During his presentation on the 2020 National Budget, Minister of Health Dr Frank Anthony claimed that the former APNU+AFC Govern-ment did not test samples from deceased persons who displayed COVID-19 symptoms. The minister alleged in his presentation that when persons who had all the clinical symptoms of COVID-19 died, the staff were instructed not to take samples from those patients and test them, therefore those deaths would not have been accounted for as COVID-19 deaths.
Considering that the testing of bodily fluid following a post-mortem was how Patient Zero, a woman who had travelled from the US to Guyana, was confirmed as having died from the coronavirus, this allegation, if true, raises major concerns. What would have been the reason to deviate from that? Given the seriousness of this disease, it boggles the mind that any government would choose to not just hide, but ignore the true picture, and worse, that public health professionals would allow themselves to be used in that manner.
In his speech, the minister referred to a World Health Organisation (WHO) model, which he said will be used by the Ministry of Health to determine excess deaths (mortality) during the pandemic. He said his ministry will be using the methodology to show the former government all the mistakes they made. Having not yet implemented use of the WHO methodology when his speech was made, how did the minister arrive at the conclusion that COVID deaths were underreported during the period mid-March to end of July? Was this based on hearsay? If not, how was the evidence gathered? Were death registrations checked? Or was this assumption arrived at by some sort of Harry Potteresque divination?
Dr Anthony had also said early in September that the spike in COVID deaths was owing to underlying conditions. He was quoted as saying, “So we had a few cases like that as well and the majority of cases when we did an analysis on deaths, you would see that they are older people and many of them had varying risk factors including other diseases.” It has always been known that people with underlying illnesses are more susceptible to contracting and dying from the coronavirus, so this does not explain the spike, particularly when so many residents of the Palms were touted as success stories in recovering from COVID-19. Further analysis clearly needs to be done.
Meanwhile, excess mortality, which the minister spoke of, is a term used in epidemiology and public health that refers to the number of deaths from all causes during a crisis, above and beyond what would be expected under ‘normal’ conditions. In this instance, researchers would be interested in how deaths during the COVID-19 pandemic compare to the average number of deaths over the same period in previous years. According to Our World in Data, excess mortality is a more comprehensive measure of the total impact of the pandemic on deaths than the confirmed COVID-19 death count alone. In addition to confirmed deaths, excess mortality captures COVID-19 deaths that were not correctly diagnosed and reported as well as deaths from other causes that are attributable to the overall crisis condition.
According to the Guyana COVID-19 Dashboard, the country has witnessed an exponential rise in deaths, from 20 between mid-March and the end of July to 78 up to September 27. Such a sharp increase requires the minister to provide the nation with an evidence-based response rather than speculate about the possible cause for the increase.
It is a matter of record that testing during the period March 15 to mid-August was not being done at the optimum rate. As of April 21, 348 tests had been done; 1,401 by May 23, and 3,685 by July 18 and the data revealed that approximately 40 percent of all confirmed cases were asymptomatic. Under such conditions it is not surprising that community spread continued undetected. The absence of a full lockdown also contributed to the spread of the disease.
There is no denying that the declaration of the results of the March 2 general and regional elections and the swearing in of the new administration saw a rapid scale-up in testing across all regions. As of September 26, 13,453 tests had been conducted. And as should have been expected, the increased testing has resulted in increased numbers of confirmed cases of COVID-19.
Socio-economic considerations prevented both the previous and the current administration from implementing a full lockdown, but with the curve steadily moving upward citizens must take responsibility to protect themselves from COVID-19. This includes complying with the control measures including wearing masks, adhering to social distancing guidelines and the night curfew, washing their hands, and sanitising their environment.
That said, citizens also have a right to demand that the government works harder to curb COVID-19 morbidity and mortality, and this includes providing the citizenry with clear and pertinent information. To this end, has the Ministry of Health implemented the WHO methodology to determine whether there were excess deaths? If not, when will this be done? Further, if the findings do not corroborate Dr Anthony’s conclusion, an investigation should immediately follow to determine the reason(s) for the increase in deaths among COVID-19 patients at a time when more resources are available.
Funding is being pumped into the battle to curb COVID-19 here. In April, the US government made available US$475,000 to help address Guyana’s priority areas of laboratory diagnostics and systems strengthening and supplies, surveillance, infection prevention and control, and emergency operation centres. And Dr Anthony announced on September 25 that the Global Fund to Fight AIDS, Malaria and Tuberculosis was providing US$357,894 in additional financial assistance that would further boost the Ministry of Health’s COVID response. Recently, donations have also been made of cash and equipment. One hopes that these resources will be used for the purposes stated. COVID-19 is much too dangerous for anything else.
