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Dominica Nearly Eradicated Covid-19. Hurricane Season Could Change That.

Healthcare professionals in Dominica unpack a cache of emergency medical supplies provided by Direct Relief. The Caribbean nation is bracing for an outbreak of coronavirus cases as the Atlantic hurricane season picks up. (Dr. Laura Espirit/Direct Relief)
Healthcare professionals in Dominica unpack a cache of emergency medical supplies provided by Direct Relief. The Caribbean nation is bracing for an outbreak of coronavirus cases as the Atlantic hurricane season picks up. (Dr. Laura Espirit/Direct Relief)

On the Caribbean island of Dominica, hurricane season threatens to undo months of preventative measures taken to stop the spread of Covid-19.

With only one public hospital and a handful of ICU beds, health officials acted quickly to contain the virus once the first case was reported in March. Since closing its borders, the island has reported a total of 18 cases, none of which have been fatal.

But with hurricane season, and a tentative reopening scheduled for July, preventing an outbreak will be much more difficult. Crowded shelters and incoming aid workers would make it nearly impossible to trace the spread of the virus and isolate infected individuals. In these conditions, strategies used to contain the island’s initial outbreak would be much less effective.

On this episode of the podcast, we speak with Dominica’s Deputy Chief Medical Officer about what the island is doing to prevent a large-scale outbreak, should a hurricane hit.

Direct Relief has sent multiple caches of emergency medical supplies, including protective gear and medicines for intensive care treatment, to equip healthcare professionals in Dominica to test and treat patients impacted by Covid-19.

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Transcript:

On the Caribbean island of Dominica, hurricane season threatens to undo months of preventative measures taken to stop the spread of Covid-19.

The island has nearly eradicated the virus within its borders, since the first case was reported in March.

With only one public hospital and a handful of ICU beds, the preemptive approach was crucial.

“With a population of 70,000, on a normal day we don’t have a full ICU, but we knew with Covid that was going to be different.”

Dianna Robinson is Dominica’s Deputy Chief Medical Officer. She has been working with the country’s Ministry of Health to respond to Covid-19.

“We know that we don’t have the capacity to deal with a larger volume of critically ill.”

With that in mind, health officials acted swiftly once the first Covid case was confirmed.

Eva Vigilant is the Nurse Supervisor of Dominica’s La Plaine Health District where the country’s initial case was reported.

“The first identified case was a male from the United Kingdom.”

Vigilant was tasked with monitoring the patient who had arrived from the United Kingdom to visit his parents on the island. When he developed a fever, Vigilant and her team moved forward with testing.

“We were masked, we were gloved, we went in to do the test and then we sent the sample down to the lab. Everybody was waiting and very suspicious.”

The results came back positive.

“I myself was crushed. Sometimes I get very emotional, you know. And a lot of things went through my mind.”

She wondered: Who else had been infected?

Within hours of receiving the test results, Vigilant and her colleagues began the laborious process of contact tracing.

After tracking down 12 suspected contacts, 9 tested positive and only 2 displayed symptoms.

The patients were quickly quarantined and treated.

Since closing its borders in March, Dominica has reported a total of 18 cases none of which have been fatal.

But, after 3 months of lockdown, the island’s economy is suffering.

“A big part of our economy is tourism and without people coming in we can’t really support that industry very well.”

The country is scheduled to be reopened by July with plans to carefully screen tourists arriving by air and sea.

But Robinson, says reopening won’t be without consequences.

“We definitely expect, at least I do, a second wave to come through when we open up those borders.”

And, with hurricane season, that wave could become a spike.

“Once you open up the borders, it will become very, very challenging as to how we will manage hurricanes as they come.”

Dominica has a long history of natural disasters the most recent of which was Hurricane Maria in September of 2017. The category 5 storm ripped through the island displacing thousands and causing more than a billion dollars in damage. The country is still recovering.

If a hurricane were to roll through, Covid would likely follow. People would need to shelter en masse, and aid workers–flown in to provide medical care or repair infrastructure–could easily carry the virus with them.

The situation has health officials running through a myriad of ‘if this, then that’ scenarios.

“If, for example, we have a storm like Maria, that 95% of people lost the roofs on their homes, then people will be in the hurricane shelters for longer periods of time, with bigger crowds and more likely to have a bigger outbreak.”

With a lower grade storm, an outbreak may be less likely.

Robinson says the response will be fluid depending on which scenario plays out.

“We have all our people in place in every constituency to manage the disaster and based on what the disaster is, then we have to fit the Covid plan into it. We know what we need to do.”

That means wearing masks, social distancing in shelters, and screening aid workers.

But precautionary measures like these can only do so much.

Like storms, the virus isn’t going anywhere.

Covid is going to come, says Robinson. The question is: How do we manage it?

This transcript has been edited for clarity.

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