REPORTING BY NICHOLAS BAYLEY
There is growing nervousness among medical professionals about the lifting of mask mandates both locally and regionally, with the growing presence of the omicron BA.5 variant in the Americas. CMO Dr Roshan Parasram said the BA.5 variant had been detected among 20 samples sent for genomic testing at the University of the West Indies last week, meaning it is present in the TT population.
Pan-American Health Organisation (PAHO) director Dr Carissa F Etienne, speaking at PAHO’s media conference on Wednesday, said a growing proportion of cases in the Americas are being caused by the BA.4 and BA.5 sub-lineages and this is driving new.
“In the US, BA.4 and BA.5 are the predominant sub variant strains, and an increasing number of countries in Latin America and the Caribbean are also reporting these sub-lineages. Omicron BA.5 has been detected in at least 22 countries and is likely to become predominant in all territories in the sub region in the next few weeks. The emergence of BA.4 and BA.5 is yet another reminder that the virus keeps evolving every time it is transmitted and that we must remain vigilant.”
PAHO health emergencies director Dr Ciro Ugarte said transmission is faster when public health measures such as the use of masking have been relaxed.
“People begin to have a false sense of security thinking that everything is back to normal, but when a virus is transmitted from person to person, this leads to more mutations, generating other variants that may be transmitted more quickly. For example, when we have mass events, they need to think of additional measures to mitigate the risk of transmission.”
Speaking at the Health Ministry’s covid19 media conference on Wednesday, Parasram said data suggests that while the BA.4 and BA.5 variants may be more transmissible, meaning that they spread easier, none of the sub-lineages of omicron have been shown to be more virulent, meaning that they don’t cause more severe disease.
“What we are mostly concerned with at this point in the pandemic is the impact on the hospitalisation and the impact on the number of people who have passed away due to the disease itself. Currently there are only 91 people in various hospital facilities in TT, which is lower than April 2021. We may expect an increase in the number of positive cases but once that doesn’t result in a concomitant increase in hospitalisations and death then the concern will be a little less.”
He said lifting the legislation relating to masks did not mean that masking is no longer required but the onus is transferred to the individual. He reminded people that wearing or not wearing a mask is now a personal choice which should be respected.
“It doesn’t have the force of law anymore except in certain places and a list of high-risk places will be uploaded to the ministry’s website. There is always a sense of trepidation when we do a change in a public health restriction but we expect after two years that people would have learned how to manage and live with covid19.
“I don’t expect that the day after the mandate is lifted that everyone will take off their mask at the same time. It’s something we don’t want to see happen and we hope people will determine their risk accordingly. it is a time of nervousness to see what will happen after that particular date, but from a health perspective we expect the lessons learned over the last 2.5 years will not be lost.”
Health Minister Terrence Deyalsingh said the new public regulations coming out on July 16 would indicate that masking is now mandatory only in health care settings. He said business places and entities would still have the right to enforce mask mandates in their places of business.
“There are now little or no other public health regulations. We are putting forward to the population an easy to understand and common-sense approach to risk mitigation at the personal, family, workplace, community, and social levels. Mitigation strategies are now squarely in the hands of the public.”
The CMO said choosing to wear a mask should be informed by each person’s level of risk in a particular setting. He advised that people base their risk assessment on the interplay between the three factors of environment, agent, and host, which determines the outcomes of getting and spreading a disease.
“We look at the virulence or severity of the agent pathogen and its infectivity; the host – vaccination status, medical illness, types of medication; and the environment- air flow, household, healthcare facility, or if it’s a travel-related environment. We take a three tiered assessment of risk: the population in which you reside and/or are going to visit, your individual level of risk, and the site- or event-specific risk.”
He said the population level risk could be estimated through the ministry’s covid19 update, which would list the numbers of new positive cases, deaths, active positive cases, and circulating variants.
Parasram said there were special groups which were at greater risk of becoming ill and should continue wearing their masks. These included immunocompromised people, those with underlying medical conditions, obese people i.e. those with a body mass index (BMI) over 30, pregnant women, people 60 years and over, and unvaccinated and not fully vaccinated individuals.
He said site-specific considerations included whether the venue was indoors or outdoors, whether there was adequate ventilation, how long people would be there and whether they knew the other people present, if the place was crowded, whether there were vulnerable people in the setting, and whether other people were complying with public health measures.
Parasram said places where masking was recommended included all retail establishments inclusive of supermarkets, groceries, and malls; public transportation and transportation hubs; ports of entry; mass gatherings; pharmacies; schools and educational establishments; workplaces, especially crowded ones without adequate ventilation; places of worship; beauty salons and barbershops; spas where possible; cinemas and theatres; buildings with high concentrations of people; and other congregate settings such as children’s homes, geriatric homes, and correctional and detentional settings.
Some parts of the US are rolling back mask mandates, including Los Angeles County, which will bring it back if transmission of the B.4 and B.5 strains has not dropped by July 29. Alaska has also reinstituted mask bans. Cyprus reinstituted its mask mandate a month after removing it in June.