Many are happy that Trinidad and Tobago has begun to lift lockdown restrictions. If the picture of the spread of Covid-19 continues to look good, we will continue to see such lifting in a gradual way. However, we must remember that we are not in the clear regarding this pandemic just yet. The World Health Organization (WHO) Chief, during his regular news briefing to journalists on April 30th, said, “We want to re-emphasize that easing restrictions is not the end of the epidemic in any country.” Mr. Tedros said ending the disease will require a sustained effort from individuals, communities, and Governments to continue suppressing and controlling the deadly new coronavirus.
This gradual lifting of lockdown has been seen to be taking place internationally for some weeks now. A major fact that has driven such action to take place, is the projected economic decline as a consequence of lockdown. A grave consequence many predict is inevitable if lockdown would continue to endure. In the case of T&T, this decision was taken in light of the apparent fall in the incidence of cases as well as our sustained healthcare capacity. We must, however, remember that the total amount of testing done since the start of the pandemic here in T&T is not sufficient to give a clear picture of our true prevalence of the disease. The fact remains though, that we wasted a lot of time in ramping up testing. Testing in an outbreak provides two functions.
1. Diagnose those who are sick.
2. To provide surveillance to see where the virus may be lurking, especially in cases where symptoms are mild and do not manifest at all.
There may very well be a monster lurking in the dark that may favor the spread of a second wave that may have the potential to be worse than the first. A meme going around on social media aptly gives the reality and gravity of the situation now that we have begun to roll back lockdown. It states “The end of the stay at home orders does not mean the pandemic is over, it means they currently have room for you in the ICU.”
Now that some non-essential services are being opened for business, we must still remember that the responsibility is on us to continue to maintain practices that will continue to reduce, if at least not prevent the spread of the virus. These include:
– Washing hands regularly
– Covering your nose and mouth when you sneeze or cough
– Avoid the temptation to touch your eyes, nose and mouth
– Staying six feet apart from others and wearing a face mask when going out
– Regularly clean and disinfectant frequently touched areas at home and in the workplace
– Eat healthy and balanced meals, get regular exercise and keep hydrated
– Individuals with comorbidities such as diabetes, heart disease, lung disease, kidney disease, liver disease and the immunocompromised should take additional care as they are most vulnerable for complications if infected
– Call your doctor if you may have fever, cough, and shortness of breath or any symptom you may be concerned about
This week is the first week where lifting measures of lockdown has begun. As per WHO’s earlier recommendations, the lifting of social distancing measures should be a gradual process that should be done over a two week period and thereafter assessed to see the outcome that will guide further measures in dealing with this pandemic. If we just go back to how things were before, the transmission may start again with the same intensity or worse.
The fact is that social distancing cannot last forever. But, what would it take to end social distancing safely will fighting the spread of the coronavirus? It isn’t easy, it would require an immense amount of leadership, coordination and more sacrifice. Social distancing is still the most crucial non-pharmaceutical measure against this pandemic and it needs to be kept in some form or fashion in the coming weeks if not months. Thus far social distancing has been the pause switch that has bought us time to move on to more pandemic strategy.
The ultimate goal is stopping a pandemic is a safe and effective vaccine that can prevent people from getting the virus. The good news is that they are already being tested, but the bad news is that it can take a year or more to find out if it is safe and effective. In the meantime, we may be able to find treatment sooner. The WHO is currently overseeing multinational clinical trials testing medication or a combination of medication in treating Covid-19.
At the end of it, economic concerns have a real impact on health. The economic ramification of the pandemic only adds to the area and is only adding to existing mental health strain and is also a major determinant of population health outcomes. But a balance must be struck. The economy must be opened up in such a way that it will not have a grave toll on the healthcare capacity. That is what ending social distancing abruptly will result in at this point. To get this balance right we need everyone on board from politicians to the general population holding their responsibility.
The greatest power we have right now is patience. It’s not easy to muster in the face of such sacrifice. At times it can feel ineffective, but we must not be daunted. Both sides of the fence need to communicate more so than any decision taken is best for all of us.
Dr. Visham Bhimull
Primary Care Physician
Diploma in Family Medicine (UWI)