COVID-19 Impact in the Caribbean

On Wednesday, June 24, Rabin Martin, as the Secretariat for the Private Sector Roundtable for Global Health Security (PSRT), hosted a thirteenth webinar in a series on the latest health impacts of COVID-19. The call featured Dr. Joy St. John, Executive Director, Caribbean Public Health Agency (CARPHA), who discussed the dynamics of the region’s epidemic.

Dr. Joy St. John

Dr. St. John described the current state of the COVID-19 response in the Caribbean and CARPHA’s role in mitigating the health and economic impact given the growing number of cases, now estimated at more than 45,000. She emphasized that the Caribbean region– comprising 33 countries – has taken a coordinated response informed by a strong health security perspective.

In tackling COVID-19, CARPHA is focused specifically on global health security, with an emphasis on resource mobilization, advice to non-health sectors, coordination of the public health response, and risk communication – especially important given rampant misinformation and “fake news” about the coronavirus.

The major challenges to the response in the region have included procuring essential medical supplies (test kits, personal protective equipment, ventilators, etc.), inadequate surveillance data, and economic shocks to the tourism and agricultural industries, in particular.

The tourism industry – the lifeblood for the region at an estimated 14 percent of the economy – has been hard hit. Cruises and flights, intra-regional tourism, and broader tourism have all been stopped or sharply reduced. Dr. St. John noted, “Safe tourism isn’t just from the traveler perspective, but also the workers’ perspective.” She added that they are exploring a certification for businesses to demonstrate that they are safe to open for tourism – the Caribbean Travel Health Assurance Stamp.

The agricultural sector has also suffered due to the lack of tourism, the shift in consumption patterns to more non-perishable goods, and overall reduction in trade.

In addition to a scale-up in communications, CARPHA has developed protocols for testing, water, sanitation and hygiene, and food service. CARPHA also established an expert advisory group of clinicians to advise on clinical management of COVID-19, identifying the need to train hospital lab technologists, develop specific surveillance for children, create mental health services, and determine participation in WHO’s Solidarity Trial to help find an effective treatment for COVID-19.

In terms of private sector engagement, Dr. St. John reported that companies collaborated with labor unions and the government to manage the damage to the tourism industry in a coordinated way. In addition, the private sector has been critical in helping ensure business continuity, including addressing the challenge of internet bandwidth and supporting new models that promote both telework and e-learning. “The private sector stepped in to help define the new normal” and developed products to adapt to the lockdown.

She closed by noting that the global community should not be talking about COVID-19 as if it is a crisis in isolation. Given that it is hurricane and rainy season now, there is potential for a rise in vector-borne diseases. With severe weather events on top of COVID-19, Dr. St. John underscored the importance of coordination with the security sector – “Health security isn’t trying to minimize the illness; it’s about making sure that people are safe from these threats.”

Industry Developments

On Monday, June 22, Gilead announced it had received the green light from the FDA to initiate Phase 1 trials of an inhaled version of remdesivir. Gilead will begin recruiting participants this week, with the intention of beginning trials in August. In May, the FDA granted Gilead emergency use authorization for an intravenous application of remdesivir after it was shown to reduce the recovery time for patients with severe COVID-19. Currently, the drug has not demonstrated efficacy in mild cases. Gilead hopes a nebulized version of remdesivir would allow for out-patient administration, reaching patients earlier in their illness before they are hospitalized.

On Monday, June 22, researchers at the University of Oxford released further data from the RECOVERY trial exploring dexamethasone as a COVID-19 treatment. As the U.K. National Health Service has already authorized use of dexamethasone to treat severe COVID-19, many providers are concerned the increased demand will lead to hoarding and a global shortage.

Sanofi Pasteur is accelerating the timeline for development of the COVID-19 vaccine candidate it is producing in partnership with GSK. Originally slated to begin Phase 1/2 trials in December, Sanofi announced on Tuesday, June 23, that trials would instead begin in September. Separately, that same day the company announced a $425 million deal to develop an mRNA vaccine candidate from Translate Bio.

Interest in AstraZeneca’s vaccine candidate continues to grow as the company signed its tenth manufacturing deal on Wednesday, June 24. This news comes a day after researchers from the Pirbright Institute found that a two-dose series produced a greater immune response than a single dose during porcine studies. The findings suggest AstraZeneca may need to scale manufacturing capacity further to produce the sufficient doses for a series.

been providing the treatment to pediatric patients with severe COVID-19 through its compassionate use program since February and under the U.S. EUA granted in May.

From the Experts

“The pandemic shows us how vulnerable Europe is.”

Angela Merkel, Chancellor, Germany
Thursday, June 18

“The world is learning the hard way that health is not a luxury item; it’s the cornerstone of security, stability, and prosperity. Now more than ever, all countries must make universal health coverage a priority.”

Tedros Adhanom Ghebreyesus, Director-General, WHO
Monday, June 22

“Science and data – not politics – [have] and will always guide our decision-making, including our work related to vaccines.”

Stephen Hahn, Commissioner, FDA
Tuesday, June 23

“Communication is critical to the response to this pandemic. People are literally dying because they are getting bad information.”

Robert Skinner, Senior Special Advisor, United Nations’ COVID-19 Communications Response
Tuesday, June 23

“We’re very concerned about what’s happening [in regard to women’s and children’s health] – particularly in sub-Saharan Africa. Many of the countries we work in are fragile and so, by definition, already have very challenging situations when it comes to health service delivery. [COVID-19] is making things worse.”

Monique Vledder, Global Financing Facility Practice Manager, World Bank
Wednesday, June 24

Additional Resources

Reports from International Governments and Bodies

Funding and Policy Trackers

Resource Pages and Market Research Literature

Communications Toolkits

What We’re Reading

The COVID-19 Catastrophe; COVID-19: The Pandemic That Never Should Have Happened: Review – Mark Honigsbaum, The Guardian

Where The Women Aren’t: On Coronavirus Task Forces – Malaka Gharib, NPR

The UN’s COVID-19 Response Team Is Calling For A New Era Of Collaborations With The Private Sector (And Kindness) – Serena Oppenheim, Forbes

Coronavirus Researchers Are Dismantling Science’s Ivory Tower—One Study at a Time – Maimuna Majumder, WIRED

Why COVID-19 Kills Nearly Twice as Many Men as Women – Paul Nuki, The Telegraph

Let the Learning Begin — a WHO Open-Access Platform Could Transform COVID-19 Response -Lawrence Gostin and Eric Friedman, Devex

Many Medical Decision Tools Disadvantage Black Patients – Gina Kolata, The New York Times

Coronavirus Racial Disparities Are Worse Than We Thought – Caitlin Owens, Axios

Potential Impacts of Delaying “Non-Essential” Reproductive Health Care – Gabriela Weigel, Alina Salganicoff, and Usha Ranji, Kaiser Family Foundation

‘Heroes, Right?’: Anthony Almojera, on Being a New York City Paramedic and the Injustices of COVID-19 – Anthony Almojera as told to Eli Saslow, The Washington Post