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.
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
Cancer - 95
Cancer - 83
Deaths by illness over a four-month period: