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With more than 2.2 million mournful reasons, Covid is on the lips of many in an amazing assortment of languages, elevating itself to astronomical heights of the only acronym recognisable in any dialect. Admittedly, this recognition is well earned, as it steamrolled it’s way to >103M cases and >2.2M deaths, as the number-1 cause of deaths in most countries.
Covid risk factors
For Covid, like most infectious diseases, seek out the weak and vulnerable albeit we’re all at risk, but these groups based on empirical evidence, live and die Covid worse outcomes.
It is those 65 years and older who have multifactorial driven worse outcomes, for ageing is associated with organ-system wear and tear rendering them dysfunctional. Further, there is a correlation between ageing and chronic diseases that impact immuno-defence.
Moreover, immunodeficiency states attributed to drugs, infections like HIV and congenital immunodeficiency states, increase the risk of severe Covid. For these states, whether acquired or congenital, have in common a compromised immuno-defence.
Additionally, underlying chronic disease eg obesity, are burdensome not only to health services but also those afflicted. For these chronic diseases eg diabetes cause a defenceless immune-system.
Moreover in Western Societies, non-whites have presented as a cohort sharing worse Covid outcomes when compared to Whites for which the postulation is an interplay of socioeconomic factors and decades of health inequalities.
Comparative mortality-rate
Dr. Mahendra Carpen, a senior member of the PPP Covid task-force, gave an interview where he posited that our Covid mortality rate is less than the international average. Certainly, Dr. Carpen was insinuating that the PPP pandemic management is of internationally standard. But undoubtedly, comparative Covid mortality rate has absolutely no role in validating pandemic performance. As a result, Dr.Carpen’s fallacious argument must be placed in the Donald Trump’s crass twaddle of injected deadly disinfectant being curative for Covid.
And it’s for this reason that Dr. Carpen’s political statement must be examined in the context of Covid Mortality rate, which speaks to the number of deaths attributable to Covid, corrected for population. For it was earlier asserted, supported by empirical evidence, that age is a determinant of Covid outcomes. So to exemplify this relationship, an illustration of how the heterogeneity of average ages between countries can result in heterogeneity of Covid Mortality rates. Guyana is a young population reflected by an average age of 26.7yrs. In contrast, Italy has an average age of 46.5yrs while Britain is 40.1yrs. From examination of these average ages, the disparities standout which is accounted for by Britain and Italy higher percentage of over 65yrs, compared to Guyana. As a result, with older populations, their Covid mortality rates will be higher than that of Guyana. And it is this absence of demographic (age, race, etc) homogeneity between countries, with multiple variable determinants, that makes Covid Mortality rate an unreliable tool to validate Covid management. Indeed, if Dr. Carpen wishes to use such a tool to validate PPP Covid management, then his comparison must be between countries with similar demographics. For our Caribbean neighbours are such comparators for which Guyana’s Covid death rate is the highest.
Covid-curve and R-number
But it is the Covid-curve and R-number that are recognisable international tools used to validate Covid pandemic management.
For the Covid-curve(Figure:1) has three distinct phases with the ascending exponential phase being steep and upwardly inclining representing rapid increases in measured variable. This is followed by the plateau phase for which the curve has a horizontal peak indicative of a stable measured variable. Finally, the declining phase depicts a curve sloping downwards, representing a decreasing measured variable. Internationally, progress in Covid management is determined by examination of trends eg, if twenty patients were dying daily from Covid, then a measure of success is stabilising or decreasing death numbers. And if these deaths from Covid over an extended period is decreasing then the curve will appear flattened. This process is known as flattening the curve(Figure:2). Flattening the curve is important since it brings the Covid infection rates within the Healthcare system capacity(Figure 2). And this flattening of the curve is easily obtained with Public Health Practices eg face mask compliance, social distancing, avoid social gatherings and lockdowns which debunks Dr. Carpen argument that we as a third world country shouldn’t be held to the same standards as first world countries. Obviously, Dr.Carpen is of the view that we cannot wear face-mask as well as those in the first world. That’s total hogwash since all that is needed is a Government that is serious about Covid to enforce it.
Likewise, the R-number which represents the number of people one infected person can infect, is a mathematical model used to measure infectivity. For the aim in Covid management is to decrease infectivity which itself is dependent on Public Health Practises eg face-mask, social distances, lockdowns their relations etc. It is for this reason that Covid task-force monitor R-numbers and make public health decisions eg lockdowns.
Therefore, Covid curves and R-numbers are guides for Covid management. Comparative mortality rates have no role.
Figure:1
Figure:2
PPP disastrous Covid management
When PPP was inserted into power, APNU+AFC had effectively managed Covid, which was evident in decreasing deaths. But within weeks of being inserted, Guyana Covid deaths transformed from decreasing to exponentially increases. And the impetus underpinning this disastrous transformation was what epidemiologist cautioned against namely, only make small intervention followed by assessments of the outcome, which informs the next intervention. But PPP gained power with the unsavoury support of their business enablers. As a result, once in power they were under their directive to relax the APNU+AFC lockdown. And that PPP did, disregarding international guidelines of only small interventions, as airports, all ports and non-essential services were all reopened, resulting in increasing infections and deaths. But rather than reassessing aforementioned failed intervention, PPP pressed on, discontinuing APNU+AFC policy of monitoring quarantining and self-isolating people while decreasing curfew-times. Unsurprisingly, the populace followed the cues of the lax PPP in disregarding social distancing, wearing face-mask under their chins and consuming alcohol in the PPP reopened bars, around the country. This resulted in the ITU being overrun along with exponential increases in deaths not attributable to increase testing. But despite the overwhelming evidence, Dr. Carpen asserted that the APNU+AFC Government mismanaged Covid. For if Dr.Carpen is correct, which he isn’t, the Covid deaths, ITU admissions and infection rates would have been high during the APNU+AFC period. But numbers don’t lie. In five months, APNU+AFC registered 420 cases and 20 deaths. For a comparable period, PPP registered 7108 cases and 157 deaths.
Guyana i’ll-prepared for Covid variant
Guyana Covid death rates, that have been consistently increasing, will pose a challenge with the newly discovered Covid variants; for their greater virulence and transmissibility are without question. When this is coupled with our background consistently increasing deaths, the outcome would be an exponential increase on ITU demands, which already lacks capacity, along with exponential increases in deaths.
For these reasons, PPP attempts at blaming the populace for the increasing deaths aren’t consistent with the evidence provided. For such an attempt at blame deflection must be seen for what it is; an attempt at deflecting attention away from their unpatriotic act of choosing dollars over deaths.
