Gail Alexan­der

The clock is tick­ing on Trinidad and To­ba­go's health­care sys­tem.

Amid a third COVID-19 wave and a record 31 deaths yes­ter­day, if cur­rent trends con­tin­ue, the par­al­lel health­care sys­tem will be over­whelmed in a mat­ter of days, Prime Min­is­ter Dr Kei­th Row­ley warned last night dur­ing a 47-minute ad­dress to the na­tion in the COVID re­sponse.

“As such, this will man­i­fest in our in­abil­i­ty to pro­vide care, not on­ly to our COVID-19 pa­tients, but to our oth­er pa­tients ac­cess­ing gen­er­al med­ical care and emer­gency care. I cau­tion you to­day that, while we’re do­ing all that we can to pre­vent this, our health­care sys­tem is un­der im­mi­nent threat."

Row­ley said he’s still hop­ing to re­open beach­es for Christ­mas and would give the num­bers a cou­ple of weeks to see where they are go­ing. If there is no fur­ther sig­nif­i­cant de­te­ri­o­ra­tion, re­open­ing could start with ear­ly morn­ing hours from 5 am to 12 noon.

“We have reached a crit­i­cal cross­road in the man­age­ment of the COVID-19 pan­dem­ic in T&T. Based on the in­creas­ing num­ber of COVID-19 cas­es over the past weeks, and with no de­crease in sight, the num­ber of deaths has con­tin­ued to in­crease with dozens of per­sons los­ing their lives on a dai­ly ba­sis.”

The Health Min­istry - which it­self is closed for sani­ti­sa­tion to­day - yes­ter­day re­port­ed 624 new pos­i­tive cas­es among T&T’s to­tal 68, 288 cas­es since March 2020 and there were 527 peo­ple in hos­pi­tals. There’s been a to­tal of 2,040 deaths so far, in­clud­ing 31 deaths yes­ter­day alone. The fig­ure of 31 sur­passed the last high­est fig­ure - 28 - record­ed last Sat­ur­day. An­oth­er child al­so died yes­ter­day and 14 ba­bies un­der one year have been re­port­ed among pa­tients in the last three months.

Row­ley said, “(Yes­ter­day) We mourned the loss of over 2,000 of our cit­i­zens who suc­cumbed to a virus over the last 18 months. The trau­ma has been pro­tract­ed and re­lent­less as we con­firm al­most 700 new in­fec­tions each day and pro­vide care for over 500 COVID pa­tients in our al­most filled hos­pi­tals.

“Even as I was prepar­ing this pre­sen­ta­tion (Wednes­day night), I re­ceived the de­press­ing news that a new vari­ant has ap­peared in Botswana, which some sci­en­tists are al­ready say­ing could be worse than near­ly any­thing else about and it may even be­come vac­cine re­sis­tant.”

In T&T, Row­ley said the cur­rent sev­en-day rolling av­er­age of pos­i­tive cas­es, as of No­vem­ber 22, 2021, is 518 cas­es per day. He said the trend in­di­cates an es­tab­lished up­surge in the trans­mis­sion of COVID-19 in the pop­u­la­tion, with sev­en con­sec­u­tive weeks of up­ward-trend­ing to­tals.

Row­ley said the par­al­lel health­care sys­tem now has 16 fa­cil­i­ties (9 hos­pi­tals and 7 step-down fa­cil­i­ties). As of No­vem­ber 2, the par­al­lel hos­pi­tal bed ca­pac­i­ty now stands at a to­tal of 999 beds, 898 in Trinidad and 101 in To­ba­go.

Against the back­drop of the cur­rent epi­demi­o­log­i­cal cli­mate as at No­vem­ber 22, he not­ed:

* Hos­pi­tal­i­sa­tions have been on the rise, with 539 per­sons as of No­vem­ber 22,d 2021, (an in­crease of 105%, from the low of 263 per­sons on Oc­to­ber 15).

* To­tal hos­pi­tal oc­cu­pan­cy was at 65%; while ICU oc­cu­pan­cy stood at 86% (61 of 70 ICU beds filled in Trinidad and 5 of 7 beds filled in To­ba­go.

* An ad­di­tion­al 64 in­di­vid­u­als – 17 of them re­quir­ing in­ten­sive care man­age­ment – are cur­rent­ly await­ing trans­fer from Emer­gency De­part­ments in the tra­di­tion­al health­care sys­tem, to the par­al­lel health­care sys­tem.

* Of note 84% (54/64) of the in­di­vid­u­als await­ing trans­fer are not vac­ci­nat­ed (in­clud­ing 100% of the 17 await­ing ICU).

He said vac­ci­na­tion, in col­lab­o­ra­tion with pub­lic health mea­sures, con­tin­ues to be a pow­er­ful com­bi­na­tion and vac­cines con­tin­ue to be high­ly ef­fec­tive at pre­vent­ing hos­pi­tal­i­sa­tion and death.

“Ful­ly vac­ci­nat­ed peo­ple with break­through in­fec­tions from this vari­ant ap­pear to be in­fec­tious for a short­er pe­ri­od.”

Lit­tle change in pub­lic be­hav­iour

But Row­ley added, “Un­for­tu­nate­ly, it seems that we have been de­sen­si­tised and the pop­u­la­tion is no longer stirred to wise ac­tion by this alarm­ing trend. There is lit­tle change in pub­lic be­hav­iour and at­ti­tude, as well as a dras­tic re­duc­tion in the rate of vac­ci­na­tion, even in the face of in­creas­ing COVID-19 deaths.

“There is al­so a lot of in­for­ma­tion that many per­sons hide their con­di­tion, refuse to be test­ed or iso­late when they know that they are sick if on­ly to be al­lowed to cir­cu­late as nor­mal. This is ex­act­ly the en­vi­ron­ment in which the virus will thrive and show up in our in­tractable dai­ly num­bers and our over­flow­ing hos­pi­tal wards.”

“I tonight ap­peal to fam­i­lies to sup­port one an­oth­er and help out so that in­fect­ed mem­bers can iso­late to re­duce the chances of the virus spread­ing among fam­i­ly mem­bers and the gen­er­al pub­lic. Quar­an­tine works, vac­cines work, mask-wear­ing and sani­tis­ing works. Adopt them to save a life, even your own."

He said Gov­ern­ment has done all it can to en­sure vac­cines are read­i­ly avail­able.

"We’ve brought vac­cines to you, where you are. Yet, we've ob­served on­ly an in­cre­men­tal change in the vac­ci­na­tion rate of about 0.1-0.2% of the gen­er­al pop­u­la­tion on a dai­ly ba­sis. Get vac­ci­nat­ed. En­cour­age oth­ers .... while it may not pre­vent you from get­ting in­fect­ed, it would al­most cer­tain­ly keep you out of the hos­pi­tal wards.

“Even as we con­tin­ue to ex­pand our pub­lic health­care ca­pac­i­ty, we will soon reach the lim­it of our abil­i­ty to pro­vide care for those who are ill if we do not make dras­tic changes now. Our health­care sys­tem is fi­nite and we will be forced, once again to pull re­sources from non-COVID-19 sites in­to the par­al­lel health­care sys­tem. The elas­tic­i­ty and re­silience of this sys­tem has seem­ing­ly giv­en the pop­u­la­tion a false sense of com­pla­cen­cy."

He said Gov­ern­ment has al­ready sig­nalled to the pop­u­la­tion that it’s es­ca­lat­ing the emer­gency re­sponse lev­els in the pub­lic health­care sys­tem and has alert­ed sup­port­ing agen­cies of the po­ten­tial need for re­in­force­ments.

“We would do well to pon­der on what the next phase of the COVID-19 re­sponse might look like if we con­tin­ue on this tra­jec­to­ry. As with any emer­gency re­sponse, as the de­mand on health­care re­sources in­creas­es, we may have no choice but to redi­rect our ef­forts from pro­vid­ing the high­est lev­el of care to a few, to pro­vid­ing the great­est good for the great­est num­ber of per­sons.”

He not­ed pan­dem­ic dev­as­ta­tion in in­ter­na­tion­al and re­gion­al coun­tries and harsh mea­sures they’ve adopt­ed to deal with COVID's ef­fect.

“I men­tion these sit­u­a­tions and de­ci­sions, so that if it ever gets to the point where we have to adopt any of these ad­di­tion­al mea­sures, it will not be be­cause we are in­com­pe­tent, ar­ro­gant, dic­ta­to­r­i­al or an­ti-de­mo­c­ra­t­ic. It would sim­ply mean that our sit­u­a­tion de­mands it and we do live on plan­et earth where COVID-19 is at­tempt­ing to reign pre­dom­i­nate.”

As at Sep­tem­ber 2021, he said Gov­ern­ment had spent $509.7 mil­lion on the na­tion­al COVID-19 re­sponse.

“At no point do we in­tend to con­cede that this fight with this virus is be­yond us and is there­fore un­winnable. We will fight it and keep ad­just­ing as re­quired even as the virus keeps mu­tat­ing.”

De­ci­sion on beach­es soon, no Car­ni­val street pa­rades

PM Row­ley al­so re­it­er­at­ed that Gov­ern­ment will not shut down the econ­o­my again, as it did last year in­to this year to pre­vent the rapid spread of the dis­ease.

“I want to re-em­pha­sise at this junc­ture that we in­tend to keep on fight­ing this virus whilst fight­ing to pre­serve our key eco­nom­ic ac­tiv­i­ties which we need to main­tain liveli­hoods. We will try to pre­vent dev­as­tat­ing re­stric­tions and will re­sort to such mea­sures on­ly as a last re­sort when all else be­come im­po­tent," he said.

“We will con­tin­ue to keep our econ­o­my open. There have been a num­ber of de­mands for fur­ther open­ing up of the few ar­eas which are still un­der re­stric­tions. Much as I would like to open up beach­es and rivers, as I want­ed to do a few weeks ago, the cur­rent sit­u­a­tion mil­i­tates against that.

“I did say ear­li­er I’m hop­ing that we could open beach­es for Christ­mas. I’m still on that. I will give the num­bers a cou­ple of weeks to see where they are tak­ing us and if there is no fur­ther sig­nif­i­cant de­te­ri­o­ra­tion, we could start with ear­ly morn­ing beach open­ings from say 5 am to 12 noon. We should be able to have ther­a­peu­tic dips at dawn with­out the par­ties at af­ter­noon and sun­set.’’

He added, “Very soon the Christ­mas sea­son and its fes­tiv­i­ties will be up­on us. We will want to have a good Christ­mas but we must be par­tic­u­lar­ly care­ful to not let that Christ­mas be the event that pushed us over the edge.

"I know you will want your fam­i­ly with you. Make plans to have your fam­i­ly as a “safe zone.” Aim to cel­e­brate in safe zones. Get your fam­i­ly pro­tect­ed by vac­ci­na­tion. Pro­tect your el­der­ly and co­mor­bid mem­bers from you. Try and avoid a fu­ner­al for Christ­mas. Act now! Get vac­ci­nat­ed."

He said Gov­ern­ment had al­so re­ceived good ad­vice, af­ter ex­ten­sive con­sul­ta­tion, about Car­ni­val.

“Car­ni­val 2022 will not see street pa­rades, un­vac­ci­nat­ed gath­er­ings and wild pub­lic par­ty­ing but there is room for safe zone, venue-spe­cif­ic events where some el­e­ments of the fes­ti­val can be sam­pled as a Car­ni­val mi­cro­cos­mic mo­sa­ic with a dif­fer­ence," Row­ley said.

Cit­ing cit­i­zens’ re­silience, he added, "Painful and dis­tress­ing as this sit­u­a­tion is, now is not the time to con­cede de­feat in any way. Now is not the time to get tired, care­less or care­free. Hope is good and luck is wel­come but they are no sub­sti­tute for be­ing sen­si­ble or rea­son­able.

"Now more than ever, we must not low­er our guard but in­stead com­mit to fight this scourge with every­thing at our dis­pos­al, not the least of which are the vac­cines we have and the per­son­al re­spon­si­bil­i­ty we must adopt. The virus has pushed back and to­day we must stand and hold the line.’’

PM cites oth­er coun­tries' COVID re­sponse

* New Zealand - with 83 per cent vac­ci­nat­ed re­quir­ing vac­cine pass­ports for par­tic­i­pa­tion in ac­tiv­i­ties from De­cem­ber 2nd, re­quir­ing teach­ers and work­ers in the health/dis­abil­i­ty sec­tors to be ful­ly vac­ci­nat­ed and keep­ing bor­ders closed to most in­ter­na­tion­al trav­ellers un­til April 30.

* Aus­tralia - vac­ci­na­tions manda­to­ry for high-risk aged-care work­ers/em­ploy­ees in quar­an­tine ho­tels. West­ern Aus­tralia re­quires min­ing, oil and gas ex­plo­ration em­ploy­ees to have their first dose by Dec. 1 and be ful­ly vac­ci­nat­ed by Jan 1, 2022.

* In the USA where COVID-19 is surg­ing in 30 states - all fed­er­al work­ers and con­trac­tors or­dered to be vac­ci­nat­ed. Man­date for pri­vate-sec­tor work­ers to be vac­ci­nat­ed or test­ed week­ly will be en­forced from Jan. 4, 2022. The US gov­ern­ment al­so re­quires em­ploy­ers with 100 or more em­ploy­ees to get em­ploy­ees vac­ci­nat­ed by Jan­u­ary 4th and re­quire un­vac­ci­nat­ed em­ploy­ees to pro­duce proof of neg­a­tive test re­sults week­ly.

* Cana­da - plac­ing un­vac­ci­nat­ed fed­er­al em­ploy­ees on un­paid leave, re­quires COVID-19 shots for air, train and ship pas­sen­gers. All of its 338 law­mak­ers must be ful­ly vac­ci­nat­ed against COVID-19. Any core fed­er­al pub­lic ser­vants – in­clud­ing mem­bers of the Roy­al Cana­di­an Mount­ed Po­lice – un­will­ing to dis­close their vac­ci­na­tion sta­tus or be ful­ly vac­ci­nat­ed will be placed on ad­min­is­tra­tive leave with­out pay from No­vem­ber 15.

* Bar­ba­dos - with 50% vac­ci­na­tion lev­el has a 9 pm-5 am cur­few.

* An­tigua - with 57 % vac­ci­nat­ed where ages 12-18, who are un­vac­ci­nat­ed, can­not at­tend school. Un­vac­ci­nat­ed gov­ern­ment em­ploy­ees must re­main away from work with­out pay. State of Emer­gency un­til De­cem­ber 22nd.

* Ja­maica - has 9 pm-5 am cur­few un­til De­cem­ber 9, plus lim­its on gath­er­ings.

* Guade­loupe - has “an ex­plo­sive sit­u­a­tion” fol­low­ing a week of vi­o­lent protests over vac­cine man­dates which ex­clude the un­vac­ci­nat­ed from many nor­mal ac­tiv­i­ties.

* France - re­quired all health­care and care-home work­ers, home aids and ur­gent care tech­ni­cians to have had at least their first shot by Sept. 15; around 3,000 work­ers were sus­pend­ed for fail­ing to com­ply. Those aged 65 and above must present proof of a boost­er shot from mid-De­cem­ber for health pass­es that give ac­cess to restau­rants, trains and planes to re­main valid.

* Switzer­land - re­quires peo­ple en­ter­ing bars, restau­rants and fit­ness cen­tres to show a COVID-sta­tus cer­tifi­cate pro­vid­ing proof of vac­ci­na­tion, re­cov­ery from in­fec­tion or a neg­a­tive test re­sult.

* Italy - made COVID-19 health pass­es manda­to­ry for all work­ers. Those un­able to show proof of vac­ci­na­tion, a neg­a­tive test or re­cent re­cov­ery from in­fec­tion would be sus­pend­ed with­out pay and face a fine if they try to keep work­ing. Health work­ers, in­clud­ing phar­ma­cists, who aren’t in­oc­u­lat­ed could face sus­pen­sion with­out pay for the rest of the year.

* Aus­tria - placed mil­lions not ful­ly vac­ci­nat­ed in lock­down from Nov. 15. It banned the un­vac­ci­nat­ed from places, in­clud­ing restau­rants, ho­tels, the­atres, ski lifts. Aus­tria will al­so make vac­ci­na­tion against COVID-19 com­pul­so­ry from Feb­ru­ary 1. There will be penal­ties for peo­ple still re­fus­ing the jab af­ter that.

* Latvia - banned law­mak­ers who refuse the COVID-19 vac­cine from vot­ing and docked their pay. On Nov. 4, it al­lowed busi­ness­es to fire work­ers who refuse to ei­ther get vac­ci­nat­ed or trans­fer to re­mote work.

* Sin­ga­pore - from De­cem­ber 8 will no longer pay the COVID-19 med­ical bills for peo­ple “un­vac­ci­nat­ed by choice.”