CMO: Covid19 deaths linked to lifestyle diseases

People came out for a lime on Brian Lara Promenade and to shop in downtown Port of Spain on Saturday morning. PHOTO BY SUREASH CHOLAI  -
People came out for a lime on Brian Lara Promenade and to shop in downtown Port of Spain on Saturday morning. PHOTO BY SUREASH CHOLAI -

As the number of deaths increases, 33 as of Saturday, people with covid19 comorbidities need to be more careful.

Chief Medical Officer Dr Roshan Parasram said local trends in covid19 deaths continue to be in line with international trends, and specifically named risk factors such as diabetes, hypertension, oncology-related illnesses such as cancer, and being over 60.

The World Health Organization has said people with underlying health conditions, such as non-communicable diseases (NCDs) including diabetes and cancer, have a higher risk of severe cases of covid19, and are more likely to die from the virus.

At the Ministry of Health’s virtual covid19 press conference, on Saturday, Health Minister Terrence Deyalsingh said covid19 disrupted the operation of outpatient clinics. He therefore urged members of the public to take more responsibility for their various conditions and told patients to continue with their medication, diet and exercise routines.

He said one of the ministry’s strategic objectives was to reduce NCD deaths by 25 per cent by 2025.

But he warned, “I will not be surprised if there is some negative fallout on our NCD plans for 2025 because of covid19.”

He said, however, the ministry had already taken steps to achieve its objective, including banning the sale of soft drinks in schools, which resulted in a 25 per cent decrease in soft-drink purchases by school-age children.

The ministry also recognised the need to treat obesity from the womb to the aged.

He also said, “We will be signing off, very soon, for the first time in this country, a national policy on testing all women for what is called gestational diabetes." This is diabetes that develops in pregnant women.

In addition, there were plans to instal exercise equipment in schools and public spaces, encouraging people to eat more healthily, and more.

Testing and treatment

Parasram said there has been a “small decrease” in the number of people going to be tested for the virus. Despite that, the ministry was setting up three more labs, at the North Central RHA (NCRHA), South West RHA (SWRHA), and the Medical Research Foundation.

He said they should be up and running next week or the week after, allowing approximately 600 additional tests to be done each day.

Deyalsingh added that an Abbott polymerase chain reaction (PCR) test machine had already been installed in the SWRHA, training was complete, and 8,000 test kits were available and had been sent to the three new labs. Reagents should arrive in the country soon and testing should start by next week.

Parasram explained that test results were usually generated within 24-48 hours of samples arriving at labs. The results were then put in the system and sent to the various county medical officers of health, who would then contact patients. The whole process from the time a patient was swabbed could take from five to seven days.

To those waiting for results, if their symptoms worsen, he said they should go to a health facility for care.

Deyalsingh added that they could call 811 and the Global Medical Response ambulance service would take them to an appropriate medical facility.

Parasram said studies showed that the deaths of critically ill patients decreased with the use of systemic steroids. In TT, medical professionals have used corticosteroids such as hydrocortisone in patients with covid19.

“It is not considered a treatment (for covid19) per se," he explained. "It is considered supportive care for any inflammatory condition, which covid19 seems to be in certain parts of the body, for example the respiratory system, as well as the vascular system.”

CMO: Employers, take care of staff

While public health inspectors visit organisations to determine compliance with the public health guidelines, Parasram said no action could be taken against employers for not following them.

“Having said that, under the public health ordinance, we don’t take to task the employer unless there is something that speaks beyond guidelines but goes directly to the law...So we are asking for persons to abide by the public health guidelines – they are all on our website – making sure that your employees are safe when they come to work.

"And most importantly, that there is some level of checking, prior to coming in to work every single day, that we can do beyond fever screening alone.”

He told employers when their staff returned to work from quarantine, negative covid19 test results, fit-for-duty certificates, or sick-leave certificates were unnecessary because they were not sick, although they had been exposed to the virus. He said the CMOH's office would give the employee a letter citing the dates and length of the quarantine.

“If you have no illness during that period, you have no signs and symptoms, you have not become positive, once your quarantine period ends, we issue the quarantine order. You can give it to your employer, and that should suffice in terms of coming out of your quarantine.”

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