Although Guyana’s risk for the presence of the mysterious new coronavirus is relatively “low,” health authorities yesterday assured that the country is “ready and equipped” in the event of an infection.
At a news conference held by the Ministry of Public Health in collaboration with the Pan American Health Organization/World Health Organization (PAHO/WHO), Minister of Public Health Volda Lawrence stated that the country is “prepared and equipped with what is needed to handle a situation” should one arise. This includes collaboration with PAHO/WHO, immigration authorities, the Ministry of Public Infrastructure and other agencies.
Chief Medical Officer Dr Shamdeo Persaud, who was present at the encounter, said that screening has started at the various ports of entry across the country, including the Eugene F Correia Inter-national Airport and the Cheddi Jagan International Airport, where the ministry has been sensitising officials on how to deal with suspected cases.
The Georgetown Public Hospital and the Diamond Regional Hospital have been identified as the two facilities for isolation of any passengers suspected to have the coronavirus.
According to PAHO/ WHO, Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syn-drome (SARS-CoV). A novel coronavirus is a new strain that has not been previously identified in humans. Coronaviruses are zoonotic, meaning they are transmitted between animals and people.
PAHO/WHO Representative Dr. William Adu-Krow told reporters that as of noon yesterday, there were 4,564 confirmed cases of coronavirus globally and that they have resulted in 106 deaths. He said 14 countries, apart from China, have reported cases that are being confirmed. Fifty-two of these cases, Adu-Krow noted, are outside of China. In the Americas, he added, there are seven confirmed cases; five from the United States and two from Canada.
The cause of the infection is unknown. “WHO doesn’t know and nobody knows,” Adu-Krow said.
However, he explained that there are three hypotheses relating to three types of sources. “One, it’s likely to have come from animals, or surfaces that have come in contact with animal fluids. The second one is what we call the person-to-person spread, that’s if I get it and you treat me you may also get it and then the third one, contaminated food,” he explained.
Adu-Krow further stated that while Guyana does not have any case to date, the country has the experience to deal with it if the need arises.
“…I think we have gained enough experience. So in this country, even though we may not have had the cases, trust me we have enough experience to be able to deal with it and I am hoping that that experience that has come as a result of the preparedness was passed on to have that high index of suspicion and if, God forbid, we get a case, we are able to handle that,” he said.
Strengthened surveillance
Persaud explained that in an effort to prevent the entry of coronavirus into Guyana, a very comprehensive action plan, centred on early detection at all points of entry, has been put together and several elements have been implemented.
“We have strengthened the surveillance activities and the screening of persons who are travelling from areas where we know this virus was identified,” he further said.
“We have a plan and we have a programme to do some sensitisation training and capacity building at several of the key ports across the country over the next couple days,” he also said.
Deputy Chief Medical Officer Dr Karen Boyle-Campbell, however, noted that while regional ports have been advised, the focus presently is on the larger ports where the risk is a “little higher.” “…But they should also make themselves ready. In terms of identifying isolation rooms, isolation areas, etc,” she added.
Dr Tracey Bovell, Mass Casualty Specialist at the GPH, said isolation areas have been identified and authorities are working to ensure that they are safe for the public and for the other patients and for visiting patients who will be visiting the hospital for medical care that is not related to the coronavirus.
Persaud further said that each arriving aircraft is now required to complete a health declaration and the flight attendants would usually indicate if there is anyone on the respective flight who reported sick, having fever, vomiting, etc.
In any such instance, he explained, the persons are identified and the necessary measures would be immediately taken. “…It’s a general system that we are preparing. Not just preparing for coronavirus alone, we preparing for any event of an unusual disease of international concern,” he added.
Through collaboration with PAHO and a team, a case definition is being formulated by the ministry that will aid in the identifying of persons who really need the attention, testing and medical care if they do present at the facilities.
In terms of clinical management, Persaud said, works have already started to put together a plan and have a system in place. “If we do have suspected cases, there is a system to manage them and to provide them with all the clinical care that they need,” he said.
At this point, he noted, it is not recommended that any special new protocol be implemented. “We do have the protocols for what is called severe acute respiratory illness and in this instance our enhanced surveillance system is trying to, our enhanced surveillance system will be capturing persons who have undifferentiated fevers with respiratory symptoms and fever with some other associated symptoms because I understand from some of the case histories from the Chinese, persons who were severely affected [with] pneumonia, even diarrhoea and some other conditions, [were] also presenting signs and symptoms,” he explained.
In terms of medication, Persaud said that there has been no specific antivirals recommended by the WHO. However, he noted that based on the review done thus far, there are adequate supplies of common medication, including antibiotics, if they are indicated.
“…There are no specific antivirals at this point in time recommended by the WHO….But if there are other respiratory conditions, we have the adequate treatment that will be needed,” he said.
The most challenging part in this instance, Persaud noted, is respiratory support. “That is ventilator support, which the hospitals do have—ventilators in our ICUs. But if we were to have cases we would definitely ensure that we have respiratory support for the other areas, including the isolations areas,” he added.
Persaud also noted that the Caribbean Public Health Agency (CARPHA) has designated a National Influenza Centre (NIC) which has the capability to test for the virus. “That means that they have the capability to be able to test everything that we send to them. We may not have to send it to Puerto Rico or CDC. We can send it to CARPHA,” he said.
“What we have to fine-tune … is the system to collect the samples and have them shipped effectively and in a timely manner to that centre,” he added.
Results, he said, are promised within three days.
Boyle-Campbell said that the lack of human resources has been recognised as one of the ongoing problems and while this is being addressed, health workers throughout Guyana are on alert. “And so for an interim period we are deploying extra environmental health officers and extra medex to our ports,” she noted.
Cabinet briefed
Meanwhile, Lawrence also reported that a team comprising officials from the Ministry of Public Health and PAHO/WHO yesterday morning met and briefed Cabinet on the country’s preparedness to deal with coronavirus.
She said during the meeting Cabinet was informed that the ministry is presently utilising the stocks that were bought last year and for the first quarter of this year in an effort to tackle the situation.
“We did indicate to Cabinet that presently we are utilising the stocks that we would have bought in 2019 and that we will see to also utilise the one-twelfth which we would have gotten for this quarter,” Lawrence explained.
The Ministry of the Presidency, in a statement yesterday, said that President David Granger applauded the team for the work they have been doing to ensure that the country is prepared to tackle the issue in the event of any occurrence.
“President Granger said Guyana’s preparedness to deal with transnational diseases is at an optimum,” the statement said.
In an effort to educate the public, the Ministry of Public Health will be launching a public education campaign soon about coronavirus.
