COVID-19 Risk Minimization

Over the past week there has been a significant surge in COVID-19 cases in Saint Lucia with close to 200 new cases. Unfortunately, Saint Lucia recorded three deaths that included one “sudden” death. There has been much debate regarding the PM’s recent comments that “there’s no point in saving people if in fact their livelihoods are being affected”. One of our key goals of Saint Lucia’s COVID-19 response should be risk mitigation based on the likelihood of COVID-19 transmission across all activities in our society. The people of Saint Lucia need to trust that the government is applying restrictions fairly and equitably during the COVID-19 pandemic.

The analyzer will dissect Saint Lucia’s current response to COVID-19.

Home Quarantine Surveillance

The government announced that the home quarantine surveillance will now include the following: “The Ministry of Health is well on its way to improving its surveillance of people on home quarantine through the introduction of innovative technology. The introduction of the two electronic monitoring devices; Bio Intellisense BioButton and Amber wristwatch is expected to come on stream on January 18, 2021.” The BioButton which will cost $100USD. The Saint Lucian version is a remote monitoring device that can collect information about your physical health and condition, such as respiratory rate, heart rate, temperature, activity level, sleep duration, body position, step count, gait analysis, coughing, sneezing and vomit frequency and other symptomatic or biometric data.

Is there any data security policy (WHO’s Ethical Considerations Guideline For Digital Tracking) from the Ministry of Health regarding how such sensitive information will be collected; how it will be stored and whom will have access to this information? Furthermore, the BioIntellisense Privacy Policy states that “Your Provider is responsible for providing you with a Notice of Privacy Practices describing its collection and use of your health information, not Bio IntelliSense.”

Why was the BioButton not required for the Trump-supporting visitors who choose to Saint Lucia? It would have provided the Ministry of Health with significant more data about possible COVID-19 positive visitors who are disregarding their government’s advice and travelling internationally. Furthermore, this device could help with early detection of COVID-19 symptoms and mitigate cases like the recent sudden death of a tourist at hotel. Cayman Islands required BioButtons to be worn by visitors when they opened their borders. Why does the government consistently appear to have different standard for visitors and Saint Lucians? The government has stubbornly refused to complete an on-island COVID-19 PCR test on visitors and yet again chooses not to require our Trump-supporting visitors to wear a BioButton.

The Ministry of Health will charge home quarantine persons $100USD for the BioButton which is a significant markup from the $20USD other institutions charge. “The University is still working out how to distribute the devices to students. It says it is taking the cost on, and it will cost $20 a month and each BioButton lasts three months.” The additional revenue is certainly needed for the Ministry of Health to support the COVID-19 response. Furthermore, if the BioButton was initiated for the Trump-supporting visitors then the 10,000 December visitors would have resulted in roughly $1M USD in revenue to the Ministry of Health in addition to the monitoring of the health of the visitors.

Consistency about COVID-19 Cases

A hotel which the government declined to name in their numerous public statements though they indicated that at least cases 60 cases could be traced directly to this establishment. Why has the government of St. Lucia refused to name the hotel during their January 14th Update to the Nation? “The Department of Health and Wellness notes the increased number of cases of COVID-19 over the past two weeks and the several cases of transmission of COVID-19 identified at a property on island. During the period Nov. 23, 2020 to Jan. 13, 2021 a total of 60 cases were documented including the COVID-19 related death of a 52-year-old UK national. Employees for quarantine and isolation to be facilitated at the property to reduce community transmission.” Subsequently one of the hotels in Saint Lucia announced the following temporary closure and likely is the hotel referred to above. “Due to recent governmental lockdowns, #RoyaltonSaintLucia will be temporarily closing from January 17 until March 31, 2021.”

This is in direct contrast to the information provided about the case 29 where personal identifiable information was in the official government release. “Commuters on public transportation on the 2H Castries-Vieux-Fort route are asked to pay particular attention to the following. The Ministry of Health is requesting anyone who travelled from the 2H Castries-Vieux-Fort route via minibus M481 during the period Monday, September 28, 2020 to Friday, October 9, 2020 to report to the following respiratory clinics for assessment and possible testing.”

The way in which Saint Lucia Government publicizes COVID-19 information leaves a lot to be desired. The following questions remain unanswered:

· Why did the government choose not to name the hotel but provided the license plate number of the minibus driver?

· Why did the government wait until January 14th, 4 days after a guest passed away on the hotel’s property to inform the public?

· When were the hotel employees informed about the rising cases at the property?

· What are guidelines for quarantine and isolation at the hotel? There is no mention of these protocols at “Reopening Saint Lucia”?

· How many COVID-19 positive persons have been completed isolation at one of the hotel properties? Who is responsible for the cost of this isolation? There is no mention of hotel isolation on the COVID-19 dashboard.

Increased Transmission Rate

The new variants of COVID-19 with higher transmission rate are of major concern as this would mean that the current protocols for everyone would need to be strengthened to keep the number of COVID-19 cases to the same level. Once the more contagious virus becomes more common, it will accelerate transmission considerably. Accelerated transmission means more cases since the virus grows exponentially. Any increase in its inherent transmissibility causes an increasingly high number of cases down the line, if control measures don’t also accelerate to keep up. A 50 percent more contagious virus is even a deadlier concern than one that’s 50 percent more deadly. “If a country has an R value (R value is a way of rating COVID-19 or any disease’s ability to spread. R is the number of people that one infected person will pass on a virus to, on average) of 1.1 and there are 10,000 people infected, in one month’s time, you’d expect to see 129 deaths. Increase the deadliness of the virus by 50 percent in that scenario and you’d expect 193 deaths — a 49.6 percent increase. Increase the contagiousness of the virus in this scenario by 50 percent and you get 978 deaths — a 658% increase”

How is the government of Saint Lucia planning to mitigate the increased transmission rate of the more contagious COVID-19 variant which can easily reach Saint Lucia due to the current COVID-19 protocols which apply in the tourism sector?

School Reopening

The government of Saint Lucia has also pushed ahead with the reopening of schools despite the rising cases. There have been no adjustments to the requirements for Trump-supporting visitors who visit Saint Lucia even with the increasing risk worldwide. A recent Wall Street Journal article indicated that even the Europeans who kept schools open for most of the fall are closing school in winter due to rising transmission rates especially with the new COVID-19 variants. “The problem is schools may nonetheless act as vectors for transmission, causing the virus to spread between households.” Recent evidence shows that children are infected as easily as adults “In Austria, a nationwide survey by universities and medical institutes found that children under 10 showed a similar rate of infection to those between 11 and 14, and that the children in general were getting infected as often as teachers, said Michael Wagner, a microbiologist at the University of Vienna who oversees the study. That is very different to what has been claimed for months, that younger children are less frequently infected”.

· Does the government of Saint Lucia have a criterion for when schools should be closed or should be open?

· Has the Ministry of Education and/or Ministry of Health defined a positivity rate for school opening or closing similar to what exists in New York?

· Is there any periodic random testing of the school population to determine COVID-19 infection rates at schools?

PCR Testing Requirements

Are there any plans for tightening of the 7-day window of the required PCR test prior to arrival ? Both the US and UK now require a negative test within 72 hours of the visitor’s flight? Is Saint Lucia able to facilitate this requirement? If the government had mandated on-island testing of tourists from border reopening, then this requirement would have been easier to accommodate as the testing capacity in Saint Lucia could have been scaled up. The SLTA indicated that some hotels will provide complimentary testing for departing tourists and PCR testing is also available. “Saint Lucia has multiple COVID-19 PCR and antigen (rapid) testing options for departing visitors, citizens and residents. Travelers can obtain a COVID-19 test conveniently at select hotels or at local testing facilities, with test results returned within the requisite 72-hour time frame. There are additional options in development to expand testing locations. As of Jan. 14, the hotels and villas offering complimentary COVID-19 antigen (rapid) testing to qualified guests…”

· What is the current testing capacity of Saint Lucia?

· Will Saint Lucia have visitors that are forced to remain on island because they did not get their negative test result in time?

· What is the process for travelers who have a positive pre-departure test? Who will be responsible for any additional costs?

· Will test results for visitors be prioritized over Saint Lucians since visitors need to depart from the island? How will that impact health care?

· If complimentary COVID-19 antigen testing was possible to be rolled out to meet the US, Canada and UK requirements why was a 2nd on-island test on arrival not done earlier to minimize the risk to Saint Lucians?