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– Dr. Carpen says
By Svetlana Marshall
Head of Medical Services at the Georgetown Public Hospital Corporation (GPHC), Dr. Mahendra Carpen said Guyana’s Coronavirus Disease (COVID-19) case-fatality rate remains within acceptable margin, as he allayed the fears of Guyanese, many of whom believe, that the pandemic here is spiralling out of control, with more and more persons dying.
Since the first COVID-19 case was recorded in Guyana on March 11, 2020, the country has recorded 5,601 confirmed cases, of which 151 persons have died. The country’s Opposition – the A Partnership for National Unity + Alliance For Change (APNU+AFC), in particular, has repeatedly pointed out that, Guyana, within a four-to-five-month span (March 11-July 30), recorded a total of 430 cases of the disease, of which 21 persons had died. Since the change in Government on August 2, 2020, the country has recorded 5,171 additional cases, and 130 additional COVID-related deaths. In the eyes of the Opposition, the pandemic is being poorly managed by the Ministry of Health, and by extension, the People’s Progressive Party/Civic (PPP/C) Government.
CASE FATALITY RATE
But Dr. Carpen, in an exclusive interview with Village Voice News, said Guyana’s COVID-19 case-fatality rate remains well below 3%. According to Johns Hopkins University and Medicine, case-fatality ratio or rate is the number of deaths per 100 confirmed cases.
“If you look across the world, the case fatality rate, which is usually the number of persons or the percentage of persons who would have died versus those who are positive; the case fatality rate, even in the best places in the world, the most advanced medical societies, it is between two-three percent, [and] we are well within that margin,” Dr. Carpen explained.
According to Johns Hopkins University, Guyana, with 5,601 confirmed cases and 151 deaths, has a case-fatality rate of 2.7%. Mexico, with a total of 1,156,770 cases and 108,863 deaths, has the highest case-fatality rate of 9.4%, followed by Iran with 4.9% and the United Kingdom, 3.6%.
Brazil, with 6,533,968 confirmed cases and 278,932 deaths, has a case-fatality case of 2.7%; while Venezuela, with 103,877 cases and 913 deaths, has a rate of 0.9%. Suriname has a case-fatality rate of 2.2%.
Dr. Carpen said Guyana is fortunate that despite limited resources, its case-fatality rate remains under the 3% mark. He rebutted the claims that COVID-19 patients are not being properly managed resulting in their deaths.
“I can tell you that there are committed, dedicated, highly skilled persons within the healthcare sector in Guyana who are focused on improving our response and outcome to the COVID-19 pandemic. And this is not an idle statement or without facts or without any foundation. If you go any part of this country, in hospitals right now, the cleaners, the attendants, the pharmacists, the doctors, the nurses, everyone is putting in an effort, often beyond the call of duty. So, it would be completely inaccurate for anyone to have that assumption that our mortality rate is as a result of poor management,” the GPHC Medical Services Head said.
In explaining the deaths, the Health Ministry, had said that the majority of the patients, who succumbed to COVID-19, had co-morbidities or in other words, preexisting conditions.
Those admitted to GPHC were severely ill, Dr. Carpen said. “Everyone who actually ended up dying in our institution, were severely symptomatic before they experienced that unfortunate outcome,” he said.
INCREASED TESTING
In addressing the concern that Guyana in the past four months has experienced a rapid increase in the number of recorded COVID-19 cases, Dr. Carpen said among factors influencing the number is the number of tests being done.
“The spike around that time [August-September], I believe, is secondary to a number of factors. One, we started doing a lot more testing [and] we started finding more cases,” he said.
Dr. Carpen said Guyana’s Health Sector, like other health sectors across the world, utilizes a four prong approach – Testing, Tracing, Isolation and Treatment (TTIT) – in its quest to suppress the spread of the disease.
He said the country was not adequately prepared to combat the disease when the first case was recorded back in March, but as time progressed tremendous improvements were made particularly in the area of testing.
“I believe in the early stages we were doing between 10, 20, 30 tests per day. The criteria for testing was pretty strict and that was essentially due to the availability of testing kits, testing equipment and personnel to carry out those tests,” Dr. Carpen told Village Voice News.
He said since then the Public Health Sector has come a far way, thanks to the dedicated group of professionals, who is focused on improving testing and the country’s response to COVID-19.
“The Public Health System now has the capacity to do between two-three hundred tests per day. Of course there were hiccups along the way, hiccups are not unique to Guyana, hiccups are seen all around the world, but what is encouraging is that every stage, the health care professionals and administrators who are part of this fight, they have stepped up, and we have found solutions and we have been able to provide credible response to this pandemic, that’s in the testing,” Dr. Carpen said.
The Polymerase Chain Reaction (PCR) Test is among COVID-19 tests being done in Guyana. Within days, the country is expected to commence the use of antigen testing kits, which will provide faster results.
While the country has seen significant improvements in the area of testing, Dr. Carpen said contact tracing remains a major issue because of the country’s population density and limited human resource in the healthcare sector.
“The same goes for isolation, when we started isolation or quarantine was being advocated to be done in a government run facility or institution but we have quickly outgrown our capacity and now the criteria for home isolation and home quarantine,” Dr. Carpen explained.
According to statistical report from the Health Ministry, as of December 4, 2020, 45 persons were in institutional isolation while 705 persons are in home isolation. Another 22 are in institutional quarantine.
“In terms of treatment, that is where we have made the biggest improvement after testing and we are comfortable that whatever is available for the majority of our CARICOM and Caribbean colleagues, we have those capabilities in Guyana. Most specifically, we are pleased to have been among the first to introduce the use convalescent plasma in Guyana, and particularly, the Georgetown Public Hospital,” he said. The Health Ministry, Dr. Carpen said, was also successful in sourcing Remdesivir at a significantly lower price than it is being sold for on the US market. Other medications being administered to COVID-19 patients include, dexamethasone, hydroxychloroquine and Vitamin C.
As the fight continues against the virus, Dr. Carpen is urging all Guyanese to adhere to the COVID-19 preventative measures by employing the correct and consistent use of a face mask when out in the public; maintaining the six feet physical distance from others; and the practice of good hand-hygiene.
