Kalain Hosein and Rishard Khan

What was the cause of the current surge in COVID-19 cases and deaths?

Until Monday afternoon, the public and epidemiologists alike were on the same page – travel and congregation during Easter.

However, during the State of Emergency debate in Parliament, the Prime Minister liked the current surge in COVID-19 numbers to candlelight and prayer vigils held in early February for murdered court clerk Andrea Bharatt. What does the data show?

Tracking the spikes

Since the start of Phase 2 of COVID-19, Trinidad has experienced several spikes that health officials acknowledged. In 2020, there was the post-2020 General Election increase in cases, connected to the number of rallies and lack of mask-wearing. Cases surged through October, with another spike in November due to a prison COVID-19 outbreak.

The subsequent surge in cases followed Christmas and New Year’s events, where medical officials attributed the surge to house gatherings and parties. These cases were clustered, and numbers declined into February.

The Andrea Bharatt effect

On January 29, news broke about the kidnapping of a court clerk attached to the Arima Magistrates’ Court. The news sent shockwaves across the country, particularly when her body was found off a precipice in the Heights of Aripo on February 6th. Over 100 vigils occurred between February 6th through February 14th, two days after Bharatt’s funeral.

These vigils were populous, but they were held outdoors, and to occur, organizers needed to seek permission from the Commissioner of Police, where COVID-19 protocols had to be followed.

Still, epidemiologists were wary.

On February 13, one day after the funeral, the Technical Director of the Ministry of Health’s Epidemiology Division, Dr Avery Hinds, said, “We are hoping that we don’t see an increase in transmission as a result of these gatherings. Only time will tell.” Dr. Hinds explained he and his team would have looked at the data to see whether there were increasing numbers instead of decreasing numbers in the wake of activities.

February cases

According to the World Health Organisation, the incubation period of COVID-19, meaning the time from exposure to first symptoms, can be anywhere from two to 14 days. With the last highest turnout vigil occurring on February 14th, cases theoretically should have climbed between February 14 through February 28.

Based on the epidemic curve, the seven-day rolling average was at its lowest for 2021 during February, with average daily cases between three and four cases. Some days of February recorded zero cases for the day.

Change in regulations

The Chief Medical Officer, Dr Roshan Parasram, on March 22 cautioned that T&T was on the vert of a significant increase in COVID-19 cases.

At this press conference, the CMO said, “Regardless of what you want to call it, it is a significant increase again, looking upwards of 89 percent in terms of cases week on week. It really needs to be viewed by the public and the Ministry of Health as something of concern now.”

On February 21, the Public Health Regulation (PHO) was updated to include outdoor recreational sports up to 22 athletes. Fourteen days after these regulations went into effect, COVID-19 cases rose at a concerning rate.

According to the CMO, on April 1, a “large number of people coming together in close proximity, no social distance, no wearing of masks, no wearing of shields have been observed,” and he continued to say they noted roughly 14 to 21 days after the new went into effect, cases notably rose. The regulations were changed on April 1st to prohibit recreational sports. However, cases continued to climb.

Easter spread

While the exact figure is debated amongst politicians, it is no question thousands of people travelled not only from Trinidad to Tobago and back but also within both islands, as beaches were open. Though the Prime Minister disagrees, epidemiologist Dr. Avery Hinds described several reasons for the post-Easter spike in cases.

“We’re seeing cases that turn up in contact tracing including workplaces, sometimes places of worship, including indoor settings of bars and bar hopping. We are concerned that the adherence to the mask-wearing, physical distancing and not gathering is not as strong as it was previously.”

Importantly, he added, “The other driving factor would have been the large congregations that would have occurred two weeks ago around the Easter period that we’re now seeing the effects of as this week’s figures roll out. We’re seeing that two-week gap between Easter and now being followed by that large surge which we have spoken about before and which we’re now experiencing.”

Tobago spread

Case spikes in Trinidad are typically mirrored in Tobago. There was a post-General Election spike from late August through October, with a second surge in December through January due to Christmas travel. During February, where there were few vigils in remembrance of Andrea Bharatt, cases remained low to near zero through the first half of March. From March 15th onward, cases continue to climb, with a record high of 42 cases reported in the last 24 hours on the island.