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Case #14 raises more questions about possible community spread in SVG

St. Vincent and the Grenadines (SVG), on Thursday, recorded its 14th COVID-19 positive case — a person “closely associated” with Case #13, the source of whose infection health officials are still trying to trace.

“Chief Medical Officer, Dr. Simone Keizer Beache, says investigations of these cases are continuing and have been productive thus far. However, it is still too early to issue a definitive statement on the source of infections,” the National Emergency Management Organisation (NEMO) said in a press conference.

On Tuesday, when Case #13 was announced, Keizer-Beache said ongoing preliminary investigations into the new case point to “a possible local transmission, since the individual in question has no known travel history”.

The Ministry of Health further pointed out the difference between local transmission and community spread.

Community spread, Keizer-Beache noted, refers to instances where several people in a community test positive for COVID-19 without any known contact with an imported case.


Citing Caribbean Public Health Agency (CARPHA) definitions, she further said that “local spread” or a “secondary case” describes a situation where the person was never abroad, but was exposed to an imported case, so that the source of the infection can be identified.

And, in Thursday’s press statement, as was initially the case on Tuesday, there was no indication of whether case #14 was imported, as the government had pointed out in the previous 12 cases.

The indication that Case #13 and Case #14 are closely associated again raises the question of whether there is community spread of the viral illness in SVG.

The confirmation of the new case came hours after a Ministry of Health press conference, in Kingstown, where Keizer-Beache responded to questions about Case #13.

Keizer-Beache said health officials had identified “more than five persons” who had had close contact with the patient.

“And I will just say more than five because it is on-going,” the chief medical officer said.

She was asked if there was any evidence, so far, that Case #13 had had close contact or interaction with a known or suspected case of COVID-19 in SVG.

The chief medical officer cited a need for confidentiality amidst contact tracing.

She said:

“And we have identified some possible, possible, okay? Possible sources. Okay? I would say that we have identified some possible sources, but until we have more definitive — even as you recognise sometimes you never will have a specific source, a clearly identified source, we have identified some possible areas of possible contact. And you see I’m saying possible this often because we are currently in this investigation.”

She was further asked if “possible” meant “possible confirmed COVID-19 cases”.

She was, therefore, asked what different measures or steps have her ministry had taken to deal with this possible local transmission.

Keizer-Beache said that every case involves contact tracing, adding, “And this is even more important in this situation.”

The chief medical officer explained that contact tracing “is where we go into the communities, we speak with the individual, we speak with those persons around them and it becomes sort of a widening circle as you attempt to identify.

“The importance of contact tracing is even greater here because you are trying to identify who and where you should be guided. It’s not a blind science; it is based on where the person might have been, what are the contacts, what are the possible exposures.”

She said that even before case #13, her ministry’s surveillance strategy has been to look for cases wherever they might be in the country.

“So, even though all of our cases, until earlier this week, we had definitive ‘this is somebody who came in and somebody who was under quarantine’, we have always been looking for that case who might not be in that group of somebody who flew in.”

Keizer-Beache said that even in the testing strategy, her ministry has not only tested persons who had travelled and returned to SVG.

She noted that this is what an imported case would be.

“We have been tracking, looking and that is what we will continue to do. So, in terms of how have things changed, we will continue.”

She said that her ministry was “looking at all of our influenza-like illnesses”, having decided to do so even before this week.

“… we were going to go into our clinics, we are going to try to identify past hotspots. We are also looking at our healthcare workers. These persons are the ones who would most likely get something and be most likely to give an infection.

“So we’re looking at our vulnerable groups in terms of our elderly persons or persons who are diabetics and hypertensive. So we have already identified some key areas, some key focus groups, and we will be looking into those focus groups, those areas to find cases because that is what we need to do.”

She said that the strategy includes early identification, quarantine, and isolation.

With these, Keizer-Beache said, “you have a better opportunity to slow the spread, which is our aim.

“We are all aware of the fact as prime minister said this COVID is here is in the world; it is something we are going to have to learn to live with to continue our lives,” she said at the press conference, which was also attended by Prime Minister Ralph Gonsalves and Minister of Health, Senator Luke Browne.

Thursday’s COVID-19 positive result came even as the ministry received medical clearance for a five persons, the second in as many days, according to tests conducted by the Caribbean Public Health Agency (CARPHA) in Trinidad.

This means that there are now nine active cases of COVID-19 in St. Vincent and the Grenadines.

Also on Thursday, Keizer-Beache explained how SVG’s COVID-19 patients are treated medically.

“Currently, the management of COVID is symptomatic. That means, if somebody has difficulty breathing, you would apply medication or techniques to deal with that.

“The persons who have recovered did not require any specific medication or intervention. They were mild; they recovered on their own,” she said, noting that it had always been said that 80% of persons with COVID will have only mild symptoms.

“And we are recognising that that figure is probably even higher, and that the proportion of persons who might not even recognise that there’s something going on, that proportion is probably even larger than we thought. So there was no specific treatment, but rather, monitoring and advice,” she said.

Eight other persons who had samples tested at CARPHA over the 48 hours ending Thursday even as part of the on-going COVID-19 surveillance were negative.

To date, samples for 108 persons have been collected for PCR testing at CARPHA, NEMO said.

NEMO said Keizer-Beache is reminding the public about the importance of maintaining the public health measures in place, which include hand hygiene, cough etiquette, physical distancing of at least 3-6 feet in public spaces and strict adherence to quarantine and isolation.

“These measures, Dr Keizer Beache maintains are vital, if we are to continue to slow the spread of COVID-19 in St. Vincent and the Grenadines,” NEMO said.

“The CMO notes that the Ministry of Health, Wellness and the Environment is cognisant of the need to keep the public aware of every development in respect of COVID-19 in St. Vincent and the Grenadines as we learn to live with it.

“Dr. Keizer Beache is assuring the public that the Ministry, the official source of COVID-19 information in St. Vincent and the Grenadines, remains committed to providing, timely, accurate and relevant information, as we continue to manage this public health challenge together,” the statement added.

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