#BTColumn – We need action, not (empty) resolutions!

Disclaimer: The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.

As we move into any New Year, one tradition is to make a New Year’s resolution. Some social marketing research shows that a majority of these resolutions focus on improving personal health, such as losing some weight, doing more exercise, and paying more attention to eating and drinking habits. Gym registrations traditionally spike in January, but quickly taper off. Coming after a long season of gorging on food and drinks, a health resolution is a good idea, but for many it’s too little too late. A better idea would perhaps be to set health resolutions at the start of the festive season; after all, an ounce of prevention is better than a pound of cure.

In Barbados, the festive season seems to start around the middle of November, as our advertisers seem to merge Black Friday sales shopping, adopted from high-income countries, into Independence Day into Christmas and then New Year’s Day, to be shortly followed by Errol Barrow Day on January 21st. Through sales and other gimmicks, we are encouraged to ‘shop till you (or at least your money, including end-of-year bonuses) drop’ and generally fete, eat, drink and be merry. For too many people, this translates to about six to eight weeks of unbridled activity (while stocks and funds last).

The food festivities start with Independence, with persons invited to sample as many conkies as possible to determine whose conkies, made with or without raisins, are the best. After ‘conkie season’, the Christmas season officially or unofficially starts: ham, stuffed turkey, jug-jug, black cake (often alcohol-infused) are washed down with sorrel, juices and a wide variety of alcoholic beverages. Mouth-watering desserts, including chocolates, sweets, biscuits and ice-creams, complete the feasts. The volumes of food and drink consumed are designed to keep our obesity figures as high as they are, in the top 20 of the world, and obese persons fuel our chronic non-communicable disease (CNDC) pandemic.

Therefore, we must reset our efforts at prevention and treatment of these CNDCs. Sure, many people behave like ‘one-day Christians’, who do many wrong things for six days a week, and on the seventh day suddenly remember the path to ‘health righteousness’. We have no shortage of speeches on the effect of the CNDCs on deaths, sickness and even the economy, in between a tsunami of advertisements that promote inappropriate health habits.

In the background, COVID-19 lurks. The pandemic may or may not be over, but the virus is still here. At a recent press conference, the Deputy Chief Medical Officer offered statistics to support a rising rate of documented COVID-19 infections on the island, even while admitting that fewer persons were coming forward for testing. Nonetheless, the Chief Medical Officer (CMO) noted that there was a cessation of many of the official (‘mandatory’) COVID-19 protection measures from midnight the same day. This coincided with the day where the media were reporting and showing crowds of persons, mainly without masks, jamming into stores to take advantage of VAT-free
shopping. The media has also been showing crowds of un-masked persons enjoying various events, many of them indoors, apparently dismissive of the threat posed by COVID-19. It must be remembered that some people here remain unvaccinated, or have refused to get the booster shots. Vulnerable individuals, and this group includes the elderly and those harbouring CNDCs, are at increased risk of severe illness and death from COVID-19.

Worldwide, in spite of best efforts, which include mitigation measures, vaccinations, specific medications like antiviral medications and monoclonal antibody treatments [neither of which we could easily afford here], COVID-19 still kills about one in one hundred persons who contract the disease, with a higher rate in vulnerable persons.

The ‘mantra’ of our Ministry of Health (MOH) over the last three decades has been “Your health is your responsibility”. Philosophy: great. Is it working with the CNDC pandemic? There is no statistical evidence to support this (so the CMO has stopped releasing annual statistics). Will it work with the COVID-19 pandemic? The MOH has cut back on releasing the COVID-19 dashboard (daily statistics), which allowed anyone interested to keep track of the pandemic here. Official statistics to follow what is happening here are harder to come by, but a rising COVID-19 rate is likely.

The resumption of Q in the Community, a monthly physical activity event aimed at getting the elderly to become more physically active, is a good thing. It unfortunately had to be stopped at the height of the COVID-19 pandemic. What is not so good now is that a high proportion of our elderly have one or more CNDCs, and are thus vulnerable to a serious health outcome. It is perhaps unfortunate that the crowds of elderly persons coming out to this function have generally declined to wear face masks.

Internationally, we see COVID-19 is on the rise again, with the emergence of new variants of the Omicron strain, specifically the XBB.1.5 which is surging in China, far away, and in the USA, much closer to us. But this virus has shown that geographic distance is no barrier to its spread. Vaccination, the three Ws – not Weekes, Worrell and Walcott but Wash your hands, Wear your mask and Watch your (social) distance – offer some protection. While the CMO has relaxed many restrictions, it should still be the case that ‘your health is your responsibility’. Act now.

At one stage in life, we were fearful that a masked person may cause you harm, and many still do, when our crime situation is being looked at. But now, no thanks to COVID-19, we are also fearful that unmasked persons may cause you harm as well.

So our health focus needs to last longer than the first week of a New Year, as many New Year Resolutions do. The CNDCs have caused, and continue to cause, significant suffering and death, and have overwhelmed our health care services. And that was before the COVID-19 pandemic. As a disease, COVID-19 creates many health problems, but among other issues it makes the CNDCs worse, and actually accelerates the demise of many CNDC patients. And right now, another ‘virus’ has crippled our main hospital, making life and death even harder for anyone who becomes ill.

We must embrace healthy eating, get adequate amounts of both sleep and exercise, and make sure we keep our weight under control. In conjunction with your personal physician, we must ensure that your blood sugar, blood pressure, and blood cholesterol are kept within your target range. “Thou shalt not smoke”, and if you must drink, practice moderation. Ensure that your COVID-19 vaccinations are up to date, and practise all COVID-19 prevention measures. Our resolution is to be healthy all year round.

Dr. Colin V. Alert, MB BS, DM. is a family physician and associate UWI family medicine lecturer.