GAME CHANGER: Country records first case of coronavirus

GAME CHANGER: Country records first case of coronavirus

Aggressive contact tracing underway, patient has no travel history

NASSAU, BAHAMAS — A 61-year-old Bahamian woman has been confirmed as the first positive case of COVID-19 in the country.

Acting Minister of Health Jeffrey Lloyd confirmed the woman tested positive for coronavirus at midnight Sunday; however, the patient’s level of exposure to the wider public is unknown at this time.

The woman presented at Princess Margaret Hospital (PMH) with symptoms of fever and cough on Friday evening and was tested the following morning.

Chief Medical Officer Dr. Pearl McMillan said the initial results were inconclusive and the woman was retested.

According to officials,  the patient had no travel history over the last 20 days, prompting officials to perform “aggressive contact tracing” to determine the source of exposure.

This involves investigating her immediate family and “social contacts” to determine the source of the infection.

McMillan said: “We have our surveillance team actually doing the required aggressive contact tracing and ensuring that we are moving in the direction of getting to understand a little better where the possible exposure occurred and what is required to ensure that we contain.

“The family will be a part of our contract tracing investigation.

“As required, we would go ahead and do necessary testing. We are very early in the investigation.”

Chief Medical Officer Dr Pearl McMillan

According to the health officials, the patient is receiving care in the designated isolation area of PMH.

“I want to use this opportunity to appeal to The Bahamas to remain calm; to follow and implement the advisories relating to the personnel hygiene and overall infection, protection control,” said Lloyd during a press conference at the Ministry of Health.

“Rely on credible and certified sources of information to stay up to date on Coronavirus in The Bahamas.

“The Government of The Bahamas will continue to keep the public informed as we manage this public health challenge.”

He added: “We remind the public if you have respiratory symptoms of fever, cough, shortness of breath call your doctor’s office or the Ministry of Health’s COVID-19 hotline at 376-9350, 376-9387 or 376-9357. A healthcare professional will discuss your symptoms and discuss your next steps.”

According to McMillan, the immediately family of the patient will likely be placed in quarantine or isolation, though she could not say when this could happen.

National HIV/AIDS and Infectious Disease Programme Dr Nikkiah Forbes said the patient was placed in the hospital’s isolation unit immediately out of an abundance of “heightened surveillance”, though she did not clearly present the case definition of COVID-19.

Deputy Chief Medical Officer Dr Delon Brennen said officials will “cast their net as wide as we can” said in the first instance, self isolation is being recommended to family members and social contacts. He said as officials learn more there may be a need to isolate more people in contact with the COVID-19 patient.

Forbes reminded the public to not “flood” PMH with symptoms of the cold or flu, which she said is common at this time.

She said those with symptoms of a fever, runny nose, joint pain and/or a cough should not “flood the hospitals and community settings — clinics or doctors’ offices”, and instead stay at home, self isolate, and take symptomatic relief medication.

Forbes said if symptoms worsen, medical care providers should be contacted or individuals can contact the COVID-19 hotline.

“If you go to a busy doctor’s office or a community clinic or the emergency room, which is currently under renovations at Princess Margaret Hospital and sit in the room, if you have COVID-19, you are highly likely to infect other persons, which will cause additional, exponential spread. Please call your doctor’s office ahead of time, so that the doctors can prepare for your arrival.”

Testing

The National Reference Laboratory has tested a total of eight people in-country.

According to officials, testing takes approximately six hours.

Forbes explained officials loosened the testing parameters to test people who would have not have fit that case definition, and we have tested a number of persons.

“That patient, who was spoken about today, was actually tested and identified because of our heightened surveillance,” she said.

“She did not clearly fit the case definition. So, that is a background. To answer your question, the reason there is no mass testing at this time is because up to midnight we had no known cases in-country. And so, your strategy can fairly be at that time, you test persons who meet the case definition. That changes.

Forbes said: “The game changes and that is why country plans have to be fluid. The game changes significantly if you have cases that you do not have a clear epidemiological link. In that case, the best advice would be to accelerate testing and do things like where they are having mass testings in other places, so that would be that answer. We did not have the clear epidemiological information to enable something such as that. We would need to be looking at that, realizing that we are on the first day of diagnosing this case.”

At current, there were approximately 100 test kits available.

McMillan said the Pan-American Health Organization (PHAO) has assured it will aid The Bahamas with additional test kits to conduct wider spread testing, which may be necessary.

“We are ahead of the game kind of, sort of, or behind the game depending on how you look at it,”

…”We have testing capacity in country. We are testing and we are seeking to increase testing capacity

McMilland said health officials have been and anticipated getting to the point of having a first case.

“We are well on our way with putting in place the surge capacity with managing a lot of cases,” she said.

She said despite some challenge within the healthcare sector, the preventative measures are being put in place to handle a large number of cases, though there is “an opportunity not to get there”.

Cases of the virus – which causes the COVID-19 disease – have topped 152,000 globally with the United States declaring a national emergency and countries like France, Spain and the Philippines shutting down non-essential businesses and implementing full or partial lockdowns.

Today, COVID-19 has spread across 49 states in the United States with more than 2,700 cases.

Coronavirus is an infectious disease that spreads between people who are in close contact with one another through respiratory droplets produced when an infected persons coughs or sneezes/or contact with a contaminated surface.

The Bahamas joins at least 157 other nations where COVID-19 has a foothold, and is the eighth Caribbean country to confirm a case.