Lifting lockdown not limited to numbers

The Barbados Association of Medical Practitioners (BAMP) is cautioning Government against re-opening the country or extending the current lockdown based solely on metrics like the highly-touted positivity rate and r-values.

President Dr. Lynda Williams, an epidemiologist, says despite slight improvements in recent numbers,  public health officials ought to be very cautious about the country’s direction, even as officials from the private sector demand a greater level of clarity.

The association suggests this is because the measures do not tell the full story of the country’s virus situation or the state of its human and medical resources.

“The fact of the matter is that any decision as to whether or not we should continue or end lockdown is not so simple as numbers. You also have to look at your capacity with numbers. How well are you doing with contact tracing? How well is your lab testing going and can you scale up that lab testing? How well are you doing in terms of bed capacity for your ICU [Intensive Care Unit] cases? What is your human resource situation? How stretched is your ability in the country to manage the other types of diseases apart from COVID-19? asked Dr. Williams.

“No matter what your statistical numbers are, these factors are also major determinants as to whether or not the lockdown has been successful or not, because even if we do everything else and have statistical numbers that are sort of lining up, but our health sectors and our capacity to cope as a country with the burden that COVID-19 has placed on the health sector is so great, then we still have a major problem,” the BAMP president added.

Dr. Williams was a guest on Barbados TODAY’s discussion “COVID-19: What Now, What’s Next?” that examined the implications of the ongoing wave of the pandemic on the country’s economy.

Even with her warnings, President of the Barbados Private Sector Association (BPSA) Edward Clarke maintained the need for businesses to be given a clear, definitive benchmark for where the country ought to be for wide-scale economic activity to resume.

“Business in Barbados is going through hell right now. There is no doubt about it and as a result, employees are at risk and the future employment of Barbadians is at risk,” warned Clarke.

“Nobody has certainty and we don’t know how to plan. I know nobody understands the full gamut of COVID and the impact on the economy, on the lives of Barbadians and the globe, but we need to have some better idea on when Barbadians can say ‘we have succeeded’ or ‘we have not succeeded’.

“We were asking that prior to the lockdown and we are still awaiting that. We were hearing about the positivity rate, the r-rate and Dr. Williams has added other things and I can understand the resource issues, but there needs to be some way for us to know exactly what we have to aim for as a country and this is what we are doing,” the BPSA president added.

According to the BAMP president, the r-value is a reproduction number which depends on accurate data to determine how many people the average COVID-19 patient is likely to infect. She however argued that the metric does not provide key details on important trends within the country.

“It is limited because it doesn’t tell us anything about clusters within the country. It’s an average, so if you have large clusters going on in your urban areas and very few cases in your rural areas, it doesn’t tell us about that and it also doesn’t account for the fact that COVID-19 is a disease that isn’t necessarily spread by everyone who has it,” Dr. Williams explained.

“So although there is a lot of focus on the R number, this is not a perfect or even an excellent metric for looking at where we are,” she added.

Dr. Williams was also asked about the usefulness of the percentage of positive coronavirus cases out of the number of tests conducted, better known as the positivity rate. The World Health Organisation (WHO) suggests countries should aim for less than five per cent consistently over a two-week span before deciding whether to reopen.

The epidemiologist explained that this effort has been significantly affected by a backlog of tests being processed, but even in recent times, the figures have been troubling.

“We have fluctuated from as low as five per cent and as high as 13 and 16 per cent on some days. In the month of February, it has hovered around 7.4 and 7.5 per cent. Those numbers are above what we would like to see,” she added.
(kareemsmith@barbadostoday.bb)