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More testing, tracing needed to curb spread of COVID-19- former Health Minister

Samuel Sukhnandan

Dr. Leslie Ramsammy

With scores of new confirmed cases of COVID-19 and 19 deaths already recorded in Guyana, the government is being urged to ramp up testing and create a robust contact tracing strategy that will lend towards controlling the spread of the deadly pandemic.

Former Health Minister Dr. Leslie Ramsammy told News Talk Radio 103.1 FM/Demerara Waves Online in an exclusive interview on Monday that Guyana lags far behind in testing, while explaining that where countries have succeeded in controlling the pandemic, testing has been one of the major interventions.

“Thus far, Guyana has not procured any testing on its own. It has depended entirely on PAHO/WHO (Pan American Health Organisation/World Health Organisation) for testing kits. Government has made no effort to expand its testing capacity by procuring more test kits and by installing more infrastructural capacity,” he said.

Dr. Ramsammy had urged the government since early January that Guyana should aggressively move to have and expand its testing capacity. However, he said, authorities failed to do so and up to now has shown no inclination towards a strategy of mass testing, even when targeted testing is now not enough.

Two weeks ago, government locked down mining areas in Aranka/Arangoy in Region Seven (Cuyuni-Mazaruni) and Moruca in Region One (Barima-Waini) and conducted mass testing and surveillance for COVID-19.

He noted that while many Caribbean Community (CARICOM) countries have brought their numbers under control, the situation in Guyana is not the same. “Guyana has not only failed to control the epidemic, but have acted in a manner that provides the perfect storm for the escalation of the COVID-19 epidemic. The government has totally mismanaged the COVID-19 public health crisis,” he opined.

Dr. Ramsammy who served as the first chairman of the Caribbean Public Health Agency (CARPHA) told this publication also that Guyana has the lowest COVID-19 testing record in CARICOM. Whereas Jamaica, which has just over 700 confirmed cases is testing close to 10,000 persons per million, Guyana’s rate is just over 3,000.

“This means that Guyana is testing at a rate less than 30 percent compared to Jamaica. Given that we are aware of hot spots, at the minimum, there should have been more wide-scale opportunistic testing in those areas. Clearly, Georgetown, Region One, Seven, Eight and Nine require far more extensive testing,” he added.

The former health minister said with more than 300 confirmed cases, there could be approximately 3,000 people who might be COVID-19 positive. “Research in all countries so far shows that in places where testing is limited, only about 10 percent of the cases are confirmed. In the United States (US), it has been shown that for every confirmed case, there are at least 10 cases where people carry the COVID-19 virus, are asymptomatic and have not been tested, but have the capacity to spread the virus.”

Strategy
In making the point that testing is good, Dr. Ramsammy told News Talk Radio 103.1 FM/Demerara Waves Online that its effectiveness is also based on its twinning with contact tracing. And given the widespread nature of the epidemic right now, he noted that contact tracing becomes far more challenging. Nevertheless, he has recommended that the government implement a robust contact tracing strategy.

“The government will argue that contact tracing was in place from the beginning. First, whatever exists has been clueless. But with limited testing, it also means limited contact tracing. Where testing has been done, it has been largely ineffective, since the government’s tracing was weak. There should have been a contract tracing team established and dedicated towards this task. A national contact tracing manager should have been appointed and given full control of the process,’ he added.

In summary, the former health minister said that in order for Guyana to be effective in tackling the pandemic, there must be more mass testing, contact tracing must identify not only all persons infected, but all persons exposed. Further, he recommended that no one should be allowed in any public space without masks.

Dr. Ramsammy did not stop there, but went on to say that a more effective lock down and aggressive public communication and social distancing campaign are also needed. Special attention should also be given to monitoring the Brazilian and Venezuelan borders, especially in areas where there is present uncontrolled movement of people.

He is of the firm view that the pandemic is not only a public health crisis, but a humanitarian crisis as well. He therefore thinks that the government needs to implement a wide-scale safety- net public assistance programme, which must include cash subsidies, food support, rent support, and tax subsidies, among others.

“While there is increasing talk of reopening, returning to normal, it is too early and a more clear-eyed lock-down strategy is important. If schools are to be open, a reopening strategy must be in place and must include all the recommendations for school reopening contained in the WHO and CDC guidelines. The same for other workplaces.”

On a positive note, he said doctors and nurses have done a good job in managing patients, and Guyanese must be grateful for the work the medical staff in Guyana has done.

The National COVID-19 Task Force recently approved the roll out of phase three of the reopening plan, where curfew hours have been reduced, outside dining is now permitted and government workers are to resume work based on a rotation plan.