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Thursday, December 31, 2020

How a deadly virus ravaged our islands    

Shortly after 1 p.m. on March 15, then-Acting Minister of Health Jeffrey Lloyd announced that a 61-year-old woman living on New Providence had tested positive for COVID-19.

She was the first confirmed case in The Bahamas.

Nine days later, health officials confirmed a case on Grand Bahama, which was the island’s first. 

By April 1, The Bahamas had confirmed 18 cases on New Providence, three on Grand Bahama and one on Bimini and Cat Cay.

Included in that figure was also the country’s first COVID-related death: a 57-year-old Bimini woman, Kim Johnson-Rolle, who died shortly after arriving on New Providence on March 31, after waiting 24 hours to be airlifted due to the unavailability of an ISO chamber to safely transport her from Bimini. 

Roughly two weeks after the first case was confirmed, Prime Minister Dr. Hubert Minnis declared that The Bahamas was “in a surge”.

“There is community spread,” he said during a press conference on April 1.

The total number of cases rose to 80 and deaths increased to 11 by April 27.

On April 27, while speaking in the House of Assembly, then-Minister of Health Dr. Duane Sands acknowledged that 80 percent of all cases were confirmed on New Providence.

He said seven cases were confirmed on Grand Bahama and nine on Bimini and Cat Cay.

“What is extremely notable is that Bimini has emerged as a hotspot for the COVID-19 virus in The Bahamas,” Sands said.

The island, which has a population of 2,000, had the second highest number of cases in The Bahamas.

On May 14, Minnis announced that Bimini will be placed under a two-week lockdown.

“A lockdown like this is not something that would have been preferred,” the prime minister said.

“But it is absolutely necessary because things will get much worse on Bimini if we don’t take this strong measure immediately.”

Minnis said the case count on the island had risen to 14.

The lockdown ultimately resulted in a reduction of cases on Bimini.

No new cases were confirmed on the island again until late-July.

At the time of the prime minister’s announcement in May, there were 96 cases in The Bahamas. 

Eight additional cases were confirmed between mid-May and the end of June, which marked the end of the first wave of the virus in The Bahamas.

The total number of cases stood at 104 — 82 on New Providence, 14 on Bimini and Cat Cay and eight on Grand Bahama — from June 14 until July 8.

Start of the second wave 

On July 1, The Bahamas reopened its borders to visitors after being closed for several months as a result of the pandemic.

While a negative RT-PCR COVID-19 test and a 14-day quarantine were mandatory for individuals traveling to The Bahamas, returning residents and citizens, who were out of the country for less than 72 hours, were not required to present a negative COVID test upon arrival.

The prime minister said the exemption was given to those traveling for less than 72 hours “because of the difficulty in obtaining a PCR COVID-19 test result within three days”.

Twelve additional cases were confirmed within two weeks of reopening the borders — 10 on Grand Bahama.

Among those cases were a mother and daughter who had contracted COVID while abroad, according to health officials. They broke quarantine after returning to Grand Bahama and subsequently infected eight other people, officials reported.

“Grand Bahama has seen a resurgence of COVID-19 cases after being COVID-19-free for a little over two months,” Minnis said in a national address on July 19.

“The increase in cases coincided with the reinstitution of international flights and passenger sea transport.”

Two days later, he announced a two-week lockdown for Grand Bahama, which had been declared a COVID hotspot.

Minnis said the measure was “absolutely necessary in order to save and to protect the lives of the residents of Grand Bahama”.

There were 574 COVID cases on seven islands, including Abaco, Cat Island, Exuma and the Berry Islands, by the end of July. Grand Bahama had the most overall cases with 286, followed by New Providence with 232.

During a press conference on July 31, Minister of Health Renward Wells said several new cases on Grand Bahama, New Providence and Bimini had been linked to “a particular funeral”.

That week, The Bahamas confirmed 273 new cases. One hundred and eighty-eight cases were confirmed the week before.

Chief Medical Officer Dr. Pearl McMillan described the rate of increase as “worrisome”.

She said it “puts pressure on our health system capacity”.

“If allowed to go unchecked, unmitigated, our health system can collapse,” McMillan said on July 31.

“Our economy will undergo undue stress and our society will have unwelcomed social chaos.”

Her comments came a week after she warned that Grand Bahama was “fast approaching its bed capacity” for COVID cases. At the time, there were 11 hospitalized cases on the island and only 16 beds.

Minnis ultimately extended Grand Bahama’s lockdown until August 24, a move that was credited with curtailing the spread of the virus on the island.

By August 31, attention shifted from Grand Bahama to New Providence, which was experiencing an explosion in cases.

The island had confirmed 1,378 cases overall, which was nearly double the number of cases confirmed on all other islands, including islands like Andros, Inagua, Acklins and Crooked Island.

Health officials noted that COVID cases were rampant within healthcare facilities — as wards at Princess Margaret Hospital (PMH) and Sandilands Rehabilitation Centre had to be closed following outbreaks — and law enforcement agencies like the Royal Bahamas Police Force and Royal Bahamas Defence Force confirmed scores of cases.

Strained system

On September 9, the minister of health said The Bahamas had witnessed “a more vicious and tenacious spread of the virus” during the second wave.

This was further noticed by the confirmation of 2,745 new cases and 49 deaths in September, which was the month when the highest number of COVID-19 cases was confirmed.

During that month, hospitalizations also reached triple digits for the first time.

The situation deteriorated to the point that, on October 7, the prime minister took to the House of Assembly to inform the public that there were “urgent challenges” on New Providence and Abaco, which had emerged as a hotspot with 157 cases.

“The persistently high case numbers, particularly on New Providence, have placed immense strain on our healthcare system and our medical professionals,” Minnis said.

“Our hospitals are full. Medical teams have been pushed to their capacity. If there is further deterioration in the COVID-19 situation on our most populated island, we risk a collapse of the healthcare system.”

At its peak, which was October 22, there were 122 cases hospitalized.

One week prior to that record being set, Sands, who resigned from Cabinet in May and is now working full time again as a medical doctor, said that healthcare workers were having to choose who lives and who dies, at that point in The Bahamas’ fight against the virus.

On October 15, when asked if decisions were being made on who would live or die as a result of overcrowding in hospitals, he said, “The answer, unfortunately, and I say this with a high degree of certainty and I understand the implications of my comment, the answer is yes; that is happening now.”

However, the next day, Dr. Nikkiah Forbes, director of the National HIV/AIDS and Infectious Disease Programme, suggested that while The Bahamas had not yet reached that point, the country was not far from it due to a strain placed on the healthcare system by the pandemic.

By the end of the month, healthcare workers at PMH were being forced to treat patients in back rooms of the Accident and Emergency Department (A&E) and in a food court at the hospital.

However, between October 10 and November 5, there was a 50 percent reduction in new cases.

“The national average of the number of new cases each week continues to fall,” the prime minister said in a national address on November 8.

“Hospitalizations have decreased by 68 percent from mid-October to now. The data suggests that transmission is decreasing. The most recent data put our national positivity rate at 16 percent, which is a 44.8 percent reduction from the week just before the measures (a reduced curfew and weekend lockdowns on New Providence and Abaco that were implemented in early-October) were put in place.”

The minister of health said that that lull gave healthcare workers “a chance to regroup and prepare to deliver additional care going forward”.

Wells said healthcare workers will continue to maintain the bed capacity of 106 at PMH alone. 

Flattening the curve

As of November, for the most part, there was a reduction in the number of cases nationwide.

However, Exuma and Eleuthera saw spikes in late-October and early-November that led health officials to conclude that they were hotspots.

The number of cases on Eleuthera jumped from 56 on October 25 to 117 on November 8, when Minnis announced a nightly curfew and other restrictions for the island.

“Health officials have reported that a number of COVID-19 cases have been linked to bars,” he said in a national address, adding, “Additionally, the current increase in cases on Eleuthera has been linked to a funeral held two weeks ago.”

A few days later, the prime minister implemented similar measures for Exuma due to an “exponential increase” in COVID-19 cases. More than 40 cases were confirmed on the island in the first two weeks of November.

The increase in cases on Exuma was linked to the October holiday weekend and two major social events, according to Minnis.

The restrictions were lifted by early-December as the two islands experienced a flatlining of cases.

On November 26, the minister of health declared that collective efforts were “flattening the COVID-19 curve”.

“For the past seven days, Mr. Speaker, there have been fewer than 30 new cases each day,” Wells said.

“Mr. Speaker, on November 24…we had nine cases. Yesterday, Mr. Speaker, we had eight cases.”

On December 15, he said the COVID numbers were “trending in the direction we are expecting it go in now”.

Wells said health officials expect that there “may be an uptick” in cases following the Christmas holiday.

He told The Nassau Guardian the government will secure a vaccine “a lot sooner” than the second quarter of 2021.

Meanwhile, the prime minister has cautioned Bahamians to be “very realistic” in their expectations over vaccine timelines.

“There is hope that medical frontline workers in the US may begin to be vaccinated as soon as next month,” he said on November 18.

“While we all should be pleased with this success, we must be very realistic with our timelines. It will take time before newly approved vaccines in the developed world become available in the developing world.”

The vaccine, which will not be mandatory in The Bahamas, will be offered to healthcare workers, frontline workers, tourism workers and the elderly first.

As of December 29, The Bahamas had confirmed 7,857 cases and 170 deaths. Twenty deaths were still under investigation. 

Rum Cay, Ragged Island and San Salvador were the only islands that remained untainted by the virus.

The post How a deadly virus ravaged our islands     appeared first on The Nassau Guardian.



source https://thenassauguardian.com/how-a-deadly-virus-ravaged-our-islands/

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