The Tribune

“In the short time since Omicron was discovered, the popular narrative about the variant has calcified around the idea that it is milder. That is true for individuals, and in comparison with Delta, but the variant certainly isn’t mild for unvaccinated people, for those who could develop long COVID from a supposedly ‘mild’ infection, and especially not for the health-care system as a whole.”

– Ed Yong, The Atlantic

THE COVID-19 pandemic continues to test the character, tenacity and imagination of individuals and countries. Some countries are faring better, others worse, for a variety of reasons. How is The Bahamas faring on a number of fronts?

Hospitalisations for COVID-19 are on the increase in various jurisdictions, which have yet to reach their peak, including here at home. Infections are on the rise in a number of Family Islands, which means there is greater community spread in these areas, which have no immediate access to intensive care and other measures.

Health and Wellness Minister Dr Michael Darville notes the new variant is now “a serious strain” on the healthcare system, including public clinics. He also noted the government is having difficulty securing a field hospital.

A physician at the Princess Margaret Hospital confirmed to this columnist similar reports in the press that the facility is in dire straits, with COVID rampant and many health care workers at home in quarantine. She says she expects matters to worsen over the next one to two weeks.

When in Opposition, the comments and attitude of many in the PLP leadership were troubling in terms of how poorly they seemed to understand the pandemic and their often highly partisan and irresponsible comments. Now in government, they bear the brunt of responsibility.

Talking points and press conferences will not bring down hospitalisations, secure field hospitals, help the country to avoid the effects of a now Level 4 Advisory by the US Centers for Disease Control and Prevention nor supply the long-term strategy the country requires as we enter the third year of a historically great pandemic, which is going to continue for some time.

BALANCE

In most countries during the pandemic there has been an inevitable tug of war between public health and economic officials at the levels of the political directorate and public service.

The balancing of the competing needs of public health and economic survival and recovery is adjudicated by cabinet, with the head of government playing a pivotal role on final decisions on a host of matters.

How we fare as a country in part depends on how well the national leadership understands the pandemic, their assumptions and theory of the case on the uncertain trajectory of the virus and its variants, and their philosophical leanings on balancing the public health and economic needs of the country.

Leaders must have a way of proceeding, based on certain values and a clear and consistent approach to a given public policy matter. By example, at what point might a cabinet or leader bring a curfew into force? How well does the current senior leadership understand this pandemic and the history of pandemics?

If there is a variant as or more lethal than Delta and as or more transmissible than Omicron, would governments around the world, including ours, be forced into lockdowns? With Omicron, many governments around the world re-imposed curfews, partial lockdowns and more vaccine mandates.

Are there any circumstances under which the Bahamas Government would require vaccine mandates in various areas of public life? What about for healthcare workers if there is a more pernicious and lethal variant?

At the beginning of the pandemic, with no vaccines and the need to quickly create a multifaceted response, most governments, including the administration of Dr Hubert Minnis, focused overwhelmingly on protecting public health.

With the arrival of vaccines and various therapeutics, there was gradual opening of the economy under Dr Minnis. Despite some missteps, most people of goodwill appear to recognize the generally good job Dr Minnis, with the extraordinary advice of Dr Merceline Dahl Regis, did to protect public health.

Unsurprisingly, some still drunk with personal animus and anger toward Dr Minnis, remain incapable of any or much acknowledgment of the successes of the previous government in response to the pandemic, despite even domestic and international praise.

With vaccines and better therapeutics, the administration of Prime Minister Philip Brave Davis has tools at its disposal, including vaccines, which will help the country to fight the next stages of the pandemic, which will likely be with us considerably longer than most would wish.

EXPIRED VACCINES

Unfortunately, as reported in this journal yesterday, the country has now discarded Johnson & Johnson vaccines that expired in December. This is worrying for a variety of reasons. But the main one is that with approximately 40 percent or so of Bahamians and residents fully vaccinated, we are throwing away life-saving vaccines.

COVID-19 has negatively affected many leaders and governments. It appears that Mr Davis has sought to keep at arm’s length from the pandemic. He has been less aggressive than Dr Minnis in promoting vaccines. His political gamble may pay off if we are nearing the end of the pandemic phase.

But, if there are more waves of the pandemic to come, and the endemic phase some time away, with more potential deaths and serious illness and more economic and social hardship and dislocation, it is through vaccines and booster shots that the country will save lives, prevent serious illness and improve our economic viability. His gamble could also fail.

Philosophically, Mr Davis seems to err more heavily on the side of fuller economic reopening. This is evidenced by the current government initially allowing in to the country the Christmas Carnival. The Prime Minister has been emphatic about no curfews.

Writing in The Atlantic last week Katherine Wu warned that describing the Omicron variant as “mild” may be foolhardy:

“COVID-19 doesn’t have to be medically severe to take a toll. Lekshmi Santhosh, a critical-care physician at UCSF, has seen Omicron exacerbate chronic health issues to the point where they turn fatal. ‘You could say they didn’t die of COVID,’ she told me.

“‘But if they didn’t have COVID, they wouldn’t have had this issue.’ Iwasaki, of Yale, also worries about the storm of long-COVID cases, which can sprout out of infections that are initially almost symptom-free, that may soon be on the way. ‘Some of these people are bedridden, unable to return to work for months,’ she told me. ‘There is nothing mild about it’.”

Even as the country wants to get back to greater normalcy and we are all tired of the pandemic, and as the Prime Minister and his government appear to want to focus the country’s attention away from the pandemic, magical thinking is not going to stop the punishing effects of the pandemic. Indeed, such thinking will exacerbate the pandemic’s toll on the country.

An Associated Press report this past Tuesday is sobering: “The fast-moving Omicron variant may cause less severe disease on average, but COVID-19 deaths in the US are climbing and modellers forecast 50,000 to 300,000 more Americans could die by the time the wave subsides in mid-March.”

DIALOGUE

There is the need for honest and considered dialogue and discussion in the country and in the government on the way forward with the pandemic. Is the country capable of such an honest dialogue or do we prefer wishful thinking?

What has the global event revealed of our national character for good and for ill? How resilient and tenacious or fragile and slack are we? Is there the imagination and political will by the current government to significantly push for vaccinations?

What is the emerging strategy for long-term COVID care? What are the plans for the learning and socialisation deficit for students affected by the pandemic? What are the structural and other economic plans for our battered economy, including stabilising public finances?

How we respond to the aforementioned questions will be determinative in how we fare in the months and weeks ahead to save and to protect lives and livelihoods.

Much of our economy remains shuttered. We are facing high levels of inflation. Because we are a COVID-19 vaccine hesitant culture, with many comorbidities, vaccinations are essential for us to move forward.

As Katherine Wu writes: “It’s worth remembering, then, that severity, or lack thereof, is not up to the virus alone. We, as hosts, dictate its damage at least as much - and that’s the side of the equation we can control. SARS-CoV-2 can’t be counted on to pull its punches, but we have the vaccines to pummel it right back. If mildness is what we’re after, that future is largely up to us.”