Safe Saint Lucia – the place to be in 2020

St. Lucia has eliminated COVID-19!

The evidence suggests that, weighing the benefits and risks, it is time to lift restrictions domestically. Schools could have been back for a month now, bus drivers should be working with reasonable numbers. This should be the strategy once there are no leaks in the system, for example, returning nationals who break self-quarantine, and inadequate border control.

As much as you and I dislike masks and would love to say we are free and don’t need them, we have to realise “to err is human” and so it is sensible, even if COVID-free, that we continue the practices that will keep us safe should a case slip into our midst. Therefore hygiene and masks for all and distancing whenever we can must be the order of the day. Never stay more than 15 minutes (some studies say 30) at a distance of less than 6 feet from someone who does not live with you. Numbers on a bus, therefore, should depend on the length of the journey. It is not an exact science at this point, but we can use whatever evidence there is sensibly.

There is a growing number of Caribbean countries with no current evidence of cases- St. Kitts and Nevis, Anguilla, St. Barts, Grenada, St. Vincent, Dominica, and the “Caribbean Netherlands.” We are “green” on Worldometer. Barbados is to be added to the list. We are undoubtedly the safest region in the world now and need to look at the opportunities this affords us. We are safe not only healthwise, but we are also ethnically and religiously diverse and well-known for our warmth and hospitality. Our tourist season begins in November so summer months are traditionally less busy.

However, with effective marketing, we can benefit from increased intra-regional travel as well as “staycations”. There are substantial numbers of West Indians who travel internationally in the summer who can now safely be welcomed to a sister island instead this year. I trust all islands will be represented equally through CARICOM and will be recognised by the developed countries as safe zones so that the United Kingdom for example will remove the quarantine restriction on travellers from all “green” countries on Worldometer and the European Union will add us to it’s ”safe“ list. We need to focus on stimulating our economy in innovative ways.

It is so much easier with technology now for any of us to market to the world if we desire. Let’s be entrepreneurial.Tourism is important to sustain our economies. There are exciting ways to benefit St. Lucian communities by exploring village tourism, involving agriculture, fishing, independent bed and breakfast accommodation, ”Live like a Lucian” , as well as niche product offerings for the different districts, according to what they are most suited to and traditionally known for, combined with the community’s emerging talents and new ideas.

The best way forward is always collaborative with a clear vision in mind for the good of the people. A non-partisan “Think-tank” involving the best minds across sectors, including Government, NGO’s, business owners/ Chamber of Commerce, educators, community leaders and youth, is important. It’s easy to “Zoom” in regional/ global minds as required.

Persons most at risk of severe COVID-19, according to the Centers for Disease Control (CDC) , June 25 th 2020 are those who are obese, type 2 diabetic, have chronic kidney disease, COPD, are immunocompromised (due to disease and/or treatment eg HIV, autoimmune disease, cancer) and those with serious heart conditions and sickle cell disease. Hypertension is a major independent risk
factor in most global reports. Also, according to the CDC, “social inequities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age. Black persons in the US have a hospitalisation rate approximately 5 times that of white”.

The above chronic non-communicable diseases are the greatest health problem in St. Lucia. We must empower people to manage themselves with a supportive team and help enable all to have a reasonable quality of life. This will be done by providing affordable health care, necessary investigations and medications for all chronic illnesses in the public sector, and social and psychological support. We must educate holistically for the changing market and be prepared to work
together across Government, NGO and private sector. Until this happens we will not improve the lot of our people or the economy of our nation. Health, education and economy are inextricably linked. All St. Lucians should have access to running water, toilet facilities and electricity. This is how we will promote well-being and prevent illness. Providing these basic necessities is not the remit of Government alone, but to be achieved with combined effort.

The cartoons from the Ministry of Health on how to recognise, prevent, manage and treat COVID- positive patients fairly, have been a wonderful strategy, and we would do well to use similar strategies to promote holistic health, including instilling pride in keeping our country clean and free of litter. Remember rat- and mosquito-borne diseases will plague us too if we do not respect our environment.
Let us appreciate and maximise our human resource. We should use the self-management program we introduced to the Caribbean to empower us to believe in ourselves. We must build on the successes this small island has achieved in diverse sectors.

We boast nobel laureate fame in literature and economics, a seamoss business that is a cottage industry gone global, innovative musicians across the genres, including Dennery segment, sculptors
with works of art by commission in China, artists who exhibit at museums like the Museum of Modern art in New York, a solar-powered mobile desalination plant used by Nauru in the Pacific, invented by a St.Lucian gentleman who did not complete secondary school but who, with innate engineering talent and years of determination realised his dream. Be inspired!

St. Lucians need to realise that we have been spared the ravages of COVID-19 thus far due to the individual and collective responsibility of the majority. COVID-19 numbers are still increasing globally and people are dying or being left with chronic disease.The United States hit a new record today with more than 50,000 cases in a single day. It may be hard for some, especially young, fit St. Lucians to believe there is any danger because we are not seeing the problem here. However, data is starting to show that younger people are at risk too. In Canada, most cases are 40-59 years old . In Jamaica, the age range of patients hospitalised at UHWI so far was 33-87. CNN reported that yesterday at a hospital in San Antonio, Texas, there were ten people between 20 and 30 years old requiring Extracorporeal membrane oxygenation (ECMO).

There were only three machines available. The doctor interviewed had never had to make such a
decision. We have heard of several 20-30 year old friends in the United States on ventilators after catching COVID-19 from a pool party. We must be grateful for our lives, and for the fact that, unlike in some parts of the world, there is enough food and water to share in St. Lucia, but if we allow this
virus in by opening to people from countries with community transmission of COVID-19, the story will be more tragic than in the “developed” countries that are making reckless decisions since they have a much more robust health system and safety net. We will overwhelm our health services, people will be turned away from the hospital.

People we know, particularly our frontline workers and other vulnerable individuals, young and old, will die. Tourists will go elsewhere, and we’ll be forced to lock down again as other places are having to do, again. Perhaps the greatest challenge of this pandemic is the uncertainty. If we proceed safely, open to ourselves, protect our borders, and immediately encourage staycations and regional travel to and from COVID-free neighbours, support and incentivise local business, then we can get our children back to school in September, and reintroduce international tourism in the “Tourist season” from COVID-free countries, exploring new, safe markets.

I am certain we will succeed if we ensure our decisions are always made in the interest of all St. Lucian people and we are not afraid to change our minds if the evidence demands.

We must stay vigilant.

By Dr. Amanda King MBBS (UWI), FRCP (Glas.), FACR, SLMM