As many countries across the world begin to tentatively reopen in the midst of the COVID-19 pandemic, UWI experts are advocating caution to ensure the process goes smoothly so as to combat the danger of a second wave.
This was emphasised at a May 3 virtual symposium - “The Impact of COVID-19 on Health Systems”– hosted by the Faculty of Medical Sciences (FMS) and the Caribbean Centre for Health Systems Research and Development (CCHSRD). Eleven presenters, representing a cross section of faculties, spoke on a variety of topics.
Dr Stanley Giddings, Lecturer of Adult Medicine at FMS, held up the 1918 Spanish Flu as an important historical lesson on what mistakes to avoid. “Reoccurrence can occur if non- pharmacological interventions are relaxed too soon.” He gave examples of American states which had deadly second waves in a pandemic that infected a third of the world’s population.
Giddings pointed out, “The second wave was highly fatal and accounted for most of the mortality.”
As she looked at physical distancing and socialisation, Dr Sandra Reid, Senior Lecturer, Psychiatry at FMS, highlighted possible risks which might arise because of the social culture of Trinidad and Tobago.
“We run the risk of our celebratory attitude leading us to ‘hyper-socialise’, to make up for missed parties and limes, which have the potential to undo all that has already been accomplished.”
Other speakers suggested issues that should be in the forefront of the minds of world leaders in managing the pandemic and its aftermath.
While analysing projections for the spread of the virus in the Caribbean, Dr Godfrey St Bernard, Senior Fellow at UWI’s Sir Arthur Lewis Institute of Social and Economic Studies, reviewed the trajectories in various countries and raised the need to access data from municipal areas within larger countries. St Bernard observed that, in addition to contact tracing to identify transmission pyramids, speculation on best case scenarios based on the examples of nations like New Zealand and South Korea was necessary.
Dr Sateesh Sakhamuri, Lecturer, Adult Medicine at FMS, considered the challenges for the health care system. He looked at data related to other coronaviruses and observed that a third of SARS and MERS patients have exhibited [lung] changes, even after three to six weeks of recovery; about a third reported diminished lung diffusion capacity up to six months later. Sakhamuri remarked on incidences of PTSD in former SARS patients. Possible long-term lung complications of COVID-19 recovered patients, he said, may include risk of developing pulmonary fibrosis, COPD, and asthma.
Christopher Oura, Professor of Veterinary Virology at FMS, explained why wildlife is a public health issue. He highlighted the growing occurrences of the movement of diseases from animals to humans and pointed out that deforestation, unsanitary butchering of wildlife, and intensive agriculture bring humans in close proximity to animals and promote disease spread.
While COVID-19 has been traced to bats, Oura urged, “Don’t blame the bats!” Rather, “we need to follow the sustainable development goals and see clearly that sustaining human health and well-being cannot be achieved without saving lives on the land and lives on the oceans.”
On the issue of food security, Dr Lystra Fletcher-Paul, Food and Agriculture Organisation (FAO) Sub-Regional Coordinator for the Caribbean and a Biometrics lecturer at UWI’s Faculty of Food and Agriculture, cited possible future concerns. These include poverty and malnutrition, increased food prices and production costs, and the importation of low quality food. She suggested short and long term solutions like home gardening and cash transfers for the vulnerable as well as strengthening institutions, increased private sector involvement, and making agriculture compulsory in schools. Fletcher-Paul considers these measures vital because they “provide an opportunity to improve our food sovereignty, be in charge of our destiny, and of the food we eat.”
Dr Marlene Attzs, development economist and advisor to the Campus Principal, expounded on the secondary societal impacts of the virus. Direct economic impacts like GDP, consumption patterns, and expenditure were not the only issues. “It is really important to unearth those secondary or indirect impacts...so that we can get an understanding of the effect of the pandemic and appropriate policy responses can be crafted.”
Presenters framed the current status of the virus within the context of Trinidad and Tobago, the Caribbean, and the world. Professors Christine Carrington, Professor of Molecular Genetics and Virology, FMS and Terence Seemungal, Dean of FMS and symposium co-host, delineated current knowledge about the virus.
Professor Carrington summed up the survival rate of SARS-CoV-2 and noted the main route of transmission was via respiratory droplets and contaminated surfaces. Depending on the type of surface, temperature, humidity, ventilation and more, the virus can persist for periods ranging from hours to days. However it is easily made inactive by common disinfection methods. She observed that the role of airborne transmission is still unclear but “is not thought to be a major route under normal circumstances”.
Prof Seemungal spoke on vaccine research, outlining research areas - like using inactive or weakened viruses, employing material present in the virus, utilising a viral vector, and creating protein based vaccines. “We need to know how and when to use the drugs and which drugs are going to be the most efficacious,” he said. “The future is hopeful, but for now we must focus on our immediate preventive methods.”
Prof Donald Simeon, Director of the Caribbean Centre for Health Systems Research and Development and symposium co-host, brought the forum to a close with a look at the response of local health systems. Assessing Trinidad and Tobago’s implementation of activities recommended by the World Health Organisation, he observed, “Of the 65 that were indicated in the WHO handbook, we have evidence that 45 of them have been implemented in Trinidad and Tobago”. He concluded that the local health system has been responsive to challenges.
Symposium presenters emphasised UWI’s role as a key player in the Caribbean’s pandemic strategy for life post- COVID-19. Professor Seemungal expressed the view that “in the years to come, we will be able to take pride in how we responded to this challenge, and future generations will say that we rose to the challenge and contributed significantly to the COVID-19 suppression and eradication efforts worldwide.”
