In only 19 days Belize has registered five hundred and five cases of Covid-19. At the end of July, the number was at forty-eight. When the month of August began, however, an unprecedented number of cases began popping up. It is quite a surge in positive cases and a long way from when we were at 18 cases back in April and May. In an extensive interview with the Director of Health Services, Dr Marvin Manzanero, he gave an overview of how these numbers began blowing up in recent weeks.
Dr.Marvin Manzanero, Director of Heal Services: “A vast amount of these are remember are even the people being in Orange Walk are from the construction site that’s one and two is the people that would have moved much more in the last two or three weeks that would have been more exposed so those would have been the movers if you will of the virus. But if you note it affects all age groups we have a child under one that has been diagnosed so that’s what explains it. It’s the workforce the bulk of your workforce and people who perhaps move for leisure purposes more than older or younger generations and they would have been the ones more exposed for now. Once those persons start to take it back home then you start seeing other age groups being affected school children age groups. Just yesterday in discussions with some of the team members at head quarters I was saying things have to change so drastically that you can’t even have lunch with your colleagues. I mean people should come to the office and depart the office without really interacting with anybody else because as I said if you’re getting it outside and not necessarily in the front line then that explains how we tend to let our guard down once you leave – I think the consensus is most of the health situations people are afraid that they’re going to get infected within a hospital setting but if you’re getting it outside of the hospital setting because you assume that the risk of infection is higher which is but let’s say you take all your PPEs within a hospital setting but the moment you step out you know you assume that outside is perhaps safer or should be safer but it doesn’t really happen like that then that’s a concern. I think that is what has happened even in office settings around different government departments. People are saying well with the colleagues people don’t wear a mask, you know they have a common area, they have a kitchenette a place where they socialize and people let their guard down in that area and I think that’s where the risk of infection is happening with the work colleagues. If you see the vast amount of numbers have come out of San Pedro. I mean 30-35% of the current active cases are in two- three clusters and the other major group is in Orange Walk. What we’re looking for closely are the Belize district and Corozal districts with numbers that are increasing slowly coming up. I think we have to monitor where they’re coming from and make recommendations in terms of perhaps stricter rules that may have to be done in those particular districts. When you have so many resources in health that are starting to be infected go to determine what levels of coverage you’re going to be having at the health system, different health systems, if a specific hospital is having X amount of staff now infected then you’re going to have to shut down some services maybe just go into emergency mode I have a feeling that that’s going to happen in north, west and we’ll see what the data today says. So the review of the data is what is the immediate situation and then make decisions based on that.”
As we noted the explosion of cases began at the start of this month. The high numbers first began coming out of Ambergris Caye. Dr Manzanero explained how the cycle of Covid-19 operates and how it led to the high figures on the island.
Dr.Marvin Manzanero, Director of Heal Services: “What we have noticed is a particular situation where towards the third week in July you started to see- well when you go back and do the history you probably didn’t identify them during the third week of July these cases but that’s when you start to see numbers start to come up and then you see what happens particular towards the beginning of this month in terms of the explosion of numbers but when you go back and review how the disease evolves you realize that it more that likely started to happen in San Pedro right after the state of emergency was lifted. The 30th of June is when it was lifted people started travelling that very first weekend back and forth for work purposes, for leisure purposes. You go back and review the data and it’s suggestive to us now that because of the cycles of how the virus goes in terms of time frames and the fourteen day window period you have for the virus we’re thinking it may have started arriving on the island one or two asymptomatic carriers the first weekend of July. Further to that the second weekend of July would have more people starting to come in and you see when you go back and review there were lots of promotions in terms of hotels for Belizeans and then the third week of July you started having this “before the plane lands” notion with specific dates saying August 15 this is when we need to go. So the asymptomatic carriers may have been, well they would not have been having any signs or symptoms you’d start having a first situation two weeks after and then you give it a further two week cycle and that’s when you start to have that explosion in terms of numbers. That’s where it’s adding up for us based on simple data and epidemiology in terms of numbers.”
Believe it or not, Belize has surpassed other countries when it comes to testing. While each evening Belizeans and the media are on the lookout for the latest infographic, Dr Manzanero explains that the raw numbers are not the only aspect of this pandemic that we need to be looking at as they relate to Belize and its population.
Dr.Marvin Manzanero, Director of Heal Services: “The situation is not only in terms of numbers. You understand that from March when we had our first case the teams on the ground have been working I mean even from January the teams that would go to the airport when the airport was open from January to March that’s the same team that has been doing the contact tracing in Belize City so it’s not a question right now of just the raw numbers but it’s everything else that is behind it. Yesterday the lab processed three hundred plus samples when you look at what other countries are doing, testing rates people are saying but you have to do testing rates compared to other countries we might be doing more testing than Mexico is doing when you do rate per population and Mexico has a raging epidemic. Similar numbers we are doing for Guatemala and Honduras that have much much higher numbers than we do so it’s not only overwhelming it’s the contact tracing element, the lab component, the epi team trying to churn up all the numbers and looking at the graphs and all of that and this is as a means of trying to contain it before it gets to a critical stage at the hospital setting that’s where it can become overwhelming. The staff as I said has been doing seven and a half months now that’s when it can be tiring because it’s ongoing it hasn’t really stopped. We are looking at what’s being done in other jurisdictions. Once a reliable test is available we will be able to say it and it can perhaps of easier use. We did have two identified that we would have been using on an exclusive population and that’s basically people coming through the airport as a tourist and going through a safety corridor for validation in country as well. We have managed to validate one of the two, the other one has not been validate as yet and that’s because the staff at the lab has been overwhelmed but once it becomes available for sure. Interestingly enough majority of health care workers exposed and positive have been exposed out of the frontline if you will and not necessarily in the health care setting. You are right it can place a dent in terms of your colleagues but it also places a dent in the services you’re going to be able to offer and also the fear that people can have because they might feel that being exposed to a healthcare worker puts you at a higher risk so we have to manage that in the general public as well.”