At the time of writing of this assessment, the planet has passed one million reported cases of the COVID-19 Virus (1,074,290). Total reported deaths are 56,989. This means that five per cent of persons who are currently contracting the virus are dying.
The current mortality epicentre of the virus is Southern and Western Europe and the USA, the Northern Mediterranean and the Atlantic seacoasts. The highest global deaths thus far are in Italy (15,447); Spain (11,522); the USA (7,502); France (5,387); The United Kingdom (4,289); The Netherlands (1,635); Belgium (1,275); and Germany (1,326). The only other countries on the planet which have exceeded the 1, 000 mortality-mark are China (3,326); and Iran (3,428). China’s reported death-rate had declined exceedingly in March; but Iran’s rate continues to show marked increases similar to that of the Northern Mediterranean, the USA and Western Atlantic nations.
Exponential means very rapid growth. Two times two is four, four times four is 16, 16 times 16 is 256, multiplied by itself gives 65, 536. Between 22nd January and the end of February, 2,977 persons on the planet had died. By the end of March, the figure was 47,198. The March figure jumped by 15 times that of the 40 days preceding it, somewhere between reverse ‘decimation’ (meaning in Latin to kill by 10 per cent) and exponential increase. If this rate continues, “April” will be “the cruellest month”. (T. S. Eliot, The Wasteland, 1922).
Observations
First, epicentres shift. This disease first struck in South-East China, then spread to South Korea (figures for North Korea are unavailable) and Japan.
Second, the current outbreaks in the Northern Mediterranean and the North Atlantic have severely stressed health care systems. Beds and tents have been erected in parks and streets next to some hospitals. There have been acute shortages of PPE: surgical masks, gloves, gowns, ventilators, respirators and testing kits and ancillary machines and medical supplies (for eg, serums reagents, for diagnosis, surveillance and investigation). Nation-states are in a current ‘my nation first’ or hoarding mode.
Third, these nations have some of the best healthcare systems in the world, especially the UK, a nation that may be used as a benchmark nation to demonstrate the characteristics of the threat set against fair medical standards and practice.
Fourth, the rates are incrementally rising in the Developing Nations: South-East Asia, the Middle East, Latin America, Africa and the Caribbean.
Trinidad and Tobago, like most nations in the latter category, suffer from several (with the notable exception of nations like Cuba, India and parts of Latin America) historical shortcomings. These include: [1] An over-reliance on foreign markets for pharmaceutical drugs; [2] An overreliance on foreign markets for the PPE and other equipment and chemicals noted above; [3] Arrested development of Research and Development (i. bio and organic chemistry labs for making drugs; ii. virology: vaccines, testing, diagnostics, surveillance; iii. medical technology) at universities, private enterprise, or state institutions; [4] Severely stressed public health-care systems; [5] A low development of the community public health care system; and [6] Weak local government, and therefore leadership on the ground.
Conclusion
1. The virus will spread through banking, money, market, travelling, food exchange; this is an especially contagious and tiny micro-organism. It is not only droplet-bourne, but airborne. It invades human cells and uses their biochemical functions to manufacture and propagate itself. It migrates deep into the lower respiratory tract.
2. The management strategy: By now, three months on, our authorities have had time to get a good ‘sighter’ of the threat. Whilst the current strategy could adequately cope with the current rate of increase and volumes of cases, if there are outbreaks such as described above, such a strategy would collapse;
3. Proactive action: The managerial burden must be shared, rationalized, de-politicized. An independent Agency or Health Task Force, with the requisite state and Government support, ought to be established to give accurate, reliable information (free from political rhetoric) and to manage such a potential outbreak;
4. A medium-term plan: The most potent modifier of the behaviour of the virus is a vaccine. A 12-month plan (the typical time to get a vaccine to market) should be developed, stress-tested and demonstrated to the national population. Each civil servant, community official or leader, private sector organization, and citizen must be engaged and explained their responsibility;
5. A stress test would include the availability of local facilities (separate and apart from our established hospitals and clinics); logistical support for emergencies and infectious cases; medical personnel, inclusive of interns and volunteers, trained for mitigation, care and protection; PPE kit and equipment as identified above; and data-collection, testing and procurement arms.
6. Swift financial logistics are required to support the unemployed, homeless, families with meal and money shortages; and food and commodity supply chains.
7. Your own stress test: In the absence of such a plan, you will have to fall back on your own devices (like big-flood days). This means doing your own stress-tests. How fit are your lungs? Do you know how to boost them? How safe are your sanitation protocols and living conditions? Are you being aired with enough sunlight and free-flowing air? How safe, stable and reliable are your food and commodity sources? And finally, do you get it? Why is the planet behaving like this? Anything to do with our behaviour?
Wayne Kublalsingh
