Rougher days lie ahead

May 19, 2021 Features / Columnists, Peeping Tom

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Kaieteur News – COVID-19 testing levels in Guyana are still low and times are inefficient. The result is that one cannot effectively gauge the true incidence of the virus in the country.
There has been a tremendous increase in the number of recorded cases over the past few months. In February, there were 944 positive cases recorded. In April, this more than tripled to 3,034.
These numbers do not appear to be fudged since the accompanying deaths have also been staggering. From a low of 13 in January, the number of deaths increased to 66 deaths in April, a more than 400 percent increase.
Yet, this did not prompt the government to tighten the restrictions. And given the fact that people are happing making money, very little pressure is being placed on the government to move towards tightening the restrictions in place.
The government appears to be tying its hopes on increased vaccination in order to achieve herd immunity of 85 percent – the government’s estimates. As has been pointed out repeatedly in this column, it is impossible for herd immunity to be achieved in Guyana because of the high percentage of under 18s who do not qualify for vaccination. More than 30 percent of the population fall in this age group and therefore a herd immunity threshold above 70 percent cannot be achieved.
More importantly, if the government is aiming for herd immunity of 85 percent, it means that this is based on a basic reproduction rate of 6.7 – a level that would overwhelm our hospitals.
However, does Guyana need such a high threshold of herd immunity to bring the vaccine under control? Herd immunity occurs when the virus cannot find enough persons to infect – because these persons are immune – and this is unable to be transmitted.
The key to determining herd immunity is the calculation of the reproduction number – or the number of persons which one person can infect. The government has not made known what is the country’s basic reproduction number. But during the early days of the pandemic, it was estimated as high as 3.5 but this is to be expected in the early stages of a pandemic before behavioural changes resulting from lockdowns and curfews.
If at best, we assume that the basic reproduction number is two then it will mean that Guyana would need to vaccinate 50 percent of its population of 375,000 persons in order to achieve herd immunity and not the 85 percent which is being projected. It is for this reason that far more important than the number of new cases is the number of persons who are susceptible to being infected by one carrier.
But that is a data which the Ministry of Health is keeping secretive, if it does have it. And it is the most important piece of information needed for herd immunity. The Ministry of Health has demonstrated a glaring reluctance to reveal epidemiological information, which is necessary for the public to make an informed assessment of the local coronavirus outbreak.
No doubt realising that it cannot achieve even 70 percent herd immunity, the government is reframing its vaccination numbers to now emphasise the percentage of the adult population, which has been vaccinated. As at yesterday, it was stated that 36 percent of the adult population has been vaccinated. But this is only 23 percent of the total population which has received a first dose.
Less than four percent of the population has been fully vaccinated. This is nowhere near 50 percent of fully vaccinated persons, which may be required for herd immunity, on the assumption that the basic reproduction number of the virus is two.  Some persons believe it is far higher.
There is therefore no light as yet at the end of the tunnel. And given the high levels of vaccine hesitancy, Guyana is likely to struggle to immunise half of its population. There are educated people in Guyana who are offering the most spurious and absurd reasons for not taking the vaccines.
Given also the reluctance of the government to tighten social and workplace restrictions, the next best option would be to ramp up testing. But this has been the area of greatest failure by the government. It is a public scandal that persons still have to wait two or more days for their test results when since last September, the government has been projecting increasing testing capabilities.
A good indicator of whether sufficient testing is being undertaken is the positivity rate. Anything less than five percent is considered fair. Less than one percent is good. Guyana’s positivity rate is 11 percent. It means that the country is not testing enough persons and that one of every 10 persons tested is giving a positive result.
Efforts therefore should be made to ramp up testing and to reduce the time for results. But considering the efforts at increasing testing capacity over the past nine months, there is not likely to be much improvement in this area.
As such, the battle will be long and hard to bring this virus under control. And the situation is not being helped by those who are refusing to take the vaccine for all manner of silly reasons.
(The views expressed in this article are those of the author and do not necessarily reflect the opinions of this newspaper.)

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