The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.
by Dr. V. Armogan
The Barbados Dental Association has had to become experts on COVID as our profession was initially ranked in the 95-99 percentile for danger to exposure.
When we recognise that autopsies are not carried out on COVID positive patients in Barbados due to the risk of exposure from aerosols, and dentists deal with aerosols generated from our drills all day long, you can understand why we had to become experts on the virus.
With our protocols and upgraded equipment, we have been able to successfully deliver treatment without a single incident of infection throughout this pandemic. All of this was done without Government guidance or assistance.
Requests were made to allow the importation of COVID-related equipment and supplies duty-and VAT-free to aid in the protection of the public, but we have received no response to date.
Meanwhile, some of our CARICOM neighbours were proactive and allowed all COVID related supplies to be imported free of duties and VAT. As such, the cost of thermometers, masks, gloves, oximeters, HEPA filters, UVC lights etc have not been driving up the cost of living as much in those territories as they have in Barbados.
Despite our vast expertise and reaching out to Government prior to the onslaught of COVID on our society, we have never been consulted, nor included, on anything COVID. This is a shame and speaks volumes on the management of COVID in Barbados.
In recent days, a document titled “Safe Zone Implementation Framework for Public and Private Healthcare Institutions in Barbados” was received and reviewed by the Barbados Dental Association. Listed below are some of our concerns.
(1) The testing frequency suggested seems to defy logic, and science, for both vaccinated, and unvaccinated, persons with low risk. The recommended 30-day testing cycle would fail to discover possible infection and contagion.
Given an incubation period of 3-23 days and a contagion period of 10-14 days for unvaccinated individuals, (approximately five days for a vaccinated person),
a test every 30 days would potentially miss many instances of spread. As such, if I were tested today, I could contract COVID tomorrow, start spreading it in three days for 14 days and then recover. On my next test, I’d likely show negative.
Considering that this policy is directed at the HealthCare offices, dealing with an immunocompromised population, we could potentially be spreading the virus and not even being able to contact trace the infected individuals. As such, a seven-day testing period is ideal, but may be stretched to 14 days, to still capture a vast majority of cases. Thirty days, however, makes no sense.
(2) While not stipulated, it is understood that the tests would be conducted using current facilities. The waiting period at these facilities is currently between two-four hours.
Clearly, with more demand on facilities as Safe Zones are established (not just in HealthCare but also in Hospitality), this will increase.
If employees are doing this on company time, this will result in all manner of difficulties: – transportation to and from the facility; time away from work; disruption of already disrupted workplaces; potential exposure at facilities; discomfort and sequelae of testing procedure (headaches, pain or discomfort) etc.
(3) A recent release from the GIS was requesting people to come forward and be trained to become swabbers. This appears to be in contravention of the Medical Act and we would strongly recommend that this is done properly and legally. Doing otherwise could open the Government of Barbados, and the establishment employing non-medical personnel, to potential lawsuits if people are injured from the swabbing.
(4) Allow testing at the medical/dental/paramedical offices. This will cut down on the demand at the Government testing facilities and prevent all of the problems mentioned above. A representative from the COVID unit can be assigned to various offices (as was done with the hotels) to follow up and maintain the records for Government. Tests can be requisitioned or delivered based on the number of employees.
(5) Allow the use of rapid antigen saliva tests. Without a doubt, rapid antigen testing is designed for this purpose – repetitive testing.
However, no one is thrilled about having a nasal swab done repeatedly. It can be uncomfortable and some people report headaches etc after swabbing and thus an inability to work effectively.
Additionally, if a doctor/nurse does not carry out the swabbing, we could be in contravention of the Medical Act. To move into Safe Zones and requiring nurses at each location is ridiculous, and will not only be expensive, but will pull nurses from frontline responsibilities (especially since some businesses will pay more than Government).
Additionally, doing nasal swabs requires a change of gloves between swabs (increasing costs and spending of foreign currency) – whereas a saliva test allows the patient to collect their own sample and administer their own test, with supervision.
(6) Change the guidelines for rapid antigen testing. A document circulated on October 15th by the Government of Barbados re Rapid Antigen Tests states that the only indications for Rapid wwAntigen tests are:
(1) for travel and
(2) symptomatic cases.
Clearly, the move to mass testing will violate that policy as we will be testing people who are asymptomatic and not travelling. As healthcare professionals with critical thinking abilities, it is disappointing that the Government of Barbados has not seen fit to include the Barbados Dental Association in matters related to COVID protocols.
Barbados Dental Association submitted on behalf of the Barbados Dental Association by President, Dr. V. Armogan ([email protected])