Shal­iza Has­sanali

De­spite warn­ings from the US Cen­ter for Dis­ease Con­trol and Pre­ven­tion (CDC) of a short­fall in the sup­ply of swine flu vac­cines as the num­bers of cas­es, hos­pi­tal­i­sa­tion and deaths grow to un­prece­dent­ed lev­els, chief med­ical of­fi­cer of the Min­istry of Health Dr An­ton Cum­ber­batch is as­sur­ing that T&T will re­ceive its 260,000 vac­cines. Cum­ber­batch said even though pro­duc­tion of the H1N1 vac­cines is slow­er than ex­pect­ed, T&T would not be af­fect­ed. In June, Health Min­is­ter Jer­ry Narace said for­eign phar­ma­ceu­ti­cal com­pa­nies had of­fered to sup­ply vac­cines to the coun­try by Oc­to­ber. That did not ma­te­ri­alise. Fol­low­ing the deaths of Vishraj Ma­haraj and an­oth­er man on Tues­day at the San Fer­nan­do Gen­er­al Hos­pi­tal, Narace con­firmed that the 260,000 vac­cines were sched­uled to ar­rive in T&T by mid-No­vem­ber.

The vac­cine helps con­trol the spread of the virus. On Fri­day, the New York Times and CNN re­port­ed a short­fall in sup­ply. CDC be­lieves that up to 12 mil­lion few­er dos­es of H1N1 vac­cine than ex­pect­ed will be avail­able by month-end.

No pow­er to quar­an­tine peo­ple

"We nor­mal­ly get our vac­cines through the re­volv­ing fund with the Pan Amer­i­can Health Or­gan­i­sa­tion and when they buy vac­cines, they buy on be­half of all the coun­tries that fall un­der PA­HO, which in­cludes many coun­tries in South and Cen­tral Amer­i­ca." Cum­ber­batch said PA­HO buys from more than one man­u­fac­tur­er. "This is stan­dard. This is not on­ly for H1N1 vac­cines, but in the way vac­cines are pro­duced and de­liv­ered on de­mand." Cum­ber­batch said in or­der to ramp up H1N1 vac­cine pro­duc­tion, man­u­fac­tur­ers will have to cur­tail pro­duc­ing oth­er vac­cines. "The de­mand for the vac­cine glob­al­ly is so strong so they will be in­creas­ing pro­duc­tion." Cum­ber­batch al­so ap­pealed to those ex­hibit­ing flu-like symp­toms to stay at home and avoid trav­el­ling on PTSC-ar­tic­u­lat­ed bus­es and air-con­di­tioned maxi taxis. "I don't think we have the pow­er to quar­an­tine peo­ple be­cause you have flu-like symp­toms."

Cum­ber­batch said the min­istry will make an­oth­er ap­peal to maxi-taxi dri­vers to keep their win­dows open to al­low fresh air to cir­cu­late in ve­hi­cles.

More fa­tal­i­ties to come

But while Cum­ber­batch was op­ti­mistic, one se­nior med­ical doc­tor at the Er­ic Williams Med­ical Com­plex (EWM­SC) pre­dict­ed more deaths. "More fa­tal­i­ties will come and more peo­ple will end up in ICU. The deaths are trag­ic but it is ex­pect­ed." From the be­gin­ning of last week the hos­pi­tal had been faced with an in­flux of peo­ple com­ing in for swine flu test­ing. The resur­gence of peo­ple's con­cern was caused by the deaths of four peo­ple–three men and a woman–with­in the past six days. "We saw a mad rush of peo­ple, who per­haps a week ago, would just stick it out at home." He al­so de­nied that there was a new strain of H1N1. New re­search com­ing out of Lon­don, the doc­tor said, showed that the flu set­tles it­self in the lungs and throat mak­ing breath­ing dif­fi­cult. "The virus pre­vents air from com­ing in­to your lungs." Those test­ed pos­i­tive are ad­mit­ted to the Iso­la­tion Ward at the Mount Hope hos­pi­tal where Tam­i­flu is ad­min­is­tered.

Three ward­ed in ICU

From April to now, the doc­tor con­firmed, over 400 peo­ple were test­ed at the EWM­SC for the virus. Of the 400, a to­tal of 157 con­firmed pos­i­tive in T&T.

"Be­tween 60 to 70 of the 157 came from this hos­pi­tal," he dis­closed. Three adult pa­tients, the doc­tor said, were ad­mit­ted to the In­ten­sive Care Unit with­in the last three weeks com­plain­ing of dis­tressed breath­ing. The pa­tients, who were put on res­pi­ra­tors, were ward­ed for nine to ten days.

ICU can ac­com­mo­date up to sev­en pa­tients at a time. "Two of the five pa­tients can be ward­ed in pri­vate, sep­a­rate rooms for treat­ment." Once ful­ly re­cov­ered, the pa­tients are ad­mit­ted to the Iso­la­tion Ward for ob­ser­va­tion, then dis­charged.

"Sta­tis­ti­cal­ly there is noth­ing strange that we have swine flu pa­tients in ICU. The ma­jor­i­ty will get away, but the mi­nor­i­ty will have se­ri­ous com­pli­ca­tions." He al­so dis­closed that at­tempts were be­ing made for all doc­tors op­er­at­ing at pub­lic health in­sti­tu­tions to con­sult and ex­change ideas. "This was one way of go­ing for­ward." The doc­tor said obese peo­ple were vul­ner­a­ble to swine flu and that preg­nant women and young chil­dren should al­so be wary. Com­par­ing T&T's H1N1 mor­tal­i­ty rate with Cana­da, Ar­genti­na and Venezuela, he said this coun­try's was rel­a­tive­ly small.

"Cana­da had 68 pa­tients in ICU. 17 per cent of those peo­ple did not make it."

Clog­ging the sys­tem

Stat­ing that peo­ple with sea­son­al flu were com­ing to the hos­pi­tal and clog­ging up the sys­tem, the doc­tor urged peo­ple who have flu-like symp­toms to first mon­i­tor their health. "If af­ter three days of med­ica­tion, you have per­sis­tent high fever, body pains and dif­fi­cul­ty breath­ing, then go to the hos­pi­tal." The doc­tor point­ed out that T&T has an enor­mous ad­van­tage over some coun­tries, "in that we have no fi­nan­cial bar­ri­ers to en­ter the hos­pi­tal sys­tem. Peo­ple want to be test­ed be­cause their neigh­bour was cough­ing yes­ter­day." In some parts of Mex­i­co, the doc­tor said, pa­tients had to fork out hun­dreds of dol­lars to be test­ed. Yes­ter­day, a rel­a­tive calm pre­vailed at the Pri­or­i­ty Care Fa­cil­i­ty, Ac­ci­dent and Emer­gency de­part­ment at the EWM­SC. A nurse at the front desk stat­ed that on­ly pa­tients with high fever were test­ed for the con­di­tion. Four guards wear­ing pro­tec­tive gear stood at the en­trance to the Iso­la­tion Room, bar­ring mem­bers of the pub­lic from en­try.

At the Port-of-Spain Gen­er­al Hos­pi­tal, pa­tients with swine flu are placed on Ward Three, an iso­la­tion ward. Up to late yes­ter­day, one fe­male pa­tient was said to be re­ceiv­ing treat­ment for the virus.