COVID Underdogs: Trinidad & Tobago

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Indi Samarajiva (Medium) writes about Trinidad & Tobago as an example of “beating an epidemic with speed.” [Many thanks to Peter Jordens for bringing this item to our attention.]

Trinidad & Tobago is a small country led by a volcanologist that recently managed to wrestle their active COVID-19 cases down to one. The secret to their success is widely available to everyone on Earth. Time. No matter how small or under-resourced you are, if you act early and act fast, that gives you massive leverage over a pandemic.

Here’s how.

Test/Trace/Isolate

The basic epidemiological playbook is not complicated or new. Test/trace/isolate has been the mantra for hundreds of years, with the only major advance being PCR testing rather than just eyeballing the sick. If you catch and quarantine any epidemic early enough, you can get it down.

That’s what Trinidad and Tobago did.

The key insight here is when they did it. Unlike ‘developed’ countries that waited until there were thousands of cases, Trinidad and Tobago reacted fast. This gave them — a small, under-resourced nation — a massive amount of leverage. They got the same WHO advice as everybody, including America. They just listened to it. When the local WHO body offered reagents and knowledge, they took it. And so they were ready. [. . .]

Note that Trinidad and Tobago (and the region) was ready well before the American CDC. As you can see, a test in time is worth nine million. Trinidad & Tobago still hasn’t tested much per capita (about 2,000 people out of 1.36 million), but they did it early. This gave them leverage. They were able to take a little and make a big impact.

That’s the power of when.

Lockdown

Regardless, Trinidad and Tobago still had to go into lockdown. Mass-testing countries like Korea and Taiwan could stay open, but most of us don’t have that luxury. We have to lockdown. All we can choose is when. The longer we wait, the more expensive it is. The longer we debate and complain, the worse it gets. Trinidad and Tobago started shutting down one day after the first confirmed case. That’s leverage again. A stitch in time.

Day 1

On March 12th, Trinidad and Tobago announced its first case of COVID-19, a returnee from Switzerland. He had returned on March 9th and gone into self-isolation, but they didn’t know what else was out there.

This is the important part. Other countries wasted time dithering, running computer models, debating how much they cared about old people. Trinidad and Tobago didn’t do that. The next day — March 13th — cruise season was suspended and people were advised to socially distance. Gradually, lockdown had begun. With a week schools were closed. Within 10 days all ports of entry were shut.

By acting early, Trinidad and Tobago saved lives (and money). The west got to these policies eventually, but by then it was too late. They had no chance of suppression and were merely fighting for their lives. Their criminally stupid governments missed the massive power of when. That’s something they need to learn from humble places like Trinidad and Tobago. It’s a lesson to us all.

Day 11

On March 23rd, Prime Minister Dr. Keith Rowley (a geochemist by training) announced expanded testing and aggressive economic support, including over $2,000 USD in direct cash assistance over three months (including rent and food). Note that announced is the keyword here, I don’t know how widely or effectively it’s been disbursed.

This was still the right policy at the right time — early. Western countries have debated supporting their citizens, but the longer they wait the more expensive it gets. [. . .]

Day 14

On March 26th, Trinidad and Tobago went into lockdown with just 66 confirmed cases. Think about that. When the UK went into lockdown on the very same day, they had 60 cases every five minutes. Again, Trinidad and Tobago’s secret weapon was just sitting there on the wall, visible to all. Time. They went into lockdown at the right time, which enabled them to chase complete suppression.

And it worked.

Trinidad and Tobago’s confirmed cases peaked at 116. They were able to effectively do contact tracing on this number and it didn’t strain their medical system. As of today, active cases are down to one. The number of tragic deaths (8) would suggest some unconfirmed, so they must remain vigilant and keep testing, but it’s still an achievement.

None of this was luck. It wasn’t because they’re an island, or because it’s hot. They had 40 infected people get off a boat on March 21st. If they weren’t on high alert they would have gotten hammered. But thankfully, they were. [. . .]

Days 60 – a long time

This, however, was just the first innings. The first wave. COVID-19 is relentless. Just one missed case can trigger another outbreak, and another lockdown, and more pain. Therefore — even though Trinidad and Tobago is nearly clear — they’re still in lockdown, and they’re only releasing very slowly. Again, this is pretty standard epidemiological advice. Be careful.

Western countries are exiting lockdown ruinously early because people want haircuts, or miss the pub. This is dumb. Trinidad and Tobago is only talking about opening up malls and beaches months from now, because they’re smart.

On May 9th, PM Dr. Rowley announced a six-phase reopening plan, which stretches on forever, and isn’t based on political dates. The last phases don’t have dates at all, because the virus eats dates for iftar. Dr Rowley said the adjustments will take place on a phased basis. Each phase will be determined by the results from the COVID-19 Community testing and monitoring done by the Ministry of Health. (PM’s Office)

They’re letting testing and science determine their reopening, not politics and impatience. [. . .]  None of this is rocket science. They’re just executing well.

The Key Lesson: When

This is why we can learn a lot from Trinidad and Tobago. Because they didn’t do anything crazy, unusual, or new. They just took the standard playbook and executed it quickly. Given that spacetime is pretty constant across the universe, this is something any of us could do. [. . .]

For full article, see https://medium.com/@indica/how-trinidad-tobago-got-covid-all-out-33bc10d99a8

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