BELIZE CITY, Mon. Aug. 31, 2020– On Friday, August 28, 2020, Rt. Hon. Dean Barrow hosted a virtual press conference that outlined further prevention measures being implemented by the government as COVID-19 cases continue to steadily rise in Belize. At this press conference, he also announced the new date for the reopening of the Philip Goldson International Airport.
Barrow’s panel at the press conference consisted of the national epidemiologist, Dr. Russell Manzanero; Director of Health Services, Dr. Marvin Manzanero, and Chief Executive Officer of the Ministry of Health, Dr. George Gough. Dr. Russell Manzanero was the first to speak, and he reported on the number of confirmed cases of COVID-19 in the country, which stood at 870+ as of Friday, but has quickly risen to 1007 as of Monday.
Dr. Russell also reported on the number of active cases, deaths resulting from the virus, and the locations and various origins of the 52 new cases that were discovered on Thursday, August 27, 2020. Dr. Russell also said that, based on their findings, 39 newly recovered persons were also detected throughout the country as of last Thursday.
Dr. Marvin Manzanero followed up on this data by highlighting that males constitute a higher percentage of the number of persons infected with COVID-19, and the number of recoveries among females exceeds those of men at a ratio of 2:1. Manzanero also made mention that the former practice of testing patients twice after they have been confirmed to be infected with COVID-19 would cease as of last Friday, and said that after a person who is confirmed to have COVID-19 receives the first negative test results, they will be deemed recovered, as is the international standard.
Dr. Marvin Manzanero also mentioned that the turnaround time for the receipt of test results is expected to improve, as the Department of Health Services has been able to clear up the back log they were experiencing due to the rapid increase in the number of infected persons. This was done through gene-expert testing in patients deemed to be in critical condition, rather than the PCR tests, which take a longer time to produce results. In regards to the repatriation process, Dr. Marvin Manzanero suggests that there may be some changes seen in the testing aspect of the process during this week.
It was also reported that an alarming 36 healthcare workers have been identified to be infected with COVID-19, including an array of doctors, nurses, pharmacists, lab technicians, and even the administrative staff of hospitals in some cases. According to Manzanero, his department is currently reviewing their testing protocol based on international guidelines, and the use of rapid-testing is very likely to be included in the process:
“There is an opening for us to go back and review our testing algorithms and have rapid testing be made available for certain areas and sectors of the population. Whenever you have documented community transmission and that you are not routinely testing everybody, that there may be room for doing rapid testing on the symptomatic persons or in a household where you have identified a case, test with a rapid test has been validated at the lab and then you have to do the validation on the field. I think there’s an opportunity there,” said Manzanero.
Dr. Gough then provided an update on the current resources garnered by the Ministry of Health to battle the virus, including the flu clinics in the country which have been successfully upgraded in the past few months. According to Dr. Gough, the Ministry of Health, through the $6 million IDB loan, has been able to secure 100,000 PPE suits, with an additional 15,000 incoming by means of an IDB subsidy. In the country there are a total of over 34,000 sterile gowns and about 20,000 non-sterile gowns, with an additional 25,000 being imported. There are currently nearly a million surgical masks in stock, with an additional 100,000 coming in the next few weeks.
Approximately 11,000 N-95 masks are currently in the country, with an additional 100,000 coming in via a grant from the Taiwanese government and aid from the IDB. Also, 144,000 K-95 masks are in stock, and it is expected that an additional 100,000 will be imported. In regards to alcohol, liquid soap, medical soap and peroxide, the country has between 140 and 150 drums of each, with an additional 100 to 150 drums coming in. According to Gough, these supplies should last Belize a minimum of nine months, even in a worst case scenario. With respect to testing, the country would be able to conduct 26,000 PCR tests and has an inventory of 5,000 rapid antigen tests. It is also awaiting an additional 20,000 rapid tests that will soon enter the country. There are a total of 5,000 rapid antibody tests which were donated by Taiwan and an additional 2,000 pending importation that was offered to the Health Ministry.
Dr. Gough made mention that as a result of the reduction in staff due to the contraction of the COVID-19 virus by some healthcare personnel, multiple frontline health workers who have been retired or left their posts within the past two months have been reinstated in the Northern, Central and Southern health regions, and there has also been the recruitment of temporary hires from PAHO and retired rural nurses. Young Belizeans doctors who studied in Cuba will be allowed to graduate one month early so that they too can join the frontline as early as Monday, August 31, 2020.
Following Gough’s update, Prime Minister Barrow shared his own announcements. Barrow explained that due to the unforeseen “astronomical rise” in cases, the systems in place for testing have been overwhelmed and results have been delayed as a result. Delays have also been the result of Belize’s reliance on the PCR tests and its reluctance to use rapid antigen and antibody tests, which provide a faster result. This, however, may change in the country, the Prime Minister said.
“Here it is that we have all these antigen rapid tests that can give you results in as little as fifteen minutes. The problem with our not having resorted to the use of these antigen rapid tests is because there are reliability issues with pretty much all of them. And the seriousness of these issues differs, of course, from manufacturer to manufacturer. But in the end it is sufficient to say that no rapid test has reached equivalency with the PCR test, and that is why in Belize we continue to place all our bets on the PCR test. No rapid test has reached equivalency with the PCR test — none that is, until now. Yesterday, news was globally circulated about the breakthrough of and FDA clearance for the Abbott Lab’s BinaxNOW rapid coronavirus antigen test. That test is 97.1% sensitive, meaning that it correctly diagnoses those tested that do have the infection 97.1% of the time. It is also 98.5% specific, and what that means is an infection is correctly ruled out 98.5% of the time. This high degree of specificity deals with the problem of false negatives and it is this probability perhaps, of false negatives, that has been the bane of other rapid tests. It there puts the Abbott rapid test right on par with the PCR regular tests,” said Prime Minister Barrow.
While this technology has made its way into the market, Barrow admits that President Trump has purchased and pre-ordered a massive quantity in the tens of millions, so he does not know when it is that smaller developing nations will have access to that specific test.
Hon. Barrow also cited a document published by PAHO which stated that Belize’s priority should be to “decentralize” testing at the community level, outpatient services level and the remote areas level. This means an increase in the number of daily samples processed and a reduction in the turn-around time for results, which they imply can only be done by utilizing rapid tests. They also assert that these antigen tests cannot replace the PCR tests, but should be prioritized for the testing of symptomatic suspected cases and the testing of contacts of confirmed patients.
As a result, the Prime Minister announced that, moving forward, rapid antigen tests will now be included in Belize’s testing regime for symptomatic persons and contacts of those who have tested positive. He then mentioned that the tests that will be utilized can produce results in as little as 15-30 minutes. All frontline workers, however, will be tested solely via PCR testing. To assuage the concerns about false negatives, Barrow suggested that the Ministry can administer a second PCR test for any person who has originally been tested with a rapid test, in the event that their results are negative but they are exhibiting symptoms or were in contact with a person who tested positive. The Ministry of Health, according to Barrow, can also opt to verify a negative test by issuing a second rapid test in the face of a questionable result. The Department of Health Services will be tasked with using their discretion to determine how these tests will be administered.
Finally, Barrow made the anticipated announcement regarding the reopening of the PGIA:
“I’m pleased to say that we have a firm date now of October 1st, 2020. This date is what we have fixed upon for two reasons. We are positive that all the protocols, the physical refurbishment or the physical alteration of spaces at the PGIA, the training of taxi drivers, the training of others, the continuing or continuous reaching out to the immigration personnel or the customs personnel and the public health inspectors. That sort of thing puts us in a sort of position where we can say with complete confidence that by October 1st we will have the proper flow through the PGIA down-packed,” said Barrow.
Barrow went on to say, “Apart from knowing that by October 1st we will absolutely be ready, the second rationale is the fact that it would’ve made no sense even if we could’ve managed it to do an earlier reopening, because nobody was coming. We have now, though, confirmation from American Airlines, that they will start to fly again to Belize on October 1st 2020. They will come initially five days a week every day, except I believe Tuesday and Wednesday. And then United is also indicating that they will start coming back to Belize on October 1st, and they are proposing to come every day.”
Additionally, Delta Airlines has also pledged to resume flights to Belize in November. The Prime Minister states that by October 1, there will be an abundance of the Abbott rapid tests in America, so tourists should have no trouble bringing their results, or bringing a test with them and having it administered at the airport so that personnel can see the results in fifteen minutes. This “breakthrough,” says Barrow, should also mean a 2020 restart to cruise ship travel to Belize. Most cruise lines announced that they would not restart travel to Belize until 2021, but Barrow suggests that with the mass-produced tests, it should be no problem for cruise lines to test all passengers before they board the cruise ships, which would suggest a possible reversion to a 2020 restart for the cruise industry.