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We Can Buy Ourselves Time But There's No Fix Without Testing

The Tribune By Malcolm Strachan Monday, May 18, 2020

As Biminites brace themselves for a painful 14-day lockdown, we are hoping for the best for our brothers and sisters. Knowing how taxing prevention measures have been for many Bahamians, the psychological and socio-economic collateral damage of a two-week lockdown is not to be taken lightly.

With the island’s community already experiencing a major disruption with the collapse of the tourism industry amid the COVID-19 global pandemic, closures of small businesses and the inability for community members to share with one another will likely take its toll as well.

All things considered, the challenge health officials are likely meeting here is limited testing capacity. Of course, most would say that with a population of 2,000, testing each Biminite should be the goal. However, with mass testing beginning in the last week of April – more than three weeks after the first reported death on the island – health officials are still in a chase. Stating they expect to test between 40-50 people a day, it may take the next 40 or 50 days to test the island’s entire population if it were to proceed without interruption. In any case, it is unclear if this is even the plan.

Perhaps this is the methodology behind the 14-day lockdown. Additionally, using a smaller sample size to test how effective this approach would be on more populated islands such as New Providence isn’t necessarily backwards in thinking. Especially as countries around the world continue to throw everything at the wall to see what sticks, we can appreciate our government is no different. However, mitigation strategies cannot be half-baked.

And to be clear, while health officials have made no indication this would be the direction the government would proceed, citizens should not be naïve in thinking the government wouldn’t escalate to more drastic measures if this experiment pans out to be successful.

Still, we’re not dealing with lab rats. We are all real people.

And although no one can understate the importance of physical distancing measures, most of us could not fathom being forced to be locked down for such a length of time.

With families, some with no one employed in the household, questions surrounding food security and how people will maintain their sanity over the next two weeks are palpable. In response, the prime minister has time and again stated no one will go hungry, but little comfort has been found in his words for some Biminites who have voiced their frustration in the media.

Such frustrations should not be minimised as the psychological damage is an often forgotten downside to the preventive measures being taken. Unfortunately, in our society, mental health is usually an afterthought with many people left to battle depression and anxiety alone.

On deciding if a lockdown is a good weapon against the pandemic, one study performed by the Imperial College London COVID-19 response team purports that tactically, such measures are done to reduce reproduction. Reproduction, in this sense, refers to the number of people each confirmed case spreads the virus to.

The study points to two routes to reducing reproduction – mitigation and suppression. Mitigation speaks to the physical distancing and isolation policies we’ve been employing since March. Such methods focus on slowing the spread, rather than stopping it. When circumstances become more severe, suppression is another alternative designed to reverse epidemic growth and reduce cases to lower levels – hence the lockdowns.

On Bimini, an island only a mile wide and seven and a half miles long with a population that lives close to one another, density was likely a major consideration in the Ministry of Health’s recommendation to lock the island down. Population density has been found to lead to nearly twice the rate of transmission, and with there now being 13 cases in Bimini at the time this was written, the little island has the highest number of cases of COVID-19 per capita in the country.

When we look at it from this angle, as painful as it will be, the government’s decision makes sense. Albeit, if an aggressive measure took place sooner after the first case on the island, we may have not been having this conversation.

Now, the best-case scenario is that we all - and Biminites in particular - adhere to these policies. Simultaneously, health officials need to test residents during the lockdown at increased levels.

With evidence in the study using examples from China, Italy and Spain as models of success for intense lockdowns, without testing, once citizens’ freedoms are returned, we continually face a self-defeating cycle.

Lockdown. Spread. Repeat.

The general outcry must continue to be on mass testing. Else, the economic, social and psychological prices we are being asked to pay will not be worth it. All we would have really accomplished is buying ourselves time. And as we take stock of the global environment as infections and fatalities are still increasing, time eventually runs out.

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