By Sue-Ann Wayow
THE definition of a “Covid-19 death” is one of the items that will be reviewed by the recently appointed committee to investigate the 3,000 plus Covid-19 related deaths in the country.
The five-member committee was appointed by Prime Minister Dr Keith Rowley to investigate the factors contributing to Clinical Outcomes of Covid-19 patients in Trinidad and Tobago starting today (Monday).
The announcement of the committee was made by Dr Rowley at a press conference on Saturday.
The committee is being chaired by Professor Terrence Seemungal Dean Faculty of Medical Sciences, University of the West Indies, St Augustine.
The other members consist of Professor Emerita Phyllis Pitt-Miller, consultant anesthetist and intensive care specialist and also former dean of UWI’s faculty of Medical Sciences, Dr Anton Cumberbatch, public health specialist and former Chief Medical Officer, Dr Vidya Dean, consultant anesthetist and intensive care specialist and Professor Donald Simeon Director, Caribbean Centre for Health Systems Research and Development and Professor of Biostatistics and Public Health Research at UWI’s Faculty of Medical Sciences.
The Prime Minister, on his Facebook page posted further details of the tasks the team will have to undergo while providing background information of Trinidad and Tobago’s death rate.
As of January 11, 2022, Trinidad and Tobago has recorded 3,102 deaths out of 97,897 positive cases.
The Case Fatality Rate (CFR) in Trinidad and Tobago has varied over the course of the pandemic ranging between 6.2% (130 cases, 8 deaths) in the first wave April 2020 to a low of 1.0% on August 27, 2021.
A case fatality rate of 0.032 or 3.2% has been recorded as at that date. This indicates that for every 100 persons infected with the Covid-19 virus, three persons succumbed as a result of the disease.
Out of the 3,102 deaths, 175 (5.6%) of those fatalities were fully vaccinated while 2,927 (94.4%) were not fully vaccinated or unvaccinated, Dr Rowley stated.
Those deaths would have occurred in both hospitals and at home. The records suggest that approximately 94% of deaths occur in hospital in the system with the remaining 6% occurring at home. Total deaths of those fully vaccinated as at January 12, 2020 was 177 (5.7%), he added.
The team will be expected to identify the profile of the patients who died from Covid-19 by number and types of comorbidities including obesity, ethnicity, age and gender.
The team will also have to review the definition of ‘Covid-19 Death’ used by the Ministry of Health for consistency with World Health Organization (WHO) guidelines and standard practice and comment on the different methodologies for CFR and make recommendations for the appropriate methodology for Trinidad and Tobago.
Chief Medical Officer Dr Roshan Parasram had said that if a person contracted Covid-19 at the point of death, the death would be listed as a Covid-19 death adding that there were persons who died as a result of Covid-19 complications and there were others who may have died as a result of other medical issues but also had the virus at the time.
Examination of the Admission, Discharge and Transfer (ADT) policy and procedure to determine the impact, if any on clinical outcome are also to be completed by the committee.
The team have to determine if the treatment and management protocols adopted by the hospitals are consistent within WHO guidelines and international best practice, with access to adequate levels of staffing appropriate in a mass response to a global pandemic, essential medicines, laboratory and diagnostic imaging services, personal protection equipment (PPE), oxygen and any other.
A review of the standards of care of Covid-19 patients, based on acuity, for uniformity and consistency within and across hospitals in the Regional Health Authorities (RHAs), is also expected to be completed.
And the committee is expected to identify any other factors that may affect clinical outcomes including, but not limited to: suboptimal home treatment for e.g., utilising non-WHO approved therapeutics, delayed presentation to health facilities, the efficiency of the transfer system in transporting patients from home to hospital and inter-hospitals in the RHA health network.
The committee is expected to have all the tasks completed by January 24.
Former government minister Dr Tim Gopeesingh in a statement on Sunday said that the time frame was way too short for a proper investigation to be completed and that a proper Commission of Inquiry needed to be done.
