Urgency to flatten Covid-19 curve in Grenada

by Wendy C Grenade, PhD 

It was 7 September 2004, seventeen years ago, that Hurricane Ivan devastated Grenada.

One of the major lessons from that experience is that the ability to bounce back depends, to a large extent, on leadership at every level of the society and collective efforts to provide financial, psychological and spiritual support for a hurting people in the midst of crisis. Another lesson from hurricane Ivan is that Grenadians have an intrinsic resilience in the face of adversity and the capacity to withstand.

As was the case 17 years ago, Grenada is at another moment of crisis. Reports from the Ministry of Health indicate that as at 6 September there were 1,194 active cases. Sadly, 12 Grenadians have succumbed to the deadly Covid-19 virus thus far, seven on 5 September alone. My condolences to the families of all those who have lost loved ones and I wish a speedy recovery to all those who have become ill as a result of contracting the virus.

For the past year and a half, the world witnessed the rampage of the Covid-19 virus as health systems were overburdened, economic activities disrupted and lives were lost. Until this point, Grenada was relatively unscathed by the health crisis itself. For instance, in most Caribbean countries access to vaccines became availability after community spread. Many Caricom countries had to ease and press with various combinations of stay-at-home restrictions and all out lockdowns. In Grenada’s case, it was the reverse: vaccines were available prior to community spread. That meant the Government and people of Grenada had the opportunity to be ahead of the game. The country was well poised to win the war against the virus because the armour of vaccination was freely available. It is heartbreaking for those of us who publicly advocated for vaccination to see our rising cases and deaths, which according to the health officials, are predominately among the unvaccinated. However, we are where we are. The challenge is to get through this moment with the best possible outcome; that is, protecting as many lives as we can.

The Government of Grenada (GOG) recently tightened restrictions with extended curfew hours, closures of some non-essential workplaces and discontinuing some indoor activities, etc. This is commendable. However, given the exponential spread of the virus and rising deaths, I wish to suggest that some further measures should be put in place to flatten the curve:

1. A total lockdown of the country for one or 2 weeks to get the situation under control. The argument against lockdown is that the Grenadian economy cannot afford a further economic contraction. That may be the case, but the economy in a macro sense, will bounce back. However, people are the core of economic activities. The dichotomy between lives and livelihoods is a false one, as there can be no livelihoods without lives! Except for essential services, all workplaces should be closed for face-to-face activities. Those who can work from home should do so. The airports can remain open for vital supplies but movement in the country should be further curtailed by instituting stay-at-home orders beyond the curfew period and the 2 ‘no movement’ weekends. There is urgency to flatten the curve and protect lives.
2. If a national lockdown is not feasible at this time, in the context of Covid-19, there should be a clear national policy to govern workplaces in both the public and private sectors. Currently, in some workplaces, it is reported that persons are showing up to work even if colleagues in the workplace (or members of their families) have tested positive or awaiting test results. This has the potential to intensify community spread.
3. Home isolation for Covid-19 positive persons should be discontinued. Given our social reality, Grenada’s housing arrangements are not equipped for home isolation. I have been made aware of several instances where Covid-19 positive persons are isolating within homes where there is an elderly family member or infants. I suggest that the schools be used to house Covid-19 positive persons who are not severely ill. This may require some logistics and retrofitting but it can be done. Community spread requires a community response. Civil society organisations, religious groups, the private sector and other volunteer groups can assist the GOG with logistics and other arrangements in this regard.
4. Ideally, the General Hospital should not be used to care for Covid-19 patients, as this compromises the health of other hospitalised patients. In the post-Cabinet Press Briefing held earlier today (7 September), the Minister for Health indicated that as part of contingency plans, Princess Alice Hospital in Mirabeau may be designated solely for Covid-19 patients. This is a good idea and I wish to suggest that this policy be adopted sooner rather than later.
5. I commend the recent efforts by the GOG to establish free testing and vaccination sites but call for a revisit to the approach Perhaps there can be time slots by alphabetical order of surnames to prevent mass gatherings. This would reduce the ironic possibility of such sites becoming super spreaders.
6. The issue of mandatory vaccination is controversial. However, I continue to encourage Grenadians to become vaccinated. Frontline workers, such as police officers, nurses, doctors, workers at nursing homes and medical institutions and other frontline workers should see it as their moral obligation to become vaccinated. The reality is, vaccination provides an additional layer of protection for individuals and the society as a whole. The more unvaccinated persons there are in a society, the longer the virus would have welcome hosts (our bodies) in which it can survive and further mutate into other variants. The more of us that are vaccinated, the greater the possibility of flattening the curve, winning the war against Covid-19 and saving lives.
7. As is the case in some other Caribbean countries, a Covid-19 Monitoring team could be established to assist the RGPF with monitoring societal behaviour, to ensure compliance. Similarly psycho-social support groups are needed to provide emotional, psychological and mental health support to persons in isolation and families of those in hospital facilities or those who have lost loved ones. Free tele-health psychosocial clinics could be quite useful.
8. The GOG cannot, on its own, tackle this crisis. There is need for inclusive governance. I recommend a broad-based committee — a sort of ‘war room’ — comprised of governmental and non-governmental stakeholders including the Grenada Medical Association, political parties, churches etc., to effectively bring the situation under control. The ‘war room’ should also include skilled public relations specialists to effectively communicate appropriate messages to the public, while listening to their concerns. Public education must be ongoing.

In short, community spread demands a whole of society approach. It is a fact that Covid-19 met a weak and under-resourced health system. This is no time for blame. We have to work with what we have in the most efficient way possible. But going forward, one of the lessons from the Covid-19 crisis is that the health system must be treated as a priority and as a critical pillar of development. In the meantime, the GOG is encouraged to ensure there are contingency plans in place (perhaps even recruiting nurses from overseas as was done in other Caribbean countries). I encourage individuals to continue to observe all the protocols. This is no time for defiance and lawlessness! Let’s take personal responsibility in order to save lives. Civil society organisations, the private sector, political parties, churches and other community leaders should continue to play their role to provide encouragement, psychosocial support, financial safety nets and spiritual guidance to Grenadians at this time.

Finally, as we reflect on Hurricane Ivan, which battered Grenada 17 years ago, let’s demonstrate inclusive governance, exercise personal responsibility and civic duty, and engage in community leadership to flatten the curve. I am confident that we will get through this. I call for a day of prayer, in keeping with the words of our national anthem: “Ever conscious of God we aspire, build and advance as one people.”

Dr Wendy C Grenade is a Senior Lecturer in Political Science, The University of the West Indies, Cave Hill Campus, Barbados.