Negocios

T&T hits grim milestone of 1,000 COVID deaths

Based on 2020 es­ti­mates from the Cen­tral Sta­tis­ti­cal Of­fice, 13.38 per cent, or 182,850 peo­ple, are above age 60 in Trinidad and To­ba­go.

As of April 2020, the Min­istry of Health said the coun­try had ap­prox­i­mate­ly 266,000 peo­ple (20.5 per cent of the pop­u­la­tion) with di­a­betes and 341,000 peo­ple (23.6 per cent of the pop­u­la­tion) with hy­per­ten­sion. Both co­mor­bidi­ties, ac­cord­ing to the Tech­ni­cal Di­rec­tor of the Min­istry of Health’s Epi­demi­ol­o­gy Di­vi­sion, Dr Av­ery Hinds, are the most com­mon ob­served COVID-19-re­lat­ed clas­si­fied deaths

Trinidad and To­ba­go reached the grim sta­tis­tic of 1,000 lives to the COVID-19 pan­dem­ic as of yes­ter­day.

The coun­try crossed the mile­stone af­ter two more deaths were record­ed.

COVID-19 has left no house­hold or fam­i­ly un­touched.

Near­ly one in every 39 peo­ple in the coun­try has been con­firmed to have the dead­ly virus.

Al­so, near­ly one in every 36 COVID-19 cas­es in the coun­try have lost their bat­tle with the dis­ease.

About one in every 1,400 peo­ple across Trinidad and To­ba­go have lost their lives to the dis­ease. How­ev­er, while ap­pear­ing high­er than the world av­er­age on the sur­face, ex­perts say it is not as con­cern­ing due to sev­er­al vari­ables.

The role of the Gam­ma (P.1) Vari­ant

In the last COVID-19 spike, oc­cur­ring be­tween late Au­gust 2020 and Oc­to­ber 2020, the coun­try re­port­ed 5,266 cas­es with 98 deaths. Dur­ing that pe­ri­od, rough­ly, for every 54 cas­es, the coun­try record­ed one COVID-19-re­lat­ed death. Based on avail­able gene se­quenc­ing, the dom­i­nant strain cir­cu­lat­ing then was the orig­i­nal SARS-CoV-2 strain (the virus that caus­es COVID-19) that orig­i­nat­ed in Wuhan, Chi­na.

On April 19, the Gam­ma (P.1) SARS-CoV-2 vari­ant, which orig­i­nat­ed in Brazil last No­vem­ber, was de­tect­ed in a lo­cal sam­ple with­in T&T’s bor­ders. Cas­es were al­ready surg­ing at con­cern­ing num­bers when this sam­ple was se­quenced. By the week of May 11, the Gam­ma vari­ant had ac­count­ed for 38 per cent of some 500 sam­ples se­quenced since De­cem­ber 2020.

Its in­creas­ing pres­ence in sam­ples se­quenced since April led Chief Med­ical Of­fi­cer (CMO) Dr Roshan Paras­ram and Pro­fes­sor of Mol­e­c­u­lar Ge­net­ics and Vi­rol­o­gy at the Uni­ver­si­ty of the West In­dies’ (UWI) Fac­ul­ty of Med­ical Sci­ences, Dr Chris­tine Car­ring­ton, to be­lieve it was be­com­ing the most dom­i­nant SARS-CoV-2 strain cir­cu­lat­ing in the coun­try. It’s an out­come ex­perts deemed as pre­dictable, giv­en the vari­ant’s high­er trans­mis­si­bil­i­ty and his­to­ry.

While ex­perts say the Gam­ma vari­ant has not been dead­lier, it is more in­fec­tious. Sta­tis­ti­cal­ly, more in­fec­tions re­sult in more deaths. AL­though its true role has not been con­firmed in all in­fec­tions since its dis­cov­ery be­cause of se­quenc­ing ca­pac­i­ty, from April 19 through Ju­ly 20, 2021, T&T record­ed 27,414 cas­es and 847 deaths, cre­at­ing an av­er­age of one death for every 32 cas­es for this pe­ri­od.

With a cur­rent case-fa­tal­i­ty rate of 2.75 per cent, ac­cord­ing to pul­mo­nolo­gist and dean at the UWI’s Med­ical Sci­ences Fac­ul­ty, Pro­fes­sor Ter­rence Seemu­n­gal, the fig­ures were with­in the sta­tis­ti­cal­ly ex­pect­ed range.

“When you look at it, our death rate is high­er than the world av­er­age right now, but when you look at the 95 per cent con­fi­dence in­ter­val…we are with­in that range, so I wouldn’t say that is some­thing to def­i­nite­ly wor­ry about,” he said.

The el­der­ly and co­mor­bidi­ties

COVID-19 does not dis­crim­i­nate – every­one is at risk for in­fec­tion.

In T&T, in­fec­tions have oc­curred in in­fants that are just months old to near-cen­te­nar­i­ans. Since the start of the pan­dem­ic, doc­tors and health of­fi­cials have warned the el­der­ly (those above age 60) and peo­ple with hy­per­ten­sion, di­a­betes and kid­ney dis­ease are at high risk.

Based on 2020 es­ti­mates from the Cen­tral Sta­tis­ti­cal Of­fice, 13.38 per cent, or 182,850 peo­ple, are above age 60 in Trinidad and To­ba­go.

As of April 2020, the Min­istry of Health said the coun­try had ap­prox­i­mate­ly 266,000 peo­ple (20.5 per cent of the pop­u­la­tion) with di­a­betes and 341,000 peo­ple (23.6 per cent of the pop­u­la­tion) with hy­per­ten­sion. Both co­mor­bidi­ties, ac­cord­ing to the Tech­ni­cal Di­rec­tor of the Min­istry of Health’s Epi­demi­ol­o­gy Di­vi­sion, Dr Av­ery Hinds, are the most com­mon ob­served COVID-19-re­lat­ed clas­si­fied deaths.

Dr Hinds al­so stat­ed in a press con­fer­ence in ear­ly June 2021 that oth­er pre-ex­ist­ing con­di­tions in­clud­ed asth­ma, is­chemic heart dis­ease (IHD) and ma­lig­nan­cies from dif­fer­ent types of can­cer, were found in COVID-19-re­lat­ed deaths.

From May 1, 2021 to Ju­ly 20, the coun­try has record­ed 708 COVID-19-re­lat­ed deaths with at least one co­mor­bid­i­ty, 120 COVID-19-re­lat­ed deaths with­out any sig­nif­i­cant un­der­ly­ing health con­di­tions, and three with­out any ad­di­tion­al de­tails, re­sult­ing in 831 deaths. No­tably, 553 of these deaths were con­sid­ered el­der­ly, 259 were deemed mid­dle-aged, 15 con­sid­ered young adults and one was a teenag­er.

Hinds in­di­cat­ed in ear­ly Ju­ly that Trinidad and To­ba­go was not­ing a spike in COVID-19 cas­es and deaths in those above age 60, with deaths spik­ing in those above age 75 to 80. On Sat­ur­day, Hinds clar­i­fied that the min­istry no­ticed “an in­crease in num­bers above peo­ple above a par­tic­u­lar age be­com­ing ill and that sev­er­al of those did ac­tu­al­ly arise out of clus­ters in care homes.”

Speak­ing at the Prime Min­is­ter’s me­dia con­fer­ence on Sat­ur­day, the CMO and Hinds ex­plained that the over­all case-fa­tal­i­ty rate would be af­fect­ed de­pend­ing on which groups be­come in­fect­ed. Ac­cord­ing to the CMO, while the coun­try’s case-fa­tal­i­ty rate is at 2.75 per cent, for the over-80 age group, this rate can be as high as 20 per cent, mean­ing one in five peo­ple at this age suc­cumbs to the dis­ease.

Case of clas­si­fi­ca­tion: Could some deaths not be COVID-19?

For­mer health min­is­ter Dr Fuad Khan said the “re­al” num­ber of COVID-19 deaths could be low­er than re­port­ed be­cause of the min­istry’s clas­si­fi­ca­tion pro­to­col.

He ex­plained that once some­one with COVID-19 dies, they are count­ed in the sta­tis­tics. How­ev­er, he said their pass­ing could be un­re­lat­ed to the dis­ease.

“All the deaths that take place un­der COVID, none of them have an au­top­sy done on them… so the cause of death is not known and it’s as­sumed to be COVID be­cause they are pos­i­tive COVID pa­tients,” he said.

The CMO pre­vi­ous­ly said a de­ci­sion was made to for­go au­top­sies on COVID-19 fa­tal­i­ties due to the risk it posed to ex­am­in­ers.

Khan said some­one could die from a heart at­tack but be­cause they test pos­i­tive for COVID-19 de­spite be­ing asymp­to­matic, they will be count­ed as a COVID-re­lat­ed fa­tal­i­ty.

Pro­fes­sor Seemu­n­gal agreed.

“That’s an in­ter­est­ing point…dy­ing with COVID-19 is not the same thing as dy­ing from COVID-19, and peo­ple who die with COVID-19 may find them­selves clas­si­fied as a COVID-19 death, where­as they died from some­thing else,” he said.

“I agree that that could be a con­trib­u­to­ry fac­tor to what we see here.”

He said a sim­i­lar analy­sis was done in Italy and they found the COVID-19 death rate was much low­er than pre­vi­ous­ly be­lieved.

Hinds al­so used Italy as an ex­am­ple.

“While it’s above the glob­al av­er­age, (it) still cor­re­sponds to places like Italy, where it’s 2.99 the last time I checked, which had a sim­i­lar pro­file of old­er in­di­vid­u­als be­com­ing in­fect­ed and then hav­ing a high­er case fa­tal­i­ty out­come just be­cause of the risk of death in those age groups.”

Re­gard­less of any more in­fec­tious strains or clas­si­fi­ca­tion se­man­tics, the proven ways to avoid be­com­ing a part of the har­row­ing sta­tis­tics are wear­ing a mask, wash­ing your hands, watch­ing your dis­tance, and get­ting vac­ci­nat­ed.