Wed | May 27, 2020

Peter Espeut | Lessons from chik-V

Published:Friday | March 27, 2020 | 12:21 AM
A medical worker uses her phone while wearing a surgical mask outside Mt Sinai West on Thursday, March 26, in New York.
A medical worker uses her phone while wearing a surgical mask outside Mt Sinai West on Thursday, March 26, in New York.

LAST MONDAY at the daily Jamaica House press briefing on the state of the COVID-19 pandemic in Jamaica, it was revealed that since the outbreak Jamaica has conducted only 89 tests, with 21 positives. Government policy is to test only those who are already showing symptoms, but the doctors tell us that even two weeks after someone is infected, they will not show symptoms, but they can be infecting those around them. In other words, there could be many hundreds of infected persons all around us, infecting us, but they won’t know until they actually get sick; by which time we may already be sick.

I thought we had learnt our lesson after the chickungunya outbreak. You remember what happened: hundreds, nay thousands, of Jamaicans were infected, and yet the PNP Government’s minister of health – Fenton Ferguson – was reporting only a few confirmed cases, because the Government wasn’t sending samples of suspected chik-V cases for testing. If you don’t test, you can’t report confirmed cases.

Below is an extract from my column published in this newspaper on October 3, 2014, on the subject:

CHICK-V OUTBREAK

“It is a good thing that the chikungunya virus (chik-V) is not normally fatal, otherwise hundreds of thousands of Jamaicans by now would be dead; Jamaica’s population would have fallen below two million for the first time since the 1970s … .

“By some estimates, at the end of this chik-V outbreak, about 60 per cent of Jamaicans will have been infected. Minister of Health Fenton Ferguson claims we have been preparing for the coming of chik-V for the last two years. I say this tongue-in-cheek: it is a good thing we were prepared, or it might have spread faster, and affected more people … .

“There have been widespread calls for the resignation of Minister Ferguson for mishandling the epidemic; but I am not convinced he has mishandled anything, I believe he has followed to the letter his instructions from Cabinet. Why were the reported number of suspected cases of chik-V so low? There was intentional under-reporting because the Government didn’t want to risk a travel advisory which would scare away the tourists. Why were the number of laboratory-confirmed cases of chik-V so low? Because a high-level decision was taken not to send any more blood samples to the Trinidad-based Caribbean Public Health Agency (CARPHA) laboratory for testing. Why did the Ministry of Health stop releasing information on the number of laboratory confirmed chik-V cases? Because it would have become too obvious that we were not doing any more testing”.

Minister Ferguson eventually lost his job, and the PNP lost the 2016 general election.

It is clear to me that the present Government has learnt some important lessons from the chik-V epidemic of 2014. Quite early on, this Government made sure that we had our own capacity to test for the novel coronavirus; and we are told that we have the test kits and the reagents to test thousands of Jamaicans.

TESTING PROTOCOL

But the big question is: why has the Government put in place a protocol that permits testing only when a person is already showing symptoms and probably has infected hundreds of other persons?

It can’t be because they are protecting the tourism industry; that is already shut down.

After contact tracing over the last three weeks has detected hundreds of persons who have been in contact with confirmed infected persons, government policy is to watch to see if they begin to show symptoms, and to test them only if they get sick. This is what you can call the reactive approach. And while the Government watches them, they could be infecting dozens of people. The proactive approach would be to test all the people they are watching to confirm whether they are infected or not, and then to isolate them if they are. This will cut down the spread of the virus and reduce infections.

The long and the short of it is that the Jamaican Government needs to do more testing.

Politicians will be politicians, I suppose, and the fewer tests, the fewer cases, which makes them look good. And I suppose it reduces panic in the society. But it cannot be in the national interest to fail to detect actual cases of COVID-19 in Jamaica, which will prevent some of us from getting infected. I call upon the authorities to change the protocol and, therefore, to conduct more tests, especially in Bull Bay and in Hayes Cornpiece Settlement. For the good of us Jamaicans, the Government must test, do more tests, and then to test some more!

Cases are going to increase drastically! But then, it is better to know than to not know.

Peter Espeut is a sociologist and a development scientist.