The Tribune

By KHRISNA RUSSELL

Tribune Chief Reporter

krussell@tribunemedia.net

THE Medical Association of The Bahamas is “disappointed” that the body was not consulted regarding the country’s newly adopted COVID-19 screening strategy for incoming international travellers.

The group does not support the decision to eliminate rapid antigen testing (RAT) at ports of entry.

MAB’s logic rests on an anticipation that cases will again increase in the country as worldwide COVID-19 cases continue to trend upward.

Government officials recently scrapped the idea of rapid antigen testing at ports of entry, saying the science does not support it being an effective screening tool at the border.

In a press statement, MAB President Dr Marcus Cooper said while doctors understand the economic necessity of the decision to restart tourism, it is important the government not only institute strict measures to mitigate a resurgence of cases, but prepare for any potential consequences that may arise.

As a result, MAB made several recommendations including RAT administration at points of entry. It said the same mode of testing for returning citizens and residents should be adopted.

Further on the fifth day of their travel, mandatory quarantines should be instituted until results from a second RAT can be confirmed, MAB has suggested.

“We are disappointed that the association was not engaged when a strategy for testing was being considered, particularly when the negative outcomes of such decision’s rests squarely on our shoulders,” Dr Cooper said in a statement.

“Nonetheless, we are ready and committed to caring for those with and without COVID-19 during these challenging times.

“We have only just begun to recover from the exponential increase in cases that stretched our healthcare facilities and medical professionals to its limits, after the relaxation of travel restrictions in July.

“As we reopen our borders, it is clear that the United States and many other countries are seeing record numbers of new COVID-19 cases every day. The MAB anticipates that we too will see an increase in cases after welcoming international travellers to our shores.

“While we understand the economic necessity of this decision, it is important that the government not only institute strict measures to mitigate a resurgence of cases in (the) country, but prepare for any potential consequences that may arise. We cannot afford to lower our guard. A robust and stringent testing policy for all persons entering the country seems prudent as we ‘test the waters’ again.”

Dr Cooper said the body is aware that the World Health Organisation does not recommend RAT as a screening tool for asymptomatic travellers at ports of entry, but the gold standard COVID-19 RT-PCR is not a practical test to perform in this setting.

“It is clear, however, that some form of screening is required to identify those persons who may have been exposed since performing the initial RT-PCR test prior to travel.

“Given the absence of a more suitable alternative and knowing that the RAT is unlikely to achieve the desired results as proposed, the MAB does not support the elimination of the rapid antigen test at the point of entry as it is likely to be the only COVID-19 screening test performed after entry, where testing is guaranteed.

“Any suspected improvement in test performance that is assumed to occur on day five of travel is likely to be offset by the inability to enforce compliance.”

MAB recommended the RAT test for all visitors upon entering The Bahamas and also on the fifth day of their travel. As an alternative, travellers may forgo testing on day five by providing a second negative COVID-19 RT-PCR test result at their expense.

“The MAB further recommends the RAT test for all returning citizens and residents upon entry and on the fifth day of their return in addition to mandatory quarantine until the second negative RAT test results can be confirmed.

“Likewise, returning citizens and residents may forgo testing on day five by providing a second negative COVID-19 RT-PCR test result at their expense. The request for a mandatory quarantine for returning citizens and residents stems from our experience that suggests the risk of community spread is highest when those who live and work among us have recently travelled.”

It also strongly recommended a more intensive campaign focused on preventative measures and health promotion.

“We agree that most are aware of the need for face masks, hand hygiene and social distancing but attention to other general health measures appears to be lacking. This includes a healthy diet, exercise, and immune boosting vitamins and supplements such as vitamin D, vitamin C and zinc.”

This should also go hand in hand with the strengthening of the country’s healthcare system in anticipation of a resurgence of cases, MAB said.

“The Public Hospitals Authority must increase its capacity outside of the tertiary care centres, to accommodate and isolate large numbers of COVID-19 cases should they present.

“The South Beach Clinic should be equipped and staffed to function at full capacity. There should be an abundance of personal protective equipment as well as supplies and resources to increase COVID-19 RT PCR testing.

“The PHA must test all hospital admissions to reduce the number of hospital related infections that occur on the open wards. Staff should be tested regularly, and policies adopted to reduce the unnecessary quarantining of providers which cripples the ability to provide adequate care to those with and without COVID-19. The relocation of some ambulatory hospital-based services may also be required to provide persons suffering from non-COVID-19 illnesses, uninterrupted access to care.”