There is much going on in the Dominican Republic to get the country back to new normal so people can get on with there lives in these Covid-19 epidemic times. Dr. Amado Alejandro Baez, an international renowned emergency physician on loan from the state of Georgia, USA, is helping the Dominican Republic understand the big picture of Covid-19 epidemic, what it means now and how it is permanently changing the country.
In April 2020, Dr. Baez was asked to join Dominican efforts to combat Covid-19. In an interview with the Americas Society / Council of the Americas, he addresses actions underway in the country to combat the disease.
The Dominican Republic since its first confirmed Covid-19 test on 1 March 2020 has climbed to be 8th in the Americas in the number of cases. It is the hardest-hit country in the Caribbean. In the interview with the Council of the Americas, Dr. Baez describes his contribution to country efforts as executive director of the Presidential Committee for Covid-19 Response. The office has been spearheading public-private partnerships and locally targeted efforts to combat the Covid-19 epidemic. The committee is based at the Ministry of Economy, that is head by the country’s youngest minister, Ariel Jimenez.
Dr. Baez summarizes these as efforts: Implement a public value concept, with public private partnerships, working with local entrepreneurs and philanthropists, ensuring results for the general population independent of socioeconomics, working with local governments, not just setting directives from the central government, working with local partners both at government and at the social level, social leaders, press, to help the efforts to be successful.
Báez explained in the Tuesday, 5 May interview that his team has focused on the “public value in crisis” model for responding to the outbreak, which involves developing public-private partnerships that allow entrepreneurs and philanthropists in the Dominican Republic to invest in a very palpable and tangible way in their local communities. He described the approach as “bottom-top,” where general response directives are provided but the actual integration and implementation of strategies happen at the local level.
In the interview, he explained he came to the country at a time when there was a tense narrative and social environment because of the upcoming presidential and congressional elections. “When we started shaping up the efforts, we looked at the public-private partnerships to build services and those services are directed at achieving the same results to the overall population and integrating the results with feedback from the community to guide our interventions so they are more targeted and build trust,” he remarked.
The dilemma was how to create a system in a tense political environment because of the elections. “How to send a message that we are all in this together, looking at it all from a local level, a bottom-up approach?” he said. He remarked that the committee can create general directives but the implementation needs to be by local authorities.
He spoke of early successes, such as the model that was first applied in San Francisco de Macorís, the capital city of Duarte province, where the local government authorities became ill with Covid-19 leaving the city without leadership. The city had the fastest rate of Covid-19 spread and the highest mortality in the country. By creating the private-public partnership, the town was able to retake and put the situation under control. The province went from the country’s hotspot to having many days without a single case being reported.
Dr. Baez said the effort was then spread to Santiago, the second largest city, they are working in Puerto Plata, Baní and Punta Cana. He said the effort will be launched in Greater Santo Domingo with Mayor Carolina Mejía, of an opposition political party. “A lot is learning as we go,” he said.
Dr. Baez is also looking at increasing testing in the country, working with popular markets, mortuary services as part of integral solutions. He sees this as a way of helping entrepreneurs channel their efforts in a more tangible way beyond donating money.
Dr. Baez is working closely with Rainier Mallol, a young Dominican engineer who is the ITC director at the Ministry of Economy, where the Covid-19 Response Committee is based. Says Dr. Baez, “Rainier was working in Malaysia on Covid-19 technological solutions. “He came back and worked with us and in 10 days we built a epidemiological intelligence fusion center integrating 12 IT platforms for private and public centers to do predictive analytics,” said Dr. Báez.
The new center allows the government to pinpoint opportunities at the local level and forecast where more preventive interventions or capacity-building efforts are needed in the country. He explained that President Danilo Medina told the team to look at the military intelligence center (C5i) that was brand new.
Baez says that now the country has the needed data for intelligent forecasting. He said the effort is also enabling them to go beyond Covid-19 and look into preventive health and care needs for other diseases in the country. He says by tackling preventive care for other diseases, the national health system can be decongested.
“Maybe this is what primary care is going to look like in the Dominican Republic after Covid-19,” he observes. “My main goal is to work at making the health care system better in the long run, more labs, more tests, better primary care, better technology,” he explains.
“Covid makes you think of the power of now. We have to look beyond the now, and look at the other things that we need to be addressing, bearing in mind we are going to have a second wave in the fall or winter. How can we have a stronger, faster system, more efficient so that if we get the second wave in the fall or winter, and it not be like the second wave in the Spanish Epidemic in 1918,” he remarked in the interview.
What few people in the Dominican Republic know is that Dr. Baez is not another high paid government officer. He said that he requested that he have authority and autonomy and not be paid by the Dominican government. He says the state of Georgia in the US has loaned him to the Dominican Republic government, so his efforts would not have a political taint and he could objectively focus on what had to be done.
Dr. Baez explains that by having his office at the Ministry of Economy he is in a better position to understand the needed balance there has to be between the economy and public health issues. “Ultimately, there is a tradeoff,” he explains mentioning the effects of social distancing and quarantine on the economy.
“But we started realizing, ultimately, be it in a week or two months, we have to talk about opening the economy, and that the economic opening has to be phased,” he said. He remarked they are focusing on the economic segments that can be opened based on productivity, expansion of essential services, safety, and learning from experiences in other countries.
The team at the Ministry of Economy took these conversations to the local level and opened discussion locally with different business associations – banking, tourism associations. “Everyone is worried, so they have done their own research, and that is the easiest and most effective crowd-sourcing method”, he explained.
Dr. Báez said his goal is to work on making the health care system in the Dominican Republic better in the long run, as a possible second wave of the pandemic could be on the horizon this fall or in the winter of 2021. While the country has had success with local engagement, he said, testing is still a big challenge because many countries are competing for the same things we need right now.
“I think we need to look beyond the now,” Báez said, looking into how the new normal in the country is about disrupting the old normal. In the interview he remarks that the focus for the tourism industry will need to be on domestic tourism, but for domestic tourism to be successful, local businesses need to get back to work so people can have the disposable income to go on a vacation…
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7 May 2020