Dear Editor,
When I was Minister of Health, I engaged the private sector every time we had to respond to public health challenges. In 2005, the private sector played a significant role in the flood response. In 2002, although Guyana did not have to deal with SARS, Guyana was already prepared months ahead, and we had engaged the private sector. We did so again with the Avian Flu in 2009 and with MERS in 2012. For, example, the private sector provided support in leptospirosis testing in 2005. In 2005, in order to assist GPHC, we shifted all our maternity cases to the private sector, while we devoted all our resources, including beds and spaces for other medical cases. Because, we needed more space for seriously ill medical cases coming in 2005, we shifted some of our ICU cases to private hospitals. The government made arrangements for covering the cost for patients we asked the private sector to manage on our behalf. Throughout Guyana’s fight against HIV, the private sector provided critical support. It is, therefore, troublesome to see the private sector begging to be engaged in the fight against COVID-19. That there has been no formal meeting with the private sector up to this time, is reckless and putting Guyanese lives at risk.
The private health sector must be mobilized in the fight against COVID-19. The private health sector has indicated their frustration that they have not been engaged to become part of the fight to crush COVID-19. Dr. Frank Anthony who is a member of the National COVID-19 Forum established by Dr. Irfaan Ali to support the national response has called for the mobilization of the private sector. It is an imperative, not an option, that the private sector become part of this fight. They are willing and waiting and national authorities must immediately, with much haste, engage the private sector. There are eight private hospitals – six in George-town, one on the East Coast Demerara and one in Region 6. There are more than a dozen private medical laboratories scattered around the country and there are now more than a hundred private doctors’ clinics in most of the regions of Guyana. To leave them out of the formal arrangements in fighting COVID-19 is reckless. I, therefore, join my colleagues, like Dr. Frank Anthony and the team in the National COVID-19 Forum, in urging the national authorities to engage the private sector. Too much time has elapsed and a critical component of the health sector has been sidelined.
The testing protocol in place more than one month since the first COVID-19 case was documented in Guyana is deadly flawed. That Guyana is only now testing 100 people is an indictment. There are already about 30 people test-confirmed for COVID-19. There are four deaths. Given that about 1% of COVID patients usually die, the four deaths indicate there are at least 400 cases in Guyana, and, therefore, a large number of asymptomatic persons walking around spreading COVID-19 SoV-2 viruses. The fact that there are about 200 people in isolation and most of these have not been tested show that the testing capacity is seriously limited. The private health sector has shown the ability to procure and provide health services. Since the public sector has shown it is limited in its ability to procure and provide wide scale testing, the private sector must be allowed to proceed. It is simply stupid, but also deadly, that the government has not seen the need to mobilize this critical capacity in private sector to help in testing for COVID-19.
Gathering COVID-19 data is critical, but the public health ordinance, the Ministry of Health Act and the Health Facilities Licensing Act mandates the private sector in providing the data we need. There was in 2005 and throughout the HIV response so far and for all infectious and non-communicable chronic diseases specific arrangements for the private sector to provide information for the national health statistics and for the epidemiological system.
The bureaucratic, autocratic approach in the COVID-19 response, where the government has sought to control the overall response, where the private sector has had their hands tied behind their backs, is reckless and deadly. That Guyana has chosen to paralyze a critical part of our health sector is irresponsible. The time has long passed for the national authorities to engage the private sector, not just the private hospitals, the private labs and the private doctors offices, but also the NGOs which have been a critical part of Guy-ana’s response to any public health challenge. Presently, it is these communities filling the vacuum for awareness and education, for getting the population adhering to social distancing and for proper hygiene and using of masks in public. Every citizen, every sector in Guyana is needed for the fight. The government’s restriction is foolish and deadly.
Yours faithfully,
Dr. Leslie Ramsammy
