The Tribune

By KHRISNA RUSSELL

Tribune Chief Reporter

krussell@tribunemedia.net

A LOCAL infectious disease expert says the vulnerability of the country’s public health system along with low vaccination numbers remain key determining factors regarding how far COVID-19 measures can be scaled back.

Dr Nikkiah Forbes, the Ministry of Health and Wellness’ National HIV/AIDS and Infectious Disease Programme director, told The Tribune that while The Bahamas is in a good place concerning the rate of new infections, officials could not “throw caution to the wind” in their consideration of returning to normal more than two years into the pandemic.

As a result, she insisted a measured and balanced approach was important in maintaining low virus numbers.

In recent weeks countries around the world have been loosening measures and Dr Forbes was adamant that in such instances those places had the right metrics.

“There has to be a balance. That has to be very important and taken into consideration when we’re rolling back restrictions,” Dr Forbes said in an interview earlier this week. “You see that we are loosening restrictions, but it has to be in a balanced, logical and appropriate way for your country and so let’s remember the context.

“So, COVID-19 it is very likely that there are still going to be variant strains that develop and we see that the cases, the waves they go up, they crest and then they go down and that has been our experience with the previous four waves.

“So, when countries are rolling back restrictions these are some of the things they have to take into consideration: they have to take into account the status of their current health system to withstand a rise in COVID cases and surges and the vulnerabilities of the health system and the ability of the health system to respond and that is hospitals as well as the public health infrastructure for contact tracing, isolation surveillance of the situation and treatment and prevention and cure.

“You also have to take into account vaccination status and coverage. In many of those countries’ vaccination coverage is very high - more than 70 percent where they’re rolling back measures. They have health care systems with multi-level institutions that can absorb some of the stress of surging COVID cases and waves of COVID cases.

“Our health system is not like that and so we really have to take a very measured cautious approach.

“It is good that we are in a better situation with COVID now and that we can roll back some restrictions but we can’t throw all caution to the wind.”

So far, 161,251 people in the country are fully vaccinated.

Dr Forbes said vaccine hesitancy continues to be a challenge.

“There is still hesitancy and we see that people are still getting vaccinated but it is slower and we have to do all we can to meet people where they are and help to understand why they’re hesitant.

“Now, these vaccines have been around for quite some time. More than half of the world’s population have taken these vaccines and we can see that in the real world that they’re very effective to prevent hospitalisations and deaths and it’s a very good point that you’re raising. With COVID, we’ve been in this fight against COVID for more than two years. It’s always going to be here as a circulating respiratory virus. What’s different now from the beginning of the outbreak is we’re better equipped.

“We have treatments, we have vaccines that we know can help to save lives and we understand more about how it spreads and as we get back to our normal lives that’s very, very important. We need to remember that we can do all we can to protect ourselves from getting COVID-19. That’s following public health precautions and getting vaccinated.”

Although daily infections have recently been in the low double and single digits, Dr Forbes said it was likely there could be another wave of COVID-19 in the country.

“Well, you know that’s what’s happened to date. We’ve had four and some countries have had others so previous experience will show you. COVID is here to stay and with the majority of the world’s population not being vaccinated that is a set up for other strains emerging.

“That just depends on what the strains will do. They become more infectious and could certainly cause the potential for more spread.”

Dr Forbes was also asked whether The Bahamas could ever reach the point where the mask mandate is rolled back as had been the case in some areas of the United States.

She insisted masks are a very effective tool in cutting the rate of transmission by 50 percent.

“So, in places where there would still be high COVID incidents and spread that wouldn’t be recommended. That would be in places where it’s under control, but again you have to take into account the context of your country and that’s what we’re always called to do and we read about guidelines and recommendations and implementations others are making for you to consider what is the context for your country.

“Again, our health system is somewhat vulnerable to COVID. When we have a COVID surge we see that ordinary care, non-COVID care is compromised and it is difficult in COVID care when we are having surges.

“Mask wearing is a simple effective tool that if it’s done effectively everyone can cut down the risk of transmission by more than 50 percent.

“It would just simply not make sense to do that if we’re in a surge especially in the setting of low vaccination in places where there is a high risk for transmission. So, it’s not something that should be tossed aside and in many places where it is being tossed aside public health experts are lamenting that this can be a little bit too early to do such things and that if it is that there is another wave for example or another strain of COVID that’s more transmissible you will very, very soon find yourself with a rise in cases again. So, you should use caution,” Dr Forbes added.