The Tribune

Approximately two years into an historically great pandemic and with the onset of the Omicron variant, the world and The Bahamas have entered another phase of the COVID-19 pandemic.

The global commons, including countries, international health agencies and biomedical institutions have learned many lessons. Yet, so much remains unknown about the virus, its variants and trajectory. And, as is human, populations and governments continue to make the same mistakes, a number of them avoidable.

Every time the case numbers go down and there is a lull, people become giddy and somewhat delirious. This was especially so this past Christmas, with many super spreader events and the ongoing disregard for personal and collective responsibility.

Unfortunately, this giddiness was exacerbated by a collapse of necessary government restrictions, including curfews and a greater limit on the number of people able to attend various events. How many countries in our region have no curfews whatsoever?

The virus mocks our exhaustion, tentative certitudes, complacency, pseudo-science, magical thinking and ignorance of history and basic science. Despite our desire to be done with the turmoil, the anxiety and the dislocation caused by the virus, it keeps returning in some form.

Though we want the worst of the pandemic to be over, our human nature and desires are continually upended by science and math. The country is getting another lesson in mathematical exponential growth.

We are dogged by many questions. Will Omicron prove the beginning of the end of the acute phase of the pandemic? Will there be even deadlier variants than Delta? How does Omicron behave differently in various locales? What are some of the long-term physical and mental health effects of the multiple variants?

We don’t fully know the answers to many of these queries, which is why we should be cautious. What we do know is that countries and jurisdictions with higher rates of vaccination with booster shots tend to have better health outcomes.

Correspondingly, those with lower rates and with many underlying health problems – like a terribly obese Bahamas – tend to fare worse. Thankfully, the Omicron variant seems less severe in terms of fatalities.

Italy mandates

Italy, which experienced a high number of deaths and suffering at the beginning of the pandemic, is doing considerably better because of an aggressive vaccination programme and a variety of mandates.

This past Monday, the country targeted more of the unvaccinated with proof of vaccination or recovery from a recent infection required to enter public transport, cafes, hotels, gyms and other popular venues. The new ‘super’ health pass requirement eliminates the ability to show just a negative test to gain access to services.

The new measures are largely supported by Italians, who understand a greater return to normalcy and less dire health outcomes require mass vaccination and mandates. Just last week Prime Minister Mario Draghi was criticized for his government’s decision to require vaccinations for those 50 and older.

But Mr Draghi has not backed down, insisting certain mandates are necessary for economic recovery and stability and to prevent serious illness and death. He noted to reporters: “The data tells us that those older than 50 run greater risks, and that intensive care units are occupied by two-thirds of those not vaccinated.”

Italy is facing the same hospital crisis as others. With hospitals overrun with COVID-19 cases, those needing surgery and care for other illnesses or diseases are at risk of not receiving the care they desperately need.

The pandemic and the economic and social fallout will remain the highest or among the highest public policy challenges governments around the world will face for some years to come.

World slowdown

The World Bank recently advised that it expects a “pronounced slowdown” in economic growth in the next two years. The Bank also noted that “elevated financial vulnerabilities in large swathes of the world could increase the risk of a hard landing.”

Bank President David Malpass warned: “The world economy is simultaneously facing COVID-19, inflation, and policy uncertainty, with government spending and monetary policies in uncharted territory. Rising inequality and security challenges are particularly harmful for developing countries.”

During the first two years of the pandemic, governments and international agencies had to develop novel policies and strategies, constantly making adjustments as one of history’s great pandemics hit, and quick and difficult decisions were made with often limited information and the fog of a new pandemic.

In a disappointing editorial in a local journal, a writer simplistically opined: “Former Prime Minister Dr Hubert Minnis and his team of health officials largely overreacted to COVID-19, as did, arguably, much of the world.

“Guided by often haphazard advice from the World Health Organization and the United States Centers for Disease Control and Prevention (CDC), many world leaders immediately chose draconian measures to stop the spread of COVID to no avail.”

This is an unconvincing and insipid narrative that has taken hold in a number of quarters. Initially, much was not known about the virus and how severe it might be. For a good period of time we did not know if there would be successful vaccines to stop the dying. We did not know the potential fatality rate.

In parts of South America bodies were placed on curbsides and mass graves were quickly readied for the many who were dying daily.

The World Health Organization has now recorded approximately five million COVID deaths. Some suggest that because of inadequate reporting the number is much higher. Trinidad and Tobago has experienced just over 3,000 deaths so far.

The Bahamas, like other countries, had to proverbially move heaven and earth to secure vaccines, which were being greedily hoarded by developed nations. There was a massive global effort to secure and manufacture ventilators, oxygen, masks and other lifesaving medical supplies.

The WHO and others responded in real-time, changing guidance as the virus mutated and events warranted. Governments intervened with economic, business, unemployment, social and food assistance as economies ground to a halt. Most of this was not “draconian” or an “overreaction”.

Monday quarterbacking

It is easy for some, who did not have the football of managing the pandemic in their hands, to now breezily offer certain opinions as Monday morning quarterbacks. Millions are now dead because of COVID-19. And many millions were likely saved because of lockdowns, curfews, masks and eventually vaccines. These proved to be of great benefit.

History will better and more accurately judge various leaders for their handling of the pandemic, including former Prime Minister Dr Hubert Minnis and his Special Advisor Dr Merceline Dahl Regis, a leading regional public health and epidemiological expert.

Still, simplistic assertions of “draconian” are an insult to individuals like Dr Dahl Regis and the other medical and scientific experts who expended themselves to save lives.

The Minnis Administration left in place vaccines, templates and other measures. But now we are in a new period. It is now the responsibility of the Davis Administration to lead the country in this phase of COVID-19.

What is the medium to long-term strategy? What are the decisions for the new phase? On a micro level, Omicron may be less severe. But what about on a macro level given how highly infectious this variant is?

Governments have to make assumptions and make decisions in real-time. What is the absolute number of people with COVID that our health system can handle because we do not have the health care personnel? Do we have sufficient oxygen? How will schools be opened as safely as possible?

COVID-19 will be with us in some form for the foreseeable future, including its public health and economic consequences, ranging from long-COVID, mental health challenges, disruption to businesses and essential services, fallout for students and public finances.

We are in an ongoing fight. The Prime Minister will need to be aggressive in organizing his government for the fight ahead. A more judicious and intellectually coherent and consistent editorial in the same local journal noted this past Tuesday:

“We believe that the Prime Minister should not permit his ill-conceived pledge not to employ lockdowns or curfews to stand in the way of leading us in this fight. It will take strong leadership to guide us out of the shadow of COVID.”

While many believe lockdowns should or may be off the table at this point, what measures will the government put in place moving forward, especially to appreciably increase the vaccination rate and to lessen the impact of future waves?

Still, we can all agree the country needs strong leadership during this phase of the pandemic as we weather this wave, with likely more to come.