New recovery standard for TCI; 14-days symptom free for release of COVID-19 patients

#Providenciales, Turks and Caicos Islands – August 27, 2020 — Turks and Caicos is added to the growing list of places which are abandoning the standard that COVID-19 patient recovery is measured by two negative RT-PCR tests.  Edwin Astwood, the Minister of Health on Wednesday said Cabinet has agreed to give clearance to previously positive patients after 10-days of having experienced no fever or symptoms of the coronavirus.

“The Ministry of Health has updated its standard operating procedures for recoveries and people being relieved from quarantine which is based on technical guidance received from PAHO, Public Health England, CDC, WHO and CARPHA.  These new protocols for recoveries and persons being released from quarantine are now being instituted by the Ministry of Health Agriculture Sports and Human Services (and) will come into effect immediately.”

The announcement, backed up by “new and emerging science” was met with skepticism and labelled risky by some tuned into the national press conference broadcast live from the Office of the Premier in Providenciales, Turks and Caicos.

Still the world’s leading health regulators including the World Health Organization (WHO), the Caribbean Public Health Agency (CARPHA) and the Centers for Disease Control (CDC) are promoting the research as a recommendation.

The WHO updated its recovery recommendation since May 27, 2020.  An excerpt from its website says this:

Criteria for discharging patients from isolation (i.e., discontinuing transmission-based precautions) without requiring retesting[1]:

• For symptomatic patients: 10 days after symptom onset, plus at least 3 additional days without symptoms (including without fever [2] and without respiratory symptoms)[3]
• For asymptomatic cases[4]: 10 days after positive test for SARS-CoV-2

The WHO says there is some risk associated with this “isolation discharge criteria” and adds, “There is a minimal residual risk that transmission could occur with these non–test-based criteria.”

Among the reasons for the change is to bring relief to medical centers which need the bed space; to cut-down workload on testing centers which are overwhelmed by new and repeated testing demands; to support healthy patients with a more expeditious return to life in the ‘new normal’ and to embrace the science which says COVID-19’s dead particles are responsible for positive diagnoses long past the time a patient is infectious.

The WHO, in that June 17 brief, encourages countries that can, to continue laboratory testing.  The Turks and Caicos has opted to go a new and different route which should dramatically increase the figures on recoveries.

“If a person who had recovered from COVID-19 is retested within three months of the initial infection they may continue to have a positive test result, even though they may be spreading COVID-19,” said Minister Astwood, who shared about individuals held in long isolations: “…they have been in quarantine for some 25 days, some 35 days, some 45 days and they feel well, they feel healthy and they are wondering why they have to stay this long in quarantine and the results now, the science now backs up that we can now release those persons from quarantine much earlier; 10-days and 14-days depending on symptoms and if the person is asymptomatic.”

While some may say we can trust the science, there is grave concern about whether we can trust the patient.  The Ministry of Health will admittedly be relying upon patients to be honest about their state of health.

“We have to rely on persons to be honest and truthful but still they will be under the quarantine order to remain at home and if they have fever and symptoms we want them to report that, the Minister of Health continued with, “We have seen that persons have not been giving full and complete information but we have more good people out there than bad so, we know that we will get from our people here in Turks and Caicos Islands, at least 95 to 95 percent compliance with this because we have a lot of people who want to do the right thing.”

Minister Astwood’s enthusiasm is not shared by many residents.  By admission, some positive patients were not forthcoming during the contact tracing phase.  By widespread observation, individuals have shown a reckless tendency to shirk responsibility of self-quarantine regulations in order to get out and about.

Thousands of tests have been used up in the previous method of retesting before clearance is given.  Scores of people have been waiting weeks for medical clearance to return to work because Health personnel have been unable to deliver timely follow-ups.

The Minister was optimistic that reducing this painstaking process of sequential negatives for the coronavirus will allow his team to move on to community testing, which had been waylaid by a surge in coronavirus cases.

In the past two days, 81 new cases of the coronavirus were recorded for the Turks and Caicos Islands; bringing the country’s total number of infections to 464.

The new measures will be made available online.