A Question of Protection: The Future of COVID-19 Vaccinations for Grenada

Written By: Central Health - Grenada

Vaccinations are important. They help prevent and control the spread of infectious communicable diseases and illnesses. However, numerous news reports have made it clear that once COVID-19 surfaced and spread rapidly around planet earth, causing over 12 million cases and over 500,000 deaths worldwide the race to develop a vaccine took off. Millions and millions of dollars are being invested into developing a vaccine to control the spread of COVID-19, even while the virus mutates. Notwithstanding, part of the process for verifying the effectiveness of vaccinations is to encourage humans to enroll in clinical trials. These facts raise two questions:

1.    What measures have been put in place to protect Grenadians from becoming ‘guinea pigs’ in an ill-intentioned scientists or individuals’ clinical trial?

2.     What reassurances will nationals be given regarding the source of the COVID-19 vaccination supplied to our region – considering our genetic makeup may be different from those tested?

As part of an ongoing online series entitled, “COVID-19 & Those Most at Risk,” Central Health – Grenada interviewed, public health practitioner E. Francis Martin (DR), MD., MPH., on the aforementioned concerns. 

Whereas Dr. Martin acknowledged that the vaccination protocol and schedule used in Grenada is guided by the technical support of PAHO/WHO, he made it very clear that currently there is an absence of legislation that deals with the protection of human sampling. “There is a concern for the region, in a sense that our small islands -  we don’t have strong legislation that speaks to the use of human sampling or use of human subjects for research purposes. So, I will make a blanket statement to say that because we have weak legislation for human sampling, a company can request to use the Caribbean as human subjects. It would be left up to the national governments and the public health and ministries to make a final decision on it,” said Dr. Martin

When asked by the Founder of Central Health – Grenada, Roslyn A. Douglas, MA, DTM whether Grenadians should have concerns about the source of the vaccine, Dr. Martin legitimized the question, stating that medications that work well for persons with one genetic makeup may not work well for another, “It is true that if your genetic sequencing puts you in a different gene pool, a vaccine that works in “A-area geographically,’ may not necessarily work in “B – geographical area.”

To watch the entire 10 minute interview segment visit Central Health – Grenada’s YouTube Channel – click here. 

For permission to publish this article email: centralhealthgnd@hotmail.com 

Should Grenada Consider a 14 Day Ban on Travelers from China?

By: Central Health – Grenada

Although Central Health – Grenada’s focus is educating nationals about Chronic Non-Communicable Diseases, it is important to acknowledge that the World Health Organization (WHO) on January 30, 2020 declared the new coronavirus outbreak a public health emergency of international concern. Therefore, it is important to share general facts about how this decision came to be, as our tri-island state is not immune to the possibility of it affecting us and appreciate how travel bans are decided and ultimately approved. 

Well-structured organizations, such as the World Health Organization, usually assemble an elite team of qualified persons to provide recommendations to Dr. Tedros Adhanom Ghebreyesus the Director – General. He in turn reviews all the facts within their reports and in particular their recommendations. His decision must embrace the principles of the WHO’s constitution, two of which are whether the health situation requires: 

• Active co-operation on the part of the public.
• To remind governments that they have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures. 

To read the others – click here  

At the meeting held on January 30, 2020, arranged by the Director- General, in addition to the said Emergency Committee, representatives from the People’s Republic of China’s Ministry of Health provided a report. Two key points extracted from their reported are: 

• There were 7711 confirmed and 12167 suspected cases throughout the country. Of the confirmed cases, 1370 are severe and 170 people have died. 124 people have recovered and been discharged from hospital. 
• There were now 83 cases in 18 countries. Of these, only 7 had no history of travel in China. There has been human-to-human transmission in 3 countries outside China. One of these cases is severe and there have been no deaths. 

Those numbers may have increased or remain same since then. 

Although the coronavirus is still an evolving situation, the committee made noteworthy recommendations, here are poignant ones:

• It is still possible for the virus to spread.
• The outbreak now meets the criteria for a Public Health Emergency of International Concern
• Countries need to put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk.
• Provide support to low- and middle-income countries to enable their response to this event, as well as to facilitate access to diagnostics, potential vaccines and therapeutics.
• WHO should provide intensified support for preparation and response, especially in vulnerable countries and regions, rapid development and access to potential vaccines, diagnostics, antiviral medicines and other therapeutics for low- and middle-income countries should be developed.
• Investigate the animal source of the outbreak.
• Investigate the clinical spectrum of the disease and its severity
• Investigate the extent of human-to-human transmission in the community and in healthcare facilities, and efforts to control the outbreak.
• It is important to study the possible source of the virus, to rule out hidden transmission and to inform risk management measures.
• Enhanced surveillance in regions outside Hubei, including pathogen genomic sequencing
• WHO should assess how best this outbreak can be contained globally. 

After reading these recommendations, it is interesting that the Emergency Committee does not recommend any travel or trade restriction - or at least at this time. However, should a country make a restriction, they must inform the WHO within 48 hours as to why that decision was made and be ready to accept the WHO’s feedback. 

What is interesting, on the day the Director-General declared the Coronavirus a public health emergency of international concern our neighbour - Trinidad & Tobago imposed restrictions on travelers from China. Their Health Minister Terrence Deyalsingh said, “Persons who are presently living in China or visiting China, regardless of your nationality, will not be allowed to enter Trinidad and Tobago for 14 days after leaving China.” As far as their Health Minister is concerned, the virus has an incubation period of 14 days, so if your passport is stamped/recorded to have left China, regardless of nationality, you cannot enter Trinidad until those 14 days have passed. 

When asked about Grenada’s position, Dr. Francis Martin – Acting Chief Medical Officer for the Grenada Ministry of Health said, “Grenada’s position is to follow the advice of our lead public health agency, as it relates to travel restrictions on the sub region. Those agencies being Caribbean Public Health Agency and World Health Organization- PAHO.” 

The Caribbean Public Health Agency’s fact sheet entitled, “Coronaviruses–what you need to know,” does not provide any travel restrictions, but does say a person should check their local Ministry of Health for information or CARPHA’s website for guidance for travelers. Additional information included: “If you travelled to a country where cases of the novel coronavirus was detected, watch yourself for symptoms within 14 days after you left that country. If you develop symptoms and feel sick with fever, cough, or difficulty breathing, you should:

• Seek medical care right away. Before you go to a doctor’s office or emergency room, call ahead and tell them about your recent travel and your symptoms.
• Wear a mask if available.
• Avoid contact with others.
• Do not travel while sick if possible.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or Wash hands often with soap and water for at least 20 seconds to avoid spreading the virus to others.
• Use an alcohol-based hand sanitizer if soap and water are not available. 

It will be interesting to see how the WHO reacts to Trinidad & Tobago’s 14-day travel restriction. Perhaps if approved, it may allow for other island.

 - END-

100% Goes To Grenada Cancer Society

Written By: Central Health  - Grenada

To address the need for more education and to assist patients with their cancer treatment, Project Blue has launched a fund raiser of which 100% of the proceeds will go to the Grenada Cancer Society.  

Project Blue is a new cancer education fundraising organization that was launched in August.  The focus of this year’s initiative is colon and prostate cancer awareness. The local leader for the organization Rhema Lewis is encouraging the public to purchase t-shirt and to wear them on Friday November 10, 2017. “Blue Friday, is beyond wearing a t-shirt, it is a way to support those who may feel that they are in this battle for their lives alone,” said Lewis.

In a recent video with Now Grenada, Senior Medical Officer for the Ministry of Health Dr. Francis Martin, stated that the upward trend of cancer cases is now more than before in Grenada. “Over the last decade or so, we recognize that incidences of cancer are increasing almost yearly,” said Dr. Martin. Within the video, data shows that prostate cancer is the leading cause of death in Grenadian men.

President of the Grenada Cancer Society - Dr. Barrymore Mc Barnette says the funds will be welcomed, “Funds are always welcome, because of the high cost of cancer treatment and the great need for public education.”

The November 10, 2017 Blue Friday t-shirts are on sale for $25 and can be ordered at projectbluegrenada@gmail.com or call the Grenada Cancer Society at 473-435-9869

Grenada: Free Bus Rides for St. David’s Diabetic Programme

Too Sweet For Your Own Good II Presenters and Event Planners

Photo By: Central Health - Grenada
 Back row: Dr. Alister Antoine-Vice President Grenada Diabetes Association, Dr. Albany Philip - Nephrologists, Roslyn A. Douglas, MA.,CC- Founder, Central Health-Grenada, Dr. Elliot Mc Guire – Opthalmologist.  Front row: Nurse Rosalind Alexis - President Grenada Diabetes Association, Mrs. Annetta George - Public   Relations Officer Perdmontemps Diabetic Group of St. David's Branch Grenada Diabetes Association and Mrs Catherine St. Bernard, President Perdmontemps Diabetic Group of the St. David's Branch Grenada Diabetes Association

The St. David's Branch of the Grenada Diabetes Association successfully hosted and educated over 75 residents during its second annual mini symposium entitled, Too Sweet For Your Own Good II. Most attendees were able to be there through a sponsorship from Grenada Public Health Association. (GPHA). 

GPHA contributed $300 towards personalized bus services, allowing over 75 St. David’s residents to attend the free programme at the Canal. These buses picked up all interested residents from their homes, took them to the event, and returned all safely at its conclusion.  As poor attendance to health programmes are largely due to lack of access to transportation, GPHA wanted to stand in that gap, “One of GPHA's mission is to advocate and promote optimal health of the society in a sustainable manner.  In order to achieve this mission, the GPHA will continue to support initiatives, such as the one undertaken by the St. David's branch of the GDA -  to keep our nation informed and motivated to protect their health.” said President of GPHA, Lindonne Glasgow.

Other supporters of the event included Hon. Oliver Joseph, representative for the parish of St. David through his contacts at Aqua Natural Limited provided water for the attendees.  Bryden & Minors freely printed fliers advertising the event, allowing Public Relation Officer Annetta George to post it at strategic locations within St. David’s and distribute to churches and schools.  The Canal, the host site also offered in-kind services.  During the event the Grenada Food and Nutrition Council displayed appropriate food portion sizes on plates and examples of healthy foods for diabetes. Speakers and their topics included Ophthalmologist Dr. Elliot Mc Guire - Diabetics & Eye Health, Nephrologist Dr. Alban Phillip - Monitor Your Kidneys and President of the Grenada Medical Association (GMA) Dr. Francis Martin spoke on the topic Diabetic Sick Days: What To Do.

Within Dr. Phillip’s presentation he stated that all diabetics should request from their doctor a kidney function test, especially those who have difficulty controlling their glucose levels, “If you have diabetes and your blood glucose, or blood sugar, levels are too high over time this can damage your kidneys. Your kidneys clean your blood and if they are damaged, waste and fluids build up in your blood instead of leaving your body.” 

The take home message from Dr. Mc Guire’s presentation on Eye Heath is that as soon as person has been diagnosed with diabetes, they should get a dilated eye examination.  This will allow their eye specialist to always compare those initial results with all subsequent ones. The dilated examination allows eye specialists to see if the diabetic patient is developing retinopathy, a complication of diabetes which results in blood vessels within the retina to burst. Retinopathy can lead to obstruction of vision or blindness. 

The President of GMA, provided an interactive session covering practical tips for patients on days they simply do not feel well. Whether a diabetic has diarrhea, a cold, or some other health ailment, Dr. Martin painstakingly stressed that the first thing a diabetic should do is know their glucose number, “For me, the main objective was for them to understand their illness and understand their disease. Know what feelings they should and should not ignore. Some feelings you should take into consideration others you just need to understand them. Simple things they can do to keep themselves stable, most important of which is knowing your numbers. Whenever anything goes wrong, check your numbers first.”

Too Sweet For Your Own Good II was held on July 28, 2016 and was planned primarily by the Perdmontemps Diabetic Group of the St. David's Branch of GDA.  The group meets every third Thursday at 3 pm, rotating location at the various health centres within the parish of St. David’s, sharing tips, encouragement and support. They have begun planning events to recognize Diabetes Awareness Month and World Diabetes Day during the month of November.  The first confirmed event will be a church service at the Westerhall New Testament Church, on Sunday November 13, 2016 at 10 am.

Article Written By: Roslyn A. Douglas, MA., CC. - Founder, Central Health - Grenada