DR VISHAM BHIMULL
Primary Care Physician
AS covid19 continues to surge internationally, sufficient time has elapsed for it to mutate and evolve.
This has resulted in the emergence of variants of concern (voc) like the delta variant which is significantly more transmissible than the original Wuhan strain.
Such variants have caused alarm since based on preliminary data, World Health Organization (WHO) approved vaccines seem less effective at controlling the spread. The WHO recently said 24 countries have almost vertical epidemic curves which reflect new waves of the pandemic due to this delta variant.
Many factors have contributed to this precarious positions. The major reason is the issue of vaccine inequity. As long as vaccines are not available to the more populated poorer countries, our goal of herd immunity to stop the transmission will not be realised.
As many countries like TT begin opening up, the possibility of the delta variant entering our country looms large. An increase in social mixing and mobility leaves us ripe for a next surge involving this new variant.
Our downfall in the past has been the inappropriate use of public health and social measures. Lockdown and curfew will indeed ultimately reduce the spread, but at a detrimental cost to the economy.
Coming out of our last surge, what are our short, medium and long term plans to prevent another from taking place?
An approach that looks at utilising the public health tools available to deter social mixing and mobility needs to be implemented from individual to community levels. The public health message of the 3Ws; Wash your hands, Wear your mask and Watch your distance, are now very prevalent in general and social media coming out of the last surge.
They have done a tremendous amount to inculcate a change in behaviour at an individual level by our citizens resulting in a breaking of the chain of transmission. However, with the opening of our borders and easing of restrictions, more such public health messages are needed as part of a short- and medium-term plan to achieve such a “new normal.”
It is crucial that the Ministry of Health reiterate the need for people to wisely choose their outings based on three factors – location, proximity and time – since this can curb new infections.
Location: open-air spaces are always safer than enclosed ones; proximity: it is safer when there are fewer people around and you can keep a safe distance and; time: the shorter your activity lasts, the better to prevent contracting the virus.
While we see variants that make vaccines somewhat less effective, most experts think it is unlikely one will emerge that evades our vaccines. The vaccines we have still protect, to some extent, against all variants.
In the US and Europe, the current stage of the pandemic is taking a toll on the unvaccinated rather than the vaccinated.
The most recent data shows that current vaccines may not protect completely from contracting the virus, but they do protect against complications, hospitalisations and death.
When the delta variant comes to TT, having a significantly vaccinated population will reduce the morbidity and mortality were we to have another surge.
Finally, a community approach to preventing the spread is essential.
This would require more private and public business stakeholder meetings with the government. One of our major follies back in April was that apart from insufficient public health messages, establishments were not properly mandated to take appropriate measures to curb congregations.
Thus far, businesses have taken it upon themselves to implement online engagements, online appointment systems, home deliveries and on-site pick-ups as measures to prevent congregation.
However, more government influence on local businesses based on WHO guidelines is needed so that at a community level, activities go on in a manner that limits congregating.
Implementing such measures at individual and community levels will go a long way in being proactive against the spread of covid19 rather than being reactive such as imposing lockdowns and curfews.