Averting a third wave

After nine months of death, emergency restrictions and job and income losses as a result of COVID-19, weathering a third wave of a viral outbreak is an unthinkable prospect Bahamians hope will never materialize.

The reopening of major resorts in the capital has filled workers with cautious optimism that brighter days are ahead, and what previously appeared to be a slowdown in new cases prompted anticipation that the worst of the country’s outbreak may be behind us.

But a recent spike in COVID-19 cases is cause for concern.

In a four-day period between December 9 and December 12, The Bahamas recorded 89 new COVID-19 cases, according to the Ministry of Health’s daily reports.

It took 11 days in the period between November 28 and December 8 to chart 81 new cases.

And two new deaths were added to the category of COVID-19 deaths under investigation since late November.

Thirty-eight new cases were recorded on December 9 alone – with seven said to be occupants of a cargo vessel sailing through Bahamian waters near Grand Bahama – representing the highest single-day count since November 16 when 56 new cases were recorded.

Regarding the spike in cases over the past several days, Prime Minister Dr. Hubert Minnis indicated that a local surge following the Thanksgiving holiday season in the United States, was expected.

What is unclear is the extent to which officials have remedied deficiencies present during the country’s deadly second wave, so as to effectively meet the expectation of a new surge.

Travel by tourists and residents continues between The Bahamas and the United States, which recorded one million new cases in just four days, according to US media reports.

One of the key deficiencies during the country’s second wave centered around the collection, collation and timely reporting of data.

Since the country’s second relaunch of commercial tourism on November 1, the problem of inadequate data reporting to the public continues, wherein no report has been provided since November 13 on compliance with fifth-day antigen testing requirements.

Health officials have not advised the public on what accounts for the recent spike in cases; whether any of the new cases are tourists; and the results of contact tracing and quarantine for any international travelers who may have tested COVID-19-positive via RT-PCR testing after their arrival.

When the country’s second and deadliest wave occurred, a ramp-up of testing did not occur until transmission of the virus was so widespread on impacted islands that sweeping lockdowns were deemed the best response to curbing the outbreak.

Grand Bahama was able to contain its outbreak in a two-week period – though its lockdown lasted for close to six weeks – owing to compliance by residents and a testing protocol wherein contacts of infected residents, as well as contacts of contacts, were tested, improving the ability of health officials to better gauge the scope of the outbreak and have infected individuals isolated.

With no recent accountability on how antigen-positive individuals are being managed, and with an existing public health protocol that tests only symptomatic patients within a set criteria, questions remain on whether the country’s recent spike could represent the start of a new wave of community transmission.

Conflicting statements between the ministers responsible for health and tourism have done little to inspire confidence that everything is being done to ensure new cases do not develop into an out of control scenario that could lead to fresh restrictions and potential deaths.

State of confusion

Tourism Minister Dionisio D’Aguilar recently told The Nassau Guardian that fifth-day antigen testing was not being performed in some instances on some Family Islands.

Health Minister Reward Wells followed by maintaining that such testing was being carried out on all islands, as far as he was aware.

This in and of itself was a signal that yet another key breakdown in the system of determining and managing the COVID-19 status of incoming travelers could exist, that leaves the country open to a new wave of infections.

In response to calls for antigen test results to be included on the ministry’s daily dashboard, Wells told this newspaper, “The antigen test is being used as a screen. So, whenever someone tests positive with the antigen test, there is a follow-up RT-PCR test to confirm that the individual is positive and, if they are, then they’re included in the numbers.

“So, even if we are at this stage not counting the rapid antigen test, that does not mean that someone who is testing positive from the RAT is not being considered in the numbers…

“…If you test positive with the RAT, the rapid antigen test, we follow up with a RT-PCR test just to confirm, to make sure that the rapid antigen test is correct. So, that is the current protocol.”

But Perspective was made aware of one case on Grand Bahama where follow-up RT-PCR testing for an antigen-positive traveler did not occur.

Hannah Warren, whose name was changed to protect her privacy, appeared in our column two weeks ago, giving details of her antigen-positive test result days after returning to the island with a negative RT-PCR test result as a condition of entry.

Warren said she was not contacted by health officials following her antigen test result, and that she voluntarily self-isolated for 14 days.

In an interesting twist, Warren later provided us a copy of an email from the Travel Compliance Unit sent approximately two weeks after her return to the island, advising her that her COVID-19 test result was negative, and that the test result was valid for 96 hours.

The Grand Bahama resident expressed to us her confusion as to whether the email was sent in error, since her antigen test result was positive, and she did not take a follow-up RT-PCR test.

She recently said, “I have no idea which test they are talking about since the only one they would have had a record of would be their rapid antigen test, which was done over 10 days earlier and was positive, not negative.

“How many positive cases have been told they are negative and feel free to go about your day? If I hadn’t had the symptoms I had I may have just thought they were wrong at the [medical] office, and without knowing I was contagious, gone about my life infecting who knows how many people.”

Lax protocol enforcement contributed to the country’s second wave.

It is unknown how many other travelers, whether resident or tourist, fall into Warren’s category, and how many of such persons may have had contact with and potentially infected others with COVID-19 throughout the country.

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