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This is the final part of Village Voice interview with Dr. Richard Van West-Charles, public health professional, former Minister of Health, Housing and Water, PAHO/WHO Representative, on the novel COVID-19.
Q. Is the Government’s COVID-19 ever evolving policies engendering compliance or resistance? Please explain.
A. The approach of the Government evolving policies really requires a more inclusive approach in the National Task Force. Also, it is important to establish Committees which will be addressing the collection of data on the Adverse effects of the vaccines in which patients and the consideration of the characteristics of the patients. Also, the decision to use only WHO Approved Vaccines would assist in the reduction of the vaccine hesitancy.
But the fact that there is a lack of inclusiveness and transparency and hence there is a breakdown of TRUST by the population with increasing mandatory declarations the vaccine hesitancy would increase. There needs to be the understanding of the concerns of citizens who do not want to take the vaccine. Education and sharing of information is critical in the strategy and with a different approach coupled with an embrace of inclusiveness and transparency the coefficient of resistance to vaccines can be lowered.
Q. Patients admitted at Linlendaal COVID-19 Hospital are required to get a CAT scan. To do this, persons reportedly have to go to a private hospital in Georgetown and pay the cost ($60-70,000) from their pockets. The question is, is a CAT scan necessary, and if so, won’t it be better for the COVID Hospital to have it? Please explain.
A. The decision to have a CAT scan done should be dependent on the clinical condition of the patient. The physician who is responsible for the patient should request same hence it cannot be seen as a prerequisite for admission. Secondly although the hospital may not have the equipment they would have to try and secure the service if it is clinically required.
Q. There have been allegations patients at the Linlendaal hospital are not being fed regularly and/or the meal is deficient, particularly for persons who have comorbidities like diabetes, hypertension. How important is the meal and/or diet for a person hospitalised with the infection?
A. For any healthy human being nutrition is important. Also, in the case of patients with comorbidities the diet has to be tailored to the health needs for the patients.
Q. How important is oxygen and ventilator to a COVID-19 patient with breathing problems, including its fitting?
A. The decision to provide oxygen and a ventilator for a patient has to be based on the clinical assessment by the health care team. In all cases of Covid 19 when the oxygen saturation is compromised and the pulmonary function is assessed, the decision will be taken for supply of oxygen and mechanical ventilation.
Q. There has been a report that a patient (deceased Nurse Vanessa Maynard) could not visit the private hospital in Georgetown to do a CAT scan because the ambulance could only take a person that needed 8 litres but that patient needed 10. Could you explain, based on the information offered by the family, what could have likely been the (health) situation here?
A. It is difficult to make a comment since without access to the clinical records it would be difficult to comment.
Editor’s Note:- A CT or CAT scan or is computed tomography scan is a medical imaging technique used in radiology to get detailed images of the body noninvasively for diagnostic purposes.
Q. Should there be another lockdown? Please provide an explanation to answer.
A. Lockdowns have a negative economic impact on the economy of the country. The government needs to make the necessary changes to the organisation of the Task Force and include the Professional Associations, The Trade Union Movement, Religious Organisations, the Ethnically based Organisations and the Security Forces, and some Service Organisations such as Rotary and Lions. The rate of vaccination must increase if not lockdown is the answer, and it has to be lockdown for All and not specific groups.
Q. What would you have done differently were you the Minister of Health or had a national role in the management of the pandemic?
A. In addition to all [I have said before] there needs to be Task Force teams in every community with the representatives of the members of the Task Force with assigned health resource personnel to assist in addressing the hesitancy and also the availability of vaccines. Confidence, quality of products used, capability of the persons involved, and trust are always critical to the success of Public Health Programmes. Last but not least communication will always be critical. Not only public advertising but focus group discussion and communication.