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KENWYN NICHOLLS

THE GEOMETRIC increase in newly confirmed cases and deaths is as distressing to me as it would be to the Prime Minister and his Cabinet, the residents and the TT diaspora, and concerned people the world over, in general. It would, however, be disingenuous of me to state that I have been blindsided by this obvious turn for the worse.
Early in the pandemic researchers noted that covid19 observations differ markedly from the pervasive narrative that has been pedalled with alarming success in the past and, until a few days ago, recasted by the TT decision-makers as the principal reason for the covid19 resurgence: mass gatherings. Mounting evidence that our porous southern borders were being violated, repeatedly, by illegal immigrants has resulted in some official retraction from this position, but only some.
Acceptance that illegal gatherings are a failed hypothesis and that illegal border entry was the more likely culprit, not only as a triggering factor but also as a crucial element in the perpetuation of past and present viral surges, is critical to the understanding of what policies and action plans need to be employed going forward. For starters it would help explain why initial hotspots were first noted in counties Caroni, Victoria, and East St George before becoming more widespread, and why the reinstitution of the ban on contact sports and other restraint measures that followed, have failed to stop the relentless spread of the virus.
Communal living such as in households or dormitories offers a more logical explanation for the manner of spread. This is true for TT as it was for Barbados in their post-Christmas viral explosion, and more likely was the mode of viral transfer in the counties referenced above.
Stopping contact sports, closing beaches, reducing the size of gatherings and so on have not led in the past and certainly not now to any meaningful impact on tamping down propagation of the bug (and thus reducing the day-by-day rising trajectory of newly confirmed cases – and deaths). What is more likely to succeed is to plug the holes in the borders, engage in more efficient contact tracing, and effectively enforce the quarantine protocols (through better use of law enforcement personnel).
The covid19 global worldometer rates TT as a relatively poor performer in respect of testing. This is reflected on the TT covid19 dashboard which shows the proportion of total positive cases to total unique tests, aka the positivity rating, at 7.1 per cent as little as one month ago. It is now at 8.77 per cent. According to Johns Hopkins University, the higher the positivity rating, the greater the likelihood that significant under-testing is taking place. And that only obviously ill people were being tested while pre-symptomatic and asymptomatic people were being missed. How bad is the problem?
At the time of writing the global worldometer lists TT as performing 92,448 tests per one million population; Venezuela, 118,403; Guyana, 151,996; and Barbados a whopping 529,779. It is therefore unsurprising that the chief epidemiologist is experiencing difficulty in connecting the P1 variant cases: dots have to be found before they can be connected; insufficient testing defeats this purpose. The goal should be to bring TT’s positivity rating down to five per cent, the internationally accepted benchmark.
The foregoing dictates that a more logical focus should be placed on mini or micro gatherings, and that has to start with improved contact tracing. Unless the dots are identified they cannot be connected; what appears to be community spread is, in fact, local spread into the community. Rising positivity rates mean rising failure to identify asymptomatic patients who may be super spreaders without knowing it. It is common knowledge that asymptomatic cases may be as much as 50 per cent of confirmed cases. That means that given recent numbers, as many as 200 asymptomatic people may be out there presently.
The focus in Australia and New Zealand is to keep covid19 from coming onshore. Lockdowns in those countries are temporary and aimed at seeking out and eliminating the virus. This strategy is employed again and again. Those two countries are quick to point out that they achieved eliminated virus status in the absence of a vaccine and are currently being criticised for their tepid approach to mass vaccination.
We in TT should take note. TT’s vaccine programme at the moment makes achieving herd immunity anytime soon a pipe dream. A limited curfew may provide the time and space to do what we must now do.
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