T&T is still not ready for an Ebola outbreak. Dr Varma Deyalsingh, treasurer of the T&T Medical Board and secretary of the Psychiatric Association, said while the Eric Williams Medical Sciences Complex (EWMSC) 12-bed capacity and Caura Hospital’s 48-bed capacity announced by Health Minister Fuad Khan to quarantine people with Ebola was a good start, it was not enough. Better containment of the virus, more equipment, and the training of staff are also required, he said.
Deyalsingh said the health sector’s state of readiness against the deadly virus can be gauged by asking any random patient in the emergency department of any hospital how long they had to wait for treatment.
Speaking to the Sunday Guardian in a telephone interview on Friday, Deyalsingh said an Ebola patient has to get up to 20 units of blood per day to save his life, “and we can’t even get two units of blood to do normal procedures that we have planned, such as elective surgery, much less cope with an influx of Ebola patients. “In T&T we lack the human and infrastructural resources to deal with Ebola. “We have to look at our Carnival, the celebrations, crowds present ideal conditions for Ebola to spread.
“The virus is just a plane ride away from reaching T&T, one person can come here and destroy the whole if he is a viral bomb. Deyalsingh said there was a consensus among doctors, and the majority of them have said that Carnival should be postponed. He said, however, that while there was public education on Ebola, the Government was sending mixed messages—don’t stop the Carnival on one hand and warning about the dangers of Ebola on the other.
‘It’s like a predatory, molecular shark’
Deyalsingh described Ebola as a predatory, molecular shark. “It has motive, invades a cell and uses the cell’s genetic material to replicate itself, eventually infecting and consuming the whole person who will be teeming with the virus just waiting to spread further.” Deyalsingh said an eye dropper of blood can contain approximately 100 million particles of the virus.
He said Ebola was like influenza in that “it can take down a lot of humans.” For the majority of cases Ebola was a virtual death sentence, from the moment the virus entered the bloodstream, for 70 per cent of cases, the war was lost. He said the damage done by Ebola in ten days took HIV ten years to accomplish.
Thermal cameras to detect Ebola give false sense of security
Deyalsingh said thermal cameras used to detect Ebola can give a false sense of security as they can register false positives. He said elevated temperature readings can be caused by another viral illness, such as Chikungunya, dengue fever, chicken pox and measles. Deyalsingh said a person taking Panadol can suppress the symptoms of a fever and pass the initial scan or Ebola test.
Ebola treatment and decontamination procedures
• He said Caura and Mt Hope hospitals’ plan for people on T&T’s Ebola watch list was to monitor them for fever. Deyalsingh said the incubation period for Ebola was 21 days and in that time they may not show any symptoms.
• He said proper medical protocols called for isolation, contact tracing, and to ensure that health care personnel did not become the vectors for the virus.
• Deyalsingh said infectious patients are put in an isolation room, and health workers have to put on protective gear before entering the room. On leaving the room their protective gear is burned.
• Deyalsingh said patients are put in negative-pressure rooms that isolate air so it can’t circulate through the building, the same precautions taken for tuberculosis.
• He said the second stage was decontamination under UV lights, but sometimes particles from the protective gear can escape and cause infection. Deyalsingh said the health care workers may be fatigued and make a mistake during the decontamination process and infect themselves.
• He recommended that masks and disposable gloves be worn by staff at points of entry—airline personnel and immigration personnel handling passports and documents are at risk.
• Deyalsingh also recommended keeping a distance of three feet away from suspect individuals, bowing instead of shaking hands, and be aware of people with a fever.
• He said Government’s policy for people on the Ebola watch list to travel to health centres to be checked twice a day to see if they developed a fever was not a good idea. Deyalsingh said it was better to keep those people at home and to send a medical team to monitor them, rather than running the risk of infecting the population while travelling.
• He said incineration was the best method to dispose of contaminated waste material.
• Deyalsingh said the proper disposal of bodies with Ebola was cremation but this may present a dilemna in T&T, as some religions such as the Islamic fate do not cremate their dead.
• He said the danger with the Ebola virus was its viral amplification jumping from animal species to man. According to Deyalsingh, Ebola has been trying to jump out from its animal hosts and into humankind for a while now.
• Deyalsingh said there was the danger of animals such as rats coming in contact with infected, buried bodies. Scientists do not have enough data at present on whether this can be spread further.
• He said pet dogs of people who died of Ebola were also killed as a precaution.
• Deyalsingh said if the virus reaches T&T it must be contained at the quarantine centres. In the worse case scenario of an Ebola outbreak and Mt Hope and Caura hospitals are overwhelmed with patients, the remote island of Chacachacare, once used as a leper colony from 1922 to 1984, was an excellent option to quarantine people with the virus.
Dr Laquis: Use Clorox to wipe equipment
Meanwhile, in an interview with Sunday Guardian columnist Ira Mathur, Dr George Laquis, the former chairman of the T&T Cancer Society agrees with Cabinet’s position that anyone from Sierra Leone, Guinea, Democratic Republic of the Congo, Liberia and Nigeria, or anyone who has been there in the past six weeks, will not be allowed entry into T&T.
“The Government is absolutely right in stopping these people from entering T&T. We don’t have cases of Ebola. The trick here is to make sure we don’t get any at all,” he added. “All it takes is one handshake with someone with a cut (it can be passed through sweat and other bodily fluids). The number grows from two to four to 16. By Christmas, as many as a million people may die from Ebola.”
Dr Laquis, however, is cynical about claims that the Government is setting up an Ebola isolation unit at Caura Hospital to the tune of millions of dollars, and the plan to spend millions to procure protective equipment for medical professionals to treat citizens who may contract the virus. “Poorer Caricom governments such as St Vincent recognise that their only defence is to block people from coming into the country,” he said.
“But we are talking big, of an isolation centre. We all know, we all—including the politicians—talk a good story. We are a spin-master nation, but we don’t take it or ourselves or anyone else seriously. We don’t deliver. We are not serious. We don’t keep our word. It may never happen.” Dr Laquis said people should use Clorox to protect themselves if in a situation close to the virus. “Clorox. Some gyms in the US have a crew wiping equipment with Clorox every hour.
“We should be doing that in Trinidad. Ebola is passed on by sweat and can get into a mucous membrane or open skin.”
‘Nurses will not be left exposed’
T&T Registered Nurses Association president Gwendolyn Loobie-Snaggs said the chief nursing officer on the Ministry of Health’s core team will ensure that nurses are given the proper training. They will also make available protective gear and equipment required for the management of Ebola patients. Loobie-Snaggs said nurses will not be left exposed, and all due care and attention will be paid to those who volunteer their services to care for Ebola patients.
Heerah: More protective equipment coming
Executive Director of the National Operations Centre (NOC) Garvin Heerah, meanwhile, said there were hazmat suits (hazardous materials suits) in the country but was unable to say how much. He said the Ministry of Health will be bringing in specialised equipment including PPEs (Personal protective equipment) very shortly to treat with the institutional management of any Ebola patient.
Heerah said the Office of Disaster Preparedness and Management will also be procuring PPEs for first responders such as the police, fire service and the Defense Force.
UWI forum on Carnival 2015 and Ebola tomorrow
The Sir Arthur Lewis Institute of Social and Economic Studies (Salises) is hosting a forum on Carnival 2015 and Ebola, tomorrow at 10 am, the Salises Conference Centre, the UWI, St Augustine. Specialist medical personnel from the UWI’s Faculty of Medical Sciences will also be present to contribute to the discussion and to answer questions.
Panelists carded for the event are Health Minister Dr Fuad Khan, Pan Trinbago president Keith Diaz, National Carnival Bands Association of T&T president David Lopez, Trinbago Unified Calypsonians’ Organisation president Lutalo Masimba (Brother Resistance) and Dr Jo-Anne Tull, lecturer in Carnival Studies, Department of Creative and Festival Arts, UWI. The session will be chaired by Roy McCree, fellow, Salises,
ebola facts
Deyalsingh said Ebola and its precursor, the Marburg virus, with similar symptoms such as headache, fever and internal bleeding, originated near Kitum cave, Mount Elgon in Kenya, where many different species of animals frequented. He said the cave also bordered Uganda, one of the first epicentres for Aids. He said the US army also kept strains of the Marburg virus for its “hot agents” or germ warfare research.