COVID-19 hits Montserrat

Contribution, Part 104 – 4/2020

After BA Flight 2157 on Tuesday, March 10, COVID-19 is here.  How can we cope?

BRADES, Montserrat, March 22, 2020 –  On Tuesday, March 17, the Government of Montserrat called a press conference, scheduled for 5:00 pm. During the conference, Hon. Minister of Education, Mr. Charles Kirnon, announced that we have a confirmed case of COVID-19 here in Montserrat. This person had flown into Montserrat the previous Tuesday on British Airways, Flight 2157, along with the first confirmed case for Antigua and as one of the  “eighty-plus” traveling to Montserrat announced on Saturday, March 14th by Hon Premier Easton Taylor-Farrell. 

The Covid-19 virus on the attack. In an infection, the virus binds to cell surfaces, allowing penetration. The cell is then hijacked to replicate and distribute further copies of the virus (Cr: Australian Pharmacist & US CDC)

(NB: The number traveling here on BA 2157 was later revised to 104, without explanation. For a week, these exposed travelers – and likely others exposed overseas and locally – were freely circulating in our community. By St Patrick’s Day, only 88 of these had been reached by authorities trying to manage the epidemic. Officials asked the others to contact them. Where, also, if we add to March 10, 14 days for incubation we can see that March 24 on will be a key time to see if a surge of further cases will emerge here. Hopefully, not.)

Immediately, such developments underscored just how ill-advised it had been to proceed with the St Patrick’s festival “as usual,” despite warnings and pleas by Lawyer Jean Kelsick and others. To date, no clear explanation for this decision has been given.

And no, it was not simply “a matter of time” before the pandemic reached our shores.

For, by proceeding with “business as usual” for St Patrick’s, we brought here perhaps 2,500 people [a 50% jump in our population], many coming from countries where the epidemic had already broken out of containment and was spreading rapidly. Obviously, too, passenger screening measures here, in Antigua and in the UK failed.  So, now, we must prepare to try to manage a pandemic with our temporary hospital, lack of equipment and inadequate staff numbers.

Then, on Friday, March 20, His Excellency, Governor Andrew Pierce announced in the name of the UK FCO, that British Nationals were to expedite their return to the UK. This hints that the sort of travel bans and restrictions already headlined for the USA and other countries may likely impact the UK; where perhaps 7,000 volcano crisis-displaced Montserratians live.

How can we cope?

For one, we must recognise that we face a pandemic spread by a highly contagious and deadly virus that (on estimates of death rate being suggested by experts) likely will kill 1 – 3+ percent of those who catch it; it thus seems to be over ten times as deadly as the common yearly influenza. Where the aged are particularly vulnerable, the disease is highly contagious during its a-symptomatic incubation stage of up to 2 – 3+ weeks, and it seems that deaths on average happen 17 days after onset of symptoms. Those who recover – which takes longer on average – may suffer permanently diminished lung functionality.

Also, the epidemic models suggest that if it is unchecked, over the course of several months to about a year, it can infect 20 – 70+ percent of a population, with perhaps 50 – 80% of cases being mild or even asymptomatic.

Obviously, such a disease can easily overwhelm health care (and especially critical care) facilities, equipment and staff in advanced countries, much less in a country with a temporary hospital that is struggling to recover from a volcano crisis. It is vital, that we find a way to flatten out and diminish the spike of new cases if we are to prevent overloading of our health care facilities; which can trigger the much higher death rates we are seeing in Italy and saw in Wuhan, China.

That means, “social distancing” is key.

That is, we need to break the transmission cycle for the disease. A good approach has been suggested by Dr. Sanjay Gupta: assume you have the disease and now try to prevent passing it on to others. Hand washing, stopping from touching your face and surfaces others will contact, sanitising surfaces, keeping six feet away from others (so particles from our noses and mouths will settle towards the ground), avoiding groups, only going to where one must go, etc.

It may even be necessary to lock down our community for several weeks to break the spreading cycle, isolating and treating cases that emerge in the interim.

Then, after that, we will have to be far more vigilant about border protection and social distancing until the global surge in cases dies away. Unfortunately, pools of the virus will remain and its rapid mutation rate may well mean that we face further global surges. As a comparison, the 1918 “Spanish Flu” came in two to three waves, with the deadliest strain being in wave 2.

Is there any good news?

Yes. Credible initial reports suggest that a cocktail of [Hydroxy-]Chloroquine and  “Z-Pack” [ i.e. azithromycin, an antibiotic for bronchitis] has been especially effective in suppressing the viral infection, in initial studies in France, Australia and China. Bayer, who discovered Chloroquine [an anti-Malaria drug] in 1934, has donated three million chloroquine phosphate tablets to the USA and testing is on the fast track. Apparently, many doctors are already prescribing it. Other drugs are being investigated, blood plasma from survivors has been used to provide antibodies and various initiatives are underway to develop a vaccine. However, vaccines will take time.

What about economic fallout and bailouts?

The USA, the UK, and other countries are unveiling pandemic economy stimulus packages meant to restore confidence and to provide businesses and households with some emergency cash. This is because a breakdown of economic activity and investor confidence could easily trigger a recession or worse. Indeed, some have suggested a possible 24% decline in GDP, great depression-level numbers; but that is likely to be extreme. Worse for the Caribbean, Tourism is our only globally competitive industry; pandemic triggered drop-offs in tourism arrivals will obviously hit us hard.

For Montserrat, that means that we will have to go hat-in-hand to the UK, appealing for further help under the force of the UN Charter, Article 73 which the UK acknowledges to be legally binding. It is under this, that 60% of our recurrent budget and up to 90% of our capital budget has been funded over the years.  (Yes, this also means that those who have dismissed the UN Charter and the linked C-24 visit last December did Montserrat no favours.)

We will also need to see if we can expedite and expand the £30 million CIPREG capital programme negotiated by the former Donaldson Romeo-led PDM administration. For example, the case for a purpose-built, world-class standard local hospital has been strengthened and we obviously urgently need a significant upgrade for equipment, training and staffing our health care services.

More subtly, we may notice how digitally based work from home, distance education, teleconferencing, telemedicine, e-cash and more have been given a step-change boost through the pandemic.

This points to the relevance and urgency of the Fibre Optic Cable project that is also part of the CIPREG project. Where, already, ducting is being installed and the survey has been done.

Thus, too, we must bend every effort to expedite fibre optics and digitalisation, as the global digital sector just got a huge push. Onward, we have to seriously upgrade education and training for our people to be ready for digital productivity in the coming, even more digitalised world economy.

So, yes, there is hope.

Yes, we have to face and fix our stumbles.

Yes, we are to have faith and confidence and we must always pray, but we must also be well-informed, prudent and we must act soundly in good time.

END

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Contribution, Part 104 – 4/2020

After BA Flight 2157 on Tuesday, March 10, COVID-19 is here.  How can we cope?

BRADES, Montserrat, March 22, 2020 –  On Tuesday, March 17, the Government of Montserrat called a press conference, scheduled for 5:00 pm. During the conference, Hon. Minister of Education, Mr. Charles Kirnon, announced that we have a confirmed case of COVID-19 here in Montserrat. This person had flown into Montserrat the previous Tuesday on British Airways, Flight 2157, along with the first confirmed case for Antigua and as one of the  “eighty-plus” traveling to Montserrat announced on Saturday, March 14th by Hon Premier Easton Taylor-Farrell. 

Insert Ads Here
The Covid-19 virus on the attack. In an infection, the virus binds to cell surfaces, allowing penetration. The cell is then hijacked to replicate and distribute further copies of the virus (Cr: Australian Pharmacist & US CDC)

(NB: The number traveling here on BA 2157 was later revised to 104, without explanation. For a week, these exposed travelers – and likely others exposed overseas and locally – were freely circulating in our community. By St Patrick’s Day, only 88 of these had been reached by authorities trying to manage the epidemic. Officials asked the others to contact them. Where, also, if we add to March 10, 14 days for incubation we can see that March 24 on will be a key time to see if a surge of further cases will emerge here. Hopefully, not.)

Immediately, such developments underscored just how ill-advised it had been to proceed with the St Patrick’s festival “as usual,” despite warnings and pleas by Lawyer Jean Kelsick and others. To date, no clear explanation for this decision has been given.

And no, it was not simply “a matter of time” before the pandemic reached our shores.

For, by proceeding with “business as usual” for St Patrick’s, we brought here perhaps 2,500 people [a 50% jump in our population], many coming from countries where the epidemic had already broken out of containment and was spreading rapidly. Obviously, too, passenger screening measures here, in Antigua and in the UK failed.  So, now, we must prepare to try to manage a pandemic with our temporary hospital, lack of equipment and inadequate staff numbers.

Then, on Friday, March 20, His Excellency, Governor Andrew Pierce announced in the name of the UK FCO, that British Nationals were to expedite their return to the UK. This hints that the sort of travel bans and restrictions already headlined for the USA and other countries may likely impact the UK; where perhaps 7,000 volcano crisis-displaced Montserratians live.

How can we cope?

For one, we must recognise that we face a pandemic spread by a highly contagious and deadly virus that (on estimates of death rate being suggested by experts) likely will kill 1 – 3+ percent of those who catch it; it thus seems to be over ten times as deadly as the common yearly influenza. Where the aged are particularly vulnerable, the disease is highly contagious during its a-symptomatic incubation stage of up to 2 – 3+ weeks, and it seems that deaths on average happen 17 days after onset of symptoms. Those who recover – which takes longer on average – may suffer permanently diminished lung functionality.

Also, the epidemic models suggest that if it is unchecked, over the course of several months to about a year, it can infect 20 – 70+ percent of a population, with perhaps 50 – 80% of cases being mild or even asymptomatic.

Obviously, such a disease can easily overwhelm health care (and especially critical care) facilities, equipment and staff in advanced countries, much less in a country with a temporary hospital that is struggling to recover from a volcano crisis. It is vital, that we find a way to flatten out and diminish the spike of new cases if we are to prevent overloading of our health care facilities; which can trigger the much higher death rates we are seeing in Italy and saw in Wuhan, China.

That means, “social distancing” is key.

That is, we need to break the transmission cycle for the disease. A good approach has been suggested by Dr. Sanjay Gupta: assume you have the disease and now try to prevent passing it on to others. Hand washing, stopping from touching your face and surfaces others will contact, sanitising surfaces, keeping six feet away from others (so particles from our noses and mouths will settle towards the ground), avoiding groups, only going to where one must go, etc.

It may even be necessary to lock down our community for several weeks to break the spreading cycle, isolating and treating cases that emerge in the interim.

Then, after that, we will have to be far more vigilant about border protection and social distancing until the global surge in cases dies away. Unfortunately, pools of the virus will remain and its rapid mutation rate may well mean that we face further global surges. As a comparison, the 1918 “Spanish Flu” came in two to three waves, with the deadliest strain being in wave 2.

Is there any good news?

Yes. Credible initial reports suggest that a cocktail of [Hydroxy-]Chloroquine and  “Z-Pack” [ i.e. azithromycin, an antibiotic for bronchitis] has been especially effective in suppressing the viral infection, in initial studies in France, Australia and China. Bayer, who discovered Chloroquine [an anti-Malaria drug] in 1934, has donated three million chloroquine phosphate tablets to the USA and testing is on the fast track. Apparently, many doctors are already prescribing it. Other drugs are being investigated, blood plasma from survivors has been used to provide antibodies and various initiatives are underway to develop a vaccine. However, vaccines will take time.

What about economic fallout and bailouts?

The USA, the UK, and other countries are unveiling pandemic economy stimulus packages meant to restore confidence and to provide businesses and households with some emergency cash. This is because a breakdown of economic activity and investor confidence could easily trigger a recession or worse. Indeed, some have suggested a possible 24% decline in GDP, great depression-level numbers; but that is likely to be extreme. Worse for the Caribbean, Tourism is our only globally competitive industry; pandemic triggered drop-offs in tourism arrivals will obviously hit us hard.

For Montserrat, that means that we will have to go hat-in-hand to the UK, appealing for further help under the force of the UN Charter, Article 73 which the UK acknowledges to be legally binding. It is under this, that 60% of our recurrent budget and up to 90% of our capital budget has been funded over the years.  (Yes, this also means that those who have dismissed the UN Charter and the linked C-24 visit last December did Montserrat no favours.)

We will also need to see if we can expedite and expand the £30 million CIPREG capital programme negotiated by the former Donaldson Romeo-led PDM administration. For example, the case for a purpose-built, world-class standard local hospital has been strengthened and we obviously urgently need a significant upgrade for equipment, training and staffing our health care services.

More subtly, we may notice how digitally based work from home, distance education, teleconferencing, telemedicine, e-cash and more have been given a step-change boost through the pandemic.

This points to the relevance and urgency of the Fibre Optic Cable project that is also part of the CIPREG project. Where, already, ducting is being installed and the survey has been done.

Thus, too, we must bend every effort to expedite fibre optics and digitalisation, as the global digital sector just got a huge push. Onward, we have to seriously upgrade education and training for our people to be ready for digital productivity in the coming, even more digitalised world economy.

So, yes, there is hope.

Yes, we have to face and fix our stumbles.

Yes, we are to have faith and confidence and we must always pray, but we must also be well-informed, prudent and we must act soundly in good time.

END