Kevon Felmine

The Ministry of Health will embark on a study of T&T’s response to COVID-19 to help formulate policies that will guide T&T through future pandemics.

During yesterday’s COVID-19 update, Health Minister Terrence Deyalsingh said a steering committee, chaired by Chief Medical Officer Dr Roshan Parasram, would oversee the study.

The committee will seek five volunteers from the survivors of 116 patients who were diagnosed with COVID-19 to share their experiences.

The five would include those who had mild, moderate and severe responses to the virus.With the parameters of the study already established, the committee has until May 9 to submit terms of reference to the Ministry’s ethics committee.

That committee has five days to respond.

“We have taken a decision to start a retrospective study of all 116 cases of COVID in Trinidad & Tobago. What that will do is to help us make plans for the future. It will help us to now consider the new symptomologies that are presenting across the world. One of the new symptomologies, I am just raising it here, is something called silent hypoxia. You would have heard last week and two weeks ago, new symptoms presenting: loss of taste and loss of smell.

“The Ministry of Health is going to be very proactive by doing this retrospective study of 116 cases so that when we prepare for future developments, we will have a model. Not only for COVID but a model as to how future ministers of health, ministries of health and future governments can deal with pandemics,” Deyalsingh said.Once approved, the committee will accept external submissions from agencies and researchers.

The committee will lead papers on:

1. ↓The clinical experience to date

2. The public health mitigation strategies implemented

3. The effectiveness of the parallel healthcare system

4. Supply chain management challenges caused by global supply chain disruptions

5. The inter-sectoral response (PAHO, CARPHA, the private sector, NGOs)

6. The management of communication, the building of trust and the implementation of behavioural change?

Other papers include governance, crisis management and crisis leadership, mental health response and the transitioning from the COVID-19 period to the hurricane season.

“This data must not go to waste, but it must be used for the benefit of Trinidad & Tobago as we move forward.

“Not only to deal with the second or third waves but to predict where the clusters may come from. We are going to use the data from the GIS mapping system that we have.

“It will also inform how future governments respond to pandemics because pandemics are going to become a feature of public health.”

Deyalsingh said the study would help the ministry examine the latest symptomology of COVID-19, such as silent hypoxia, loss of taste, loss of smell and COVID fingers and toes.

Parasram said that when people present with a respiratory condition such as pneumonia of a bacterial origin or asthma, medical staff would usually check the patient’s pulse symmetry to ascertain blood oxygen level.

A healthy person would average around 98 per cent in room air, but for someone with a severe asthma attack, it could go down to 87 per cent.

In that case, medical staff would administer oxygen to increase the person’s blood oxygen level.

“In cases where you have 87-90 per cent, what we see in other types of pneumonia is that people are experiencing respiratory distress. Visible signs include flaring of the nostrils, you have an increase in your intercostal muscles being used, and you find that someone looks visibly short of breath.

“The phenomenon of silent hypoxia as it relates to COVID seems pathognomic to some extent, meaning that it defines the disease. While that is a clinical sign, what it is suggesting is that the level is actually somewhere between 50-60 per cent oxygenation.

“People can be sitting around normally with no signs of respiratory distress, using their phones, talking normally but their blood oxygenation level is far below what we will expect for a person in that non-respiratory distress setting.”

Parasram noted this among the cohort of COVID-19 patients and said the study would look further into it.