…to ensure improved quality of service, infrastructure in COVID-19 fight

By Navendra Seoraj
GUYANA has taken a major leap in the fight against the dreaded novel coronavirus (COVID-19) pandemic, with the commissioning of its new Centre for Disease Prevention and Control, at the site of the former Ocean View Hotel.
This “leap” is expected to radically improve the quality of service and infrastructure for patients and staff, as the country continues to battle COVID-19 and other infectious diseases, which may arise in the future.

The situation in Guyana is still evolving. And, according to recent statistics, the country recorded 44 new cases between July 25 and July 28, 2020, a span of just three days. Authorities have recorded 401 cases to date. “Today, life on earth is confronted with one of humanity’s gravest health challenges for more than one hundred years. The COVID-19 pandemic – an event which no country anticipated and for which few could pretend to have been adequately prepared – has brought the death and disease completely unanticipated to millions of persons in every continent,” lamented President David Granger, as he addressed a small gathering at the opening ceremony of the facility, on Thursday.

He said the A Partnership for National Unit and Alliance For Change (APNU+AFC) Government’s objective of universal healthcare is all the more important given the present situation.

The global pandemic has tested public health systems everywhere. The new reality requires that public health systems increase and strengthen their capacity to address sudden and unexpected outbreaks of communicable diseases by providing more hospital beds, improved protective gear for medical personnel, better communicable diseases surveillance and specialised hospitals, such as this institution, devoted exclusively to infectious diseases.
To this end, President Granger said: “The establishment of this infectious diseases’ hospital represents an essential and urgent investment in safeguarding our people’s health, not just against the coronavirus pandemic, but also against future communicable epidemics.”

This facility, which was rehabilitated and built at a cost of $1.6B billion, is seen as an essential element of the emergency response.
Government recognised the urgency of having an institution which could be dedicated exclusively to providing treatment to coronavirus patients. And, according to the President Granger, the model which was developed in the “early days” of the pandemic required Guyana to have the capacity and the capability to achieve accommodation of 197 Intensive Care Unit (ICU) patients at any one time.
He, therefore, believes that the infectious diseases hospital is strategic, as it will be used primarily for COVID-19 patients but, eventually, will become a fully-specialised communicable disease hospital.

“It is an important step forward towards protecting our people from epidemic disease. It is always preferable for infectious patients to be isolated away from the general hospital population so as to reduce the risk of transmission and to ensure a better environment for treatment and recuperation,” said the President.
Minister of Public Health, Volda Lawrence, also spoke about the importance of the new facility, noting that it indicates a change in trajectory of how Guyana will address outbreaks, epidemics and pandemics.

She reminded persons that this is not the first, local specialised institution, but noted that it reflects the will and resolve of the government to be proactive rather than reactive.

Minister Lawrence admitted that COVID-19 had seemed distant at first, but it reached Guyana on March 11. And, with it, came immediate challenges such as the need for surveillance, contact tracing, isolation and quarantine facilities and equipment.

“There were myriad of unknowns about the highly-infectious disease, particularly symptoms, protective measures…there was even much speculation about COVID-19, and there is still much speculation about COVID-19,” said the minister.
The country, however, quickly realised that it lacked capacity, having limited hospitals and one national referral hospital, the Georgetown Public Hospital Corporation (GPHC), to cater for all services.

The GPHC, which has the country’s only COVID-19 ICU, has 500 beds and an occupancy rate of 99 per cent. The other district hospitals account for the remaining 64 per cent of beds, but only provide basic inpatient services.

“This situational assessment left us in a quandary, as there were challenges in the capacity and other areas…it was as such deemed necessary for the country to have a designated facility for any surges in patient load, caused by COVID-19,” said Minister Lawrence.
The new facility, as such, serves as the first all-inclusive infectious diseases facility which the public health ministry envisages, will remove the constraints from GPHC and the regional and district hospitals.

The new facility has the capacity for 190 beds and will have a staff complement of 200 persons. It also caters for laboratories, a pharmacy, an ICU, an operation theatre and even a mortuary. A section of the facility will also house the Health Emergency Operations Centre (HEOC), a surveillance centre, a research centre and administrative offices.

“In the aftermath of COVID-19 this facility will be used to address our needs, which are bound in the tropics… it will facilitate testing, research, treatment of identifiable and unidentifiable diseases, enhance surveillance and provide assistance for neighbouring countries,” said Minister Lawrence.
Resident Pan American Health Organisation/World Health Organisation (PAHO/WHO) Representative, Dr. William Adu-Krow also shared the view that the facility will be effective in the fight against COVID-19 and other infectious diseases.

He, however, said that while government has its part to play in the fight against COVID-19, the role of individuals cannot be overlooked.
This was also the view of President Granger, who, in his address, said Guyanese need to practice personal measures. He said they need to avoid leaving home; avoid gatherings of more than five persons; avoid visiting sick persons; avoid coughing and sneezing in the presence of other persons; avoid touching other persons; avoid touching parts of your own faces; and adopt the habit of washing of hands frequently and thoroughly.

“We must continue to observe the rules of social distancing, by wearing face masks and practicing good hand hygiene. We will win the fight against the COVID-19 and other communicable diseases. Exercising personal and social responsibility will help keep our people safe,” said the president.
His belief is that human lives are the most precious resource. Human health is, however, being threatened by the increasing incidence of transnational infectious diseases. These diseases, unfortunately, are not expected to disappear completely.

The country’s public health systems, therefore, must never be found deficit in responding to emerging communicable diseases, said President Granger.
He assured that no effort will be spared, now or in the future, to protect the nation’s health. Every life matters.
Testimony to government’s commitment was the establishment of the National Coronavirus Task Force (NCTF), just hours after the death of the first COVID-19 patient.
Government also published an extraordinary issue of the Official Gazette on March 16, and promulgated a menu of measures based on the Public Health Ordinance for the enforcement of protective measures.

This was supplemented, on April 3, by the promulgation of emergency measures which included the imposition of a curfew, the closure of Guyana’s airspace and borders and other restrictions. A draft National Action Plan was also promulgated in the form of a ‘White Paper.’
Every ministry has been responding to the pandemic through carefully-coordinated action plans – Rural Entrepreneurial Action Plan (REAP); Coordinating Agency for Small Enterprise (CASE); Mobile Emergency Enforcement Teams (MEETS); National Implementation Scheme for Interconnectivity (NISI); Public Education Remote Learning-Teaching Scheme (PERLS); Social, Cultural and Arts Renewal Scheme (SCARS); Social Protection Implementation Measures (SPIM) and others.
The enforcement arms of the state have adopted the four Es – engage, explain, encourage and enforce – in their interaction with the public in urban, rural and hinterland districts.

“Your government has recognised the public health threat posed by communicable diseases even prior to the outbreak of the COVID-19 pandemic. Attention, in recent years, has been focused on reducing the incidence and improving treatments for communicable diseases. The public health system is being made more resilient and responsive to the threats posed by communicable diseases,” said President Granger.

As it regards plans for the future, the president referred to the “Decade of Development: 2020-2029,” through which government will continue to improve public health services. These efforts will be consistent with the approaches outlined in Guyana’s Green State Development Strategy: Vision 2040 which identifies communicable diseases as a challenge to public health and public well-being, said President Granger.

The Decade of Development will see public health expenditure achieve or surpass the PAHO-WHO target of six per cent of GDP. This will allow for the continued protection of the country’s most valued resource – our people.

The Decade of Development will witness the establishment of a more inclusive public health system. And, among the priorities will be the augmentation of resources to address infectious diseases.