With a big “yes” to ongoing conversations, but an equally firm “no” to removing restrictions, the representative of the Pan American Health Organization (PAHO) in the Dominican Republic says the country does not meet the criteria to open up its economy.
“With the epidemiology to date, what we’ve seen in the last three days, the country opening up to total normality would be a time bomb because there would be a greater spread of the virus,” Dr. Alma Morales said in an interview for Huchi Lora and Amelia Deschamps on El Dia morning TV talk show.
Her main complaint is that the Dominican medical authorities have not been able to show consistency in numbers of tests and test results. She says the local authorities have yet to show a constant in the confirmed cases in a week. She spoke of the pronounced differences in the confirmed cases. She said the country is improving in the quantity of PCR diagnostic tests, yet the number of tests continues to vary significantly. The availability of inputs for the tests is the major obstacle to increasing the number of PCR diagnostic tests.
Dr. Morales was very clear when explaining the PAHO recommendation is that a country should eradicate local transmission before returning to normalcy. To determine if there is no local spread in the country, she says the epidemiology statistics need to be stable for at least a week. She gave the example of the country showing 100 to 200 cases, but with the same number of diagnostic tests being carried out. She estimated these at keeping 1,700 or 1,800 tests a day, and reporting 100 to 150 new cases. “Those would be epidemiological indicators that reveal there is a slowdown of local transmission,” she said.
At present, epidemiological stats are all over the place. These may be 300 one day, and then spike to 500 the next. Public Health Minister Rafael Sánchez Cárdenas attributes the variability to the lack of supplies to carry out the PCR tests.
Dr. Morales stressed that for the country to reopen to economic activities safely, there cannot be the risk of outbreaks in geographical areas. She says Greater Santo Domingo has been reporting several outbreaks. “The DR has many barrios where people live in slums,” she stressed. She says the health authorities need to be able to identify the people that are showing symptoms and that these people be given easy access to get tested. Those testing positive need to be isolated to stop the spread. She said the government has adequately managed the situation, keeping the needs for hospitalization at levels that can be managed by the health system.
She recommends the government keep open the conversations, such as the meetings on Monday when President Medina met with labor, religion and business representatives at the Presidential Palace. She expressed concern the people seem to not be taking the disease seriously, even when the government has not removed the stringency measures. “It is normal for people to become accustomed and no longer fear the disease,” she said. She alerted against this generalized attitude.
“Nothing has changed,” she warned. “We have more cases in May than in April or March. People need to continue to avoid agglomerations, social gatherings, respect physical distance, wash hands, use masks,” she said. “There is nothing that shows that the epidemiological curve has slackened,” she stressed.
“The country does not comply with any of the PAHO criteria for relaxing stringency measures,” she said. What the country needs to do is to start discussing plans taking into account how public transport will operate, beauty salons, restaurants and hotels. Normalcy cannot be achieved from one day to another. It will need to be gradually phased in, she explained.
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13 May 2020