Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.
Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
Standard recommendations to prevent infection spread include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.
—- World Health Organization
I do not know how many Belizeans have been paying keen attention to the world news about this novel coronavirus named COVID-19 that has been wreaking havoc in developed countries in Asia and Europe. This week, Italy went on lockdown as 168 persons infected with the virus died within 24 hours. The military has been guarding the streets and ensuring citizens remain indoors in compliance with the orders to stay inside their homes.
In China, the little that came out through reports from the country indicated that there was mass quarantine of citizens to prevent the spread of the disease. One of the tragic reports from that country is about the collapse of a hotel housing persons plagued with the disease, resulting in casualties and serious injuries to both the sick and the health workers.
Closer to home, as of the writing of this article, reports are that there are two (2) confirmed cases in Honduras; Mexico has (11) confirmed cases; and El Salvador is not waiting to have confirmed cases, and is already taking steps to close its borders. Guatemala has announced that it will not allow entry through its borders to persons coming from Europe, China, Korea and Iran. The USA also announced it is banning all flights from Europe, except the United Kingdom, for now.
The problem is real, and I say that, for Belize, it is just a matter of time before we report our first confirmed case of COVID-19. I believe that it is already here, but with the incubation period being what it is, we will not know of it until two weeks after a person is infected, or until the person suddenly dies.
Are we ready?
No! No! No! We are not ready in any way, form or shape. I say this for several reasons.
Firstly, the much-needed educational campaign that should have already been in full swing by the Ministry of Health is very lacking! A few podcasts or interviews or press releases, all in English, is NOT going to cut it. The educational process has got to be door-to-door, just as it is when the politicians come knocking at your door for your votes. We are a multilingual society, and as such the message has got to be in every possible language so as to ensure it reaches the citizenry in the language they know.
Secondly, there is lack of leadership at the highest level to deal with a master plan – including issues of evacuation, isolation, quarantine, security, supplies and even allocation of resources. Sadly, at the writing of this article, there is barely a notice that the Prime Minister will finally hold a press brief to address COVID-19. Now, while I do not know what to expect from said briefing, it must be noted that what is needed, is not only assurances not to panic, but the commitment of much-needed resources to ensure we have basic necessities such as more medical spaces to house the sick, medication to help cure them, test kits so that we can be very pro-active with testing, and even food security, as there is always the possibility of this pandemic having a strain on our availability of food products.
Thirdly, there are key steps that need to be taken, yet no indication as to what is our government’s position has been given. For one, I opine, it is time to stop all cruise ships from calling at our port. I know this will have a damaging effect on our economy, but this is one of those areas where our government has to be ready to assist families whose financial standing will be adversely affected.
Fourthly, we just do not have the medical capacity to properly address a pandemic, if the number of our casualties would reach the double digits. This is real…. Our health facilities are already strained with the everyday illnesses, accidents and shootings. This is an additional strain our health system truly CANNOT sustain.
KHMH being pro-active
I was privileged to be amongst a few who got to hear from the CEO of KHMH, Michelle Hoare, on the steps being taken at the country’s only referral hospital — the only one that offers tertiary care. This is basically our best hospital, yet it is the one taking on the risk to outfit itself to deal with any critical patients with COVID-19!
As I expressed in the meeting and I voice now, I have several key concerns, namely:
1. I opine the isolation unit should never have been placed at the only tertiary care hospital for fear of contamination. CEO Hoare justifies it by saying that it is still the one with the best resources to manage the care of critical patients; it is not possible to go and create any new facility in such a short period of time; and while the isolation unit is part of the same building, it is cut off, access-wise, from the rest of the hospital.
2. I am worried that the medical staff and support staff, when faced with the task of dealing with coronavirus patients, will not only be exposed to the dangers, but, given the limited number of personnel, they might become over-worked, exhausted and possibly ill themselves.
3. I am concerned that the morgue does not have the capacity to deal with daily death in the double digits and that immediate internment of those who succumb to the COVID-19 is a must.
4. I am concerned that while KHMH is taking the lead and being proactive, their efforts are insignificant if at the highest level the much-needed steps and decisions are not being taken in a timely manner.
5. I honestly believe that this matter is being taken too lightly and not with the level of urgency and seriousness that it requires. The pending press brief is okay, but that is not the most practical step in formulating and planning solutions to a crisis that will soon be upon us.
At this stage, I opine, NEMO, CEMO and DEMO should have already been activated and they should have already been on the ground helping with the education campaign, while gathering data on the vulnerable citizens, their living conditions, their support system and financial position. The reality is that the masses will NOT be able to pay for medical attention and thus this bill MUST be absorbed by the government. It is the reality!
Citizens, be proactive
I will not sit and wait for the government to tell me to do the things I can do and take control of. Therefore, I highly recommend that the head of each household, workplace and organization, must be proactive and create a response plan of action. We do not need any government to tell us to have minimal contact with the masses to protect ourselves, nor to have good hygiene at home and at work.
Imagine the worst-case scenario, as is happening in Italy now, and based on that make your plans. There are those of us who will not be able to do so because of our living conditions, socio-economic means, even level of awareness of the illness, but there are those of us who know better and can do better, and we should help ourselves, so that we do not become a burden on the already overburdened health system.
May I suggest you do some of the following:
1. Identify an isolation area in your home, should there be need for isolation of a family member who is displaying the symptoms or is diagnosed with COVID-19.
2. Have readily available the contact number of your doctors, your nearby clinic or nearest hospital and even an ambulance service.
3. Cancel all foreign travel, as you are only placing yourself at risk of exposure to the virus.
4. Cancel all plans for massive public gatherings, such as concerts, dances, and sporting events, because the fewer people you come in contact with, the less likely an infected person will come in contact with you.
5. Be prepared to pull out your children from school and, where possible, do your work from home (I know not all can do this).
6. Clean and disinfect your room, bathroom, and office and wipe your cell phones and office phones, as these are items you put close to your face and near your mouth and are surfaces that can host the virus.
7. Have a plan for the elderly, sick and children in the home, and especially ensure that you are teaching your children basic hygiene and talking to them about the dangers of the coronavirus. Kids need to be informed and guided about this pandemic.
8. If the local situation becomes critical, be sure you have in stock food supply for at least two months, should a state of emergency be called.
Now, I am realistic that not all will heed and can heed my suggestions, but, those of you who can, please do, since one way of helping the country is ensuring you protect yourself and not become another victim and burden on the already strained health system!
My people, keep monitoring the situation, as it can barely affect us if we do have an outbreak, or it can bring us to our knees if we have an uncontrollable outbreak! Your level of response will be dependent on the level of infection in the country.