A frank look at where we are and a grim reminder about the road ahead.
A Deadly Cocktail
Recent actions by Caribbean Governments to bring stricter measures to combat COVID 19 and to open their economies have been met with a mixture of strong opposition and sighs of relief from different sections of the population. What is disturbing however, is the attempt by some Governments and some opposition parties to politicize the issues. Equally disturbing is the lack of individual responsibility by some persons who seem to believe that they are immune to this deadly disease.
Some of us are not realizing that our behavior can put many others at risk. The premature and risky declaration by some Governments of COVID free status has made some of us believe that the disease is gone. The truth is we don’t know if it’s gone. What we know is that one asymptomatic person, just one person, who may have been missed by the various screens can make hundreds of persons sick.
What we have simply been asked to do is to make a sacrifice far less than what any of our predecessors and ancestors made. Unlike many of our ancestors who had no rights, we are being asked temporarily not to exercise all our rights for the good of our aunts and uncles; grand parents; and great grandparents. These at risk persons who we could infect, ironically are the ones who made sacrifices for us in the past that allow us to have the rights which we now enjoy.
With respect to the politicizing of COVID. Politics and pandemics definitely do not mix and if they do, the resulting cocktail is a deadly one, often with some catastrophic consequences. The reason for this is simple. Politics is adversarial and divisive. By its nature it creates winners and losers and it also thrives on divide and conquer. Pandemic recovery is different. It requires uniformity of thought and behavior. Without the population uniformly complying to set standards and protocols the disease cannot be defeated. The actions of one person can affect the entire population. This is totally opposite to democratic politics which encourages rampant individualism. In politics two or more sides fight against each other for power but unfortunately now the fight is not with each other, it is with an unprecedented dangerous virus.
If we in fact examine the countries which have managed this virus the best there is a very common trend. Most of them have very good leaders, strong and in touch Governments and Governmental Systems; responsible opposition parties, a robust private sector and a population willing to make sacrifices. Taiwan; New Zealand; Singapore; Germany; South Korea; Canada; Iceland and Argentina all have received high marks. Some may argue that Argentina can not be described as having a strong Government and that maybe true. However, a responsible opposition allowed them to take a bi partisan approach to this problem.
So how do Caribbean Governments stack up? Caribbean Governments have largely taken themselves and their populations away from the most serious consequences of the pandemic. Geography allows this. Most Caribbean Governments quite wisely, instituted early lockdowns meaning that the pandemic’s impact was minimal. Some Caribbean islands also have had extremely robust testing and contact tracing programmes. Aruba, Barbados, Cayman Islands, Grenada and St Barths are probably the model countries in the Caribbean.
However the true test is yet to come. The Forbes Coronavirus safety index describes the Caribbean in the following way, “ most of the countries there have apparently underdeveloped healthcare infrastructure, lack of efficient anti-crisis government management and zero experience to neutralize bio-hazard threats. Yes indeed, currently as they are geographically separate islands it creates temporarily perception [of] safety, but as most of them are directly dependent on tourism, once the tourists will start to arrive in the next weeks and months, those locations might quite quickly become problematic zones.”
In other words the worse may still be yet to come for us. But what are the threats facing the Caribbean and what would we be facing. Let’s look at some of the realities we are facing in the region and some of the eventualities.
Testing and Contact Tracing
Most Caribbean Governments have not done nearly enough testing, meaning that the true picture of the virus may or may not be known. In fact, most Governments have done only responsive testing, instead of a random, representative section of the population. On the other hand, contact tracing and reporting has been better. With the close knit populations and family ties which we enjoy, identification of contacts and reporting of disease has been much more successful. The main problem with reporting has been stigma and the discriminatory behavior which it may encourage. Health officials fear this may have driven some persons underground.
Testing needs to be more representative of the population and should be scheduled. A national testing policy needs to be formulated for each island and should be clearly articulated to the population. As borders open testing will become more important as an early warning mechanism. Therefore it must now be looked at in a more strategic way instead of reactive. Governments must realise that tests are snapshots in time and their validity has a time limit. There will need to be a monthly testing regime of all at risk workers and visitors. Therefore Caribbean Governments should also be sharing information and jointly procuring test kits and PPE to get best available pricing and sourcing.
To Open Or Not
Opening the local domestic economy is something most Caribbean Governments have done. With strict protocols most Caribbean islands have opened their local economies. However, this has encouraged a level of complacency which has quickly festered because most Caribbean residents are still ignorant about the consequences and damaging effects an outbreak can cause. Also many people saw the end of lockdown as the end of danger. Caribbean Governments have also not done the best job in communicating this message and most have focused their messaging too heavily on announcement of cases.
Consider the following:
Our small populations mean that our working populations are also small. Consider the OECS islands for example. The working population in many OECS islands is between 20 to 50 thousand persons. Now let’s look at some specifics. In any one OECS country there are between 300 to 700 police officers, about 200 to 600 qualified construction workers; and between 50 to 200 stevedores. Imagine if 100 of any of these workers were infected at any one time. This could mean a shut down of the port; A shut down of all major construction sites and a severely compromised and ineffective security/ policing situation. Unlike other parts of the world if the stevedores or the qualified construction workers are infected, there is no second or third crew of workers to call in from another part of the country. What makes it worse is that full recovery from COVID is not Guaranteed. Many persons are left with long lasting debilitating conditions. This means that essential services could be compromised for an extended period of time.
Our small size means that people are using the same facilities over and over again. This leads to density spikes during the normal course of a day. Therefore, unlike other places where there are several options in supermarkets for example, in the Caribbean a significant percentage of the population is going to the same supermarket or the same Government building. This means that if an infection is spreading in a building it could likely infect a significant percentage of the population.
Our healthcare systems are already stretched. Most Caribbean countries already have serious challenges with their health care systems. There is no Caribbean country which can comfortably fight a deadly pandemic given already constrained health care systems. This could result in large numbers of deaths and a severe health crisis.
The high incidence of obesity and chronic diseases means that Caribbean people are predisposed to adverse effects of COVID. Chronic diseases and obesity make this virus more deadly and severe. In some Caribbean countries well over half of the working and retired population would be at a higher risk because of pre-existing Chronic conditions and obesity.
Our travel and service based economies mean that reopening travel is important. In some Caribbean islands 60 to 80 percent of GDP is derived from tourism, travel and leisure related services. What compounds this is the heavy dependence on the USA and UK tourism, two countries where the virus is still out of control. Even more worrying is the large Caribbean population in the USA in particular. Many of our Caribbean people are being affected by inadequate health care in the USA and are seeking repatriation flights back to the region. All of this puts us at higher risk.
Because of early action of Governments to shut down and subsequent announcements that certain islands were COVID free meant that attitudes to COVID have become way too lax which makes the region more vulnerable. Safety protocols in many places have already been watered down and without independent monitoring and strict enforcement we may find ourselves unprotected.
Finally if the news were not bad already please consider that we are in one of the most active hurricane seasons we have experienced for a long time. The impact of any hurricane on the region could severely compromise all of our COVID mitigation systems and create a really serious disaster. This is compounded because the entire international community is already dealing with this pandemic and we are not guaranteed hurricane relief assistance.
If this sounds bleak it is because it is. We are in the most serious crisis the Caribbean has faced in modern times. It is more serious than world wars; natural disasters; recessions or any other thing we may have faced before.
Governments need to continue to act decisively. Caribbean residents need to get a grip of reality and stop expecting the situation to get back to normal quickly. If we are not more responsible and consistent in our everyday behavior we will pay a heavy price.
In the mean time Caribbean Governments need to seize this opportunity to integrate around COVID and should consider the following:
An agreed Caribbean testing policy, operational protocols and entry protocol for ALL flights. This should be done as a regional project, with each island taking examples and best practice measures from each other.
The consideration of a cessation on all USA flights except those on specially arranged charters. This may happen anyway as some experts think that US based airlines may have to discontinue international flights as the situation in the US continues to worsen and more and more countries ban US visitors.
Better communication and more transparency with the regions people on the risks and deadly consequences of this pandemic
More transparency in dealing with COVID. Government should establish a COVID council to disseminate information and hear feedback and input. This council should have representatives from different sections of society including the Opposition parties.
Above all Caribbean Governments should take the Latin phrase, Festina Lente “ hasten slowly” to their reopening plans. These re-openings should be performed with a proper balance of urgency and diligence. If tasks are rushed then mistakes are made and successful long-term results are not achieved. They should also probably note that it is the countries which are able to produce adequate protocols; enforce strict compliance laws; unite the population and execute all plans flawlessly that will be the most successful. The ones that rush to open and to “get back to normal” will most likely get the worse results. And the people of the region willing to make the most sacrifice and exercise the most patience will be the ones who will have the best results.