From 0 to nearly 1000 in less than a month

For months Dominica was hailed as a virus control success story and one of the few places that have seen virtually zero or single-digit COVID-19 cases since the start of the year.

But this month, the country with an estimated 70,000 residents is seeing a sudden and aggressive rise in cases - with a projected 30 plus positive cases recorded daily.

By global standards, these numbers may seem small - but for a country that went months with no active cases, the nearly 1000 cases the county presently has would have been unthinkable just months ago.

According to the Director of Primary Health Care Services, Dr. Laura Esprit, the outbreak began on July 28, 2021, and was first detected in the Portsmouth Health District and has continued over 16 days.

She further revealed that many persons were engaged in the non-observance of the established protocols, including that of mass gatherings that catapulted the outbreak.

The youngest diagnosed with the virus thus far is a two-month-old and the oldest at 80 years old, to which she pointed out, "in this wave, the virus appears to be very infectious, with many cases affecting our most vulnerable population, including children, the elderly, the disabled, and the housebound."

She added that many are also symptomatic, presenting with fever, headache, vomiting, diarrhoea, the new loss of taste, the new loss of smell, cough, fatigue, shortness of breath, and joint pains, which were not as prevalent during the first wave.

While positive cases appear to be in almost every village island-wide, the most predominant is the Roseau Health District which includes Warner and Campbell in the north to Soufriere and Scotts Head in the south.

Communities such as Stockfarm, Tarish pit, Soufriere, Point Mitchel, Bath Estate, Silver Lake, Roseau Valley, Mahaut, Campbell, Scott's Head, Bellevue Chopin, Canefield, Kingshill, and Fond Cole are of the most concern.

Given the increase in positive cases, as of August 13, 2021, the Government has made amendments to its isolation and quarantine protocols.

According to Chief Medical Officer (CMO) Dr. David Johnson, moving forward, all symptomatic COVID-19 cases regardless of vaccination status (vaccinated or unvaccinated) will be admitted to a Government approved isolation facility.

A PCR test will be done on day 9 and if positive the patient will complete 14 days of isolation and will be medically discharged following at least 3 days without symptoms.

If the PCR Test done on day 9 is negative, the patient will be medically discharged.

As for asymptomatic COVID-19 positive cases, who are fully vaccinated, upon a visit to the health care provider for testing, the individual will be required to present his or her vaccination certificate to the medical officer and if the test result is positive, the health care provider shall place a band on the wrist of the individual and issue a certificate to the individual indicating positive test result with recommendation for home isolation.

The wristband will be removed by an authorized health care professional on day 11 and the patient will be medically cleared.

On the other hand, all unvaccinated asymptomatic positive patients will be quarantined at a Government approved isolation facility.

A repeat Rapid Antigen Test will be done on day 5 post-testing and if positive, the patient will complete 10 days of isolation and will be medically discharged, if he or she remains asymptomatic.

If the Rapid Antigen Test done on day 5 is negative, and the patient remains asymptomatic, the patient will be sent home with a wrist band for an additional 5 days of home isolation to complete a total of 10 days of isolation.

As stated by the CMO, the wristband will be removed by an authorized health care professional on day 11 and the patient will be medically cleared.

He went on to explain that patients placed on home isolation will require the supplement and/or medication prescribed by the medical officer (medical officer to prescribe vitamins C & D, and zinc), masks, hand sanitizers, a thermometer to take daily readings and report, by telephone, to their district health team-contact information will be provided by the medical officer.

These individuals are also not permitted to leave their homes or allow any visitors over. They must not remove the wrist bands placed on their hands by the health officials and must isolate themselves from others who live in their homes and wear masks at home.

If supplies are to be dropped off, the individuals doing the delivery are advised to place the items outside of the COVID-19 positive patient door and leave immediately.

All employees who have received antigen-positive or PCR positive test results will be issued with a medical certificate for the period of isolation to which they are advised to send pictures of these certificates electronically to their employers.