­is­ter of Health: We be­gan work­ing on it four months ago and will an­nounce that short­ly from that de­part­ment.

Are you com­fort­able with the length of time it takes at the pub­lic health care fa­cil­i­ties, in some in­stances hours at best and days at its worst, to move from the Ac­ci­dent and Emer­gency De­part­ment to get a bed and placed in the ward? What is be­ing done to im­prove this sit­u­a­tion?

Min­is­ter of Health: Send me da­ta on that as that is not my in­for­ma­tion. I get a dai­ly re­port, and there may be ex­cep­tions, but it's cer­tain­ly not the rule. No, the ser­vices haven't been com­pro­mised.

Are you con­cerned about the se­cu­ri­ty of drugs at the pub­lic health fa­cil­i­ties and the gen­er­al ef­fi­cien­cy of equip­ment at the in­sti­tu­tions?

Min­is­ter of Health: Yes, and that's why since last year we in­sti­tut­ed a pro­gramme where all ve­hi­cles leav­ing ma­jor hos­pi­tals have to be searched more CCTV cam­era sys­tems, re­port­ing mon­i­tor­ing and con­trol.

Cur­rent­ly, the CT scan ma­chine at the PoS Gen­er­al Hos­pi­tal is re­port­ed­ly down. Why does the PoS hos­pi­tal not have a car­di­ol­o­gy dept, a neu­rol­o­gy dept or a CT lab?

Min­is­ter of Health: A new tube was or­dered and in­stalled. The PoS hos­pi­tal nev­er had a neu­rol­o­gy de­part­ment. CT scans and car­di­ol­o­gy is rou­tine­ly re­ferred to the EWM­SC and nephrolithotrip­sy to San Fer­nan­do. In the ter­tiary health care sys­tem, it is glob­al best prac­tice not to repli­cate all ser­vices at all fa­cil­i­ties. Dif­fer­ent ser­vices are of­fered in var­i­ous fa­cil­i­ties, but all health ser­vices are cov­ered by the Gov­ern­ment.

There is a per­cep­tion that jour­nal­ists who can­not at­tend the pressers are stonewalled, and the Min­istry of Health team man­ag­ing the COVID-19 virus are un­avail­able for com­ment or in­for­ma­tion.

Min­is­ter of Health: I dis­agree with that per­cep­tion. We don't de­cide on who comes to the press con­fer­ences or the ro­ta­tion of jour­nal­ists com­ing to pressers. We've had blog­gers send in ques­tions via email. We en­cour­age that and are hap­py to part­ner with the Me­dia As­so­ci­a­tion to send in fur­ther ques­tions. Our doors are wide open to all me­dia, tra­di­tion­al and non-tra­di­tion­al. But we can't guar­an­tee an in­stan­ta­neous re­sponse be­cause some­one on FB says some­thing, and the re­quests come five min­utes be­fore the news. Every time some­one on so­cial me­dia spews dis­in­for­ma­tion, we can­not stop all work to cor­rect that. Peo­ple, in­clud­ing the me­dia, must get their in­for­ma­tion from sci­en­tists, doc­tors, and reg­u­lat­ed gov­ern­ment sites. We al­so can't com­pro­mise pa­tient con­fi­den­tial­i­ty. As I said, our doors are open. We al­so com­mit to an­swer­ing five writ­ten ques­tions sent to us un­der the am­bit of the Me­dia As­so­ci­a­tion of T&T, and tak­ing ad­di­tion­al ques­tions on a ded­i­cat­ed email.

I say to jour­nal­ists in main­stream and non-tra­di­tion­al me­dia, let's work to­geth­er to pro­vide ac­cu­rate fact and sci­ence-based in­for­ma­tion to the pub­lic so the coun­try can get back on its feet.

Min­is­ter of Health and CMO in­ter­viewed by Ira Math­ur.