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Edwin Astwood weighs in on PNP Government management of Covid-19 resurgence

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#TurksandCaicos, January 15, 2022 – It is clear that the Hon. Premier and his Cabinet have lost all control of the spread of COVID-19 in the Turks & Caicos Islands. We all have seen a lack of action, and a lack of complete information, and the lack of innovation and proactivity in response to Pandemic.  The local picture of COVID-19 is now worse than it has ever been. We are seeing a lack of urgency and a lack of leadership in response to this new COVID-19 wave in our beloved Turks and Caicos Islands.

The daily COVID positive numbers being reported continues to be alarming high, and making things worse is the fact that the reported numbers do not include the lateral flow COVID positives, which are roughly 4 times higher than the daily reported positive numbers of the dashboards.  It is suspected that for every one case reported on the dashboard, five lateral flow COVID-19 positives go unreported, and not positive persons not followed up or monitored.   Also, there is no requesting of contacts to report for testing, no compliance or enforcement of regulations being carried out and they are not visible as complaints are been heard by the Public at large.

It is also very alarming to hear the government now resorting to handling the responsibility of the management of the Pandemic to the individual person, as they are now vigorously pushing this “personal responsibility “tag line.

  • COVID-19 is a “public health” disease, which caused a “global Pandemic”, hence it is the responsibilities of all Governments in all countries for public health. Our elected Governments has to bear the responsibility of safeguarding our citizens and borders, bear the responsibility to make decisive, timely, and proper decisions, bear the responsibility of strengthening the country’s public health response, bear the responsibility for preventing the spread, and bear the responsibility of increasing and improving the treatment and care options. This is the Elected Government’s work, not the personal responsibility of our citizens.

It is evident that the Government is suffering from Decidophobia, which is the irrational fear of making decisions.

With all the advances and information available, with all the infrastructure that had to be put in place (Lab PCR testing, High Dependency Units, Oxygen Generators, Vaccine availability, epidemiological software, private providers lab testing, approved rapid COVID-19 testing, travel portal, proven compliance and viral spread mitigating measures, the Hon. Premier and his Cabinet response shamefully underperforming in their response to the work they said that they came for; they are definitely not ready for the Pandemic work!

The Hon Premier and his Cabinet has not provided for the increase and expansion of Health Care Professionals in the Turks & Caicos Islands, to prevent the possibility overwhelming of the Health Care System.

The Government has not learned from the first two waves of the pandemic, and has not been proactive (anticipating possible future outbreaks and increase in positive COVID-19 Cases, and preparing for the occurrence ahead of time, like we do each year for hurricane season).  What we are seeing now is them being reactive (trying to take action after the damage is done, and great increases in positive cases are happening).

 

The Government has not:

  • expanded Government operated testing facilities, in particular in Grand Turk, who is now receiving Cruise Ship Passengers. By now a testing site should have been place near the cruise center.
  • The Government has not implemented any lifesaving early treatment options that have been approved, and are available.
  • The Government has not made proper adjustments to the country’s COVID-19 mitigating measures, that can prevent high increases in viral spread and hospitalizations, while protecting livelihoods.
  • The Government has not provided complete and timely information to our people, bringing the people along by providing credible, evidence based scientific information, that can cultivate buy in and restore trust.
  • The Government has not expanded the availability of face masks, like was done with condoms during the peak of the AIDS epidemic (where condoms were made freely available in all public places- Public and Private offices, restaurants, bars, etc.)
  • The Government has not increased policing and compliance activities (which now appears to be nonexistent).
  • The Government has been slow to respond and to make suitable adjustments to the measures before the further progressing of the spread of the virus.
  • The Government has been inconsistent in the restrictions that are in place; preventing and closing down some forms of gathering, while allowing others which has the potential to be a “super spreader” event.
  • The Government has not any advancements to the monitoring and tracking of COVID-19 positive persons.
  • The Government has not adapted nor adjusted their policies on vaccines, natural immunity, vaccine mandates, with all the new knowledge information available now. There has been no updating or coming up with a different plan from the knowledge of vaccinated and bolstered individuals are still becoming infected, and still able to spread the virus, and still being hospitalized. Rather it appears that the Government’s only focus, is to promote the vaccine as if that is the only measure that is needed.

The Government has failed in protecting the family islands with a small and older population, in particular Salt Cay and Middle Caicos, from viral spread.

No one wants to go through another lockdown, and we do not want to see our country in one. Lockdowns are bad for our economy and for our people, as was explained by the Deputy leader and myself in our last PTV interview.

No one want to see another person lose their life from being infected with COVID-19, when there are effective early treatments options available.

We the PDM again urge the Premier and his Government to make the appropriate decisions that could prevent further increases in positive cases, further deaths, further economic losses, and further time away from school and work.

Health

How to Manage Your Diabetes in Extreme Summer Heat  

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How weather can affect your blood sugar  

 

We often look forward to a change of seasons and warmer temperatures. But if you have diabetes, you may be especially sensitive to the hot weather of summer.

Extreme heat can affect your blood sugar control. If you use insulin or your blood sugars aren’t effectively controlled, you could be at higher risk during the summer months. Worsening blood sugar control is often the main concern, and depending on your level of activity, developing low blood sugars may also be a concern.

If you’ve had complications from diabetes that have damaged the nerves to sweat glands, you may be unable to sweat properly. This can become serious as outdoor temperatures rise, leading to heat exhaustion and heat stroke.

Extreme temperatures can also damage your medications and testing equipment, says Dr. Marwan Hamaty, endocrinologist at Cleveland Clinic, Ohio. “I always remind my patients to take precautions to protect themselves and their supplies during both winter and summer.”

He says it’s important to get a handle on your blood sugar control before you engage in summer fun. “If your blood sugars are mostly higher than 250 mg/dl, I recommend improving your blood sugar control before engaging in heavy physical activity — regardless of the climate and the temperature, as recommended by the American Diabetes Association.”

Dr. Hamaty also advises that the extreme heat of summer affects blood sugar levels. How the heat affects your levels depends on what you’ve eaten, whether you’re well-hydrated and your activity level.

If the heat and your activity make you sweat a lot, you may become dehydrated, leading to a rise in glucose levels. “If you become dehydrated, your blood glucose levels will rise. This can lead to frequent urination, which then leads to further dehydration and even higher blood sugar levels — a kind of vicious cycle,” he says.

Things can become even worse if the treatment includes insulin: “Dehydration reduces blood supply to your skin and, therefore, the ability of your body to absorb the insulin you’ve injected is reduced,” he says.

Most types of insulin can tolerate temperatures up to 93-95 degrees Fahrenheit. Exposing your supply to anything higher than this will make the medication quickly break down. Be careful and pay attention to any insulin you’re carrying with you in the heat.

While it’s fine to store insulin and glucagon in the refrigerator, hot temperatures (as well as freezing temperatures) will cause the medications to degrade, making them ineffective and unusable. High temperatures can have a negative effect on other medications and diabetes management supplies too. Don’t forget about the weather’s effect on things like test strips and monitoring devices. When the mercury begins to rise, these items can change in their effectiveness.

Physical activity usually causes blood sugar levels to decrease, reducing your need for insulin. The sudden addition of exercise may put you at an increased risk for low blood sugars.

Therefore, if you’re active in extreme heat, know that you’re at high risk for both low and high blood sugars. This means you should take extra precautions and monitor your sugar levels before exercising.

“I advise my patients to maintain warm skin and adjust insulin dosage prior to engaging in physical activity because insulin adjustment could vary significantly,” says Dr. Hamaty. “But don’t allow the heat to keep you indoors. It’s OK to participate in outdoor activities and enjoy all types of weather as long as you take a few precautions.”

Dr. Hamaty also suggests seeking input from your doctor regardless of the temperature before adding physical activity to your routine.

Follow these tips to help manage your diabetes while enjoying the outdoors:

  1. Drink plenty of water.Staying hydrated is important for everyone during physical activity, and it’s especially critical if you have diabetes.
  2. Avoid becoming dehydrated.Carry small bottles of water or low-calorie electrolyte-replenishing sports drinks in a backpack or on a belt while you’re hiking or playing sports.
  3. Adjust your insulin as needed.Ask your provider or diabetes educator how you should adjust your insulin (and sometimes eating extra carbohydrates) before exercising. Typically, your first few doctor’s visits focus on urgent issues, such as getting diabetes under control. Ask about how to adjust your insulin so you can prepare to be physically active.
  4. Test your blood sugar levels frequently.Since hot temperatures can cause blood sugar levels to fluctuate, it’s a good idea to test more often. That way, you can take appropriate and immediate action to keep your levels stable. You should continue frequent monitoring for several hours after you’re done with your workout or other activity. That’s because the effects of activities on blood sugars usually last for a longer period of time.
  5. Keep items to treat low blood sugar with you. This includes glucose tabs or glucose gel. If you’re at high risk for very low blood sugar (if you have frequent low blood sugar or had very low blood sugar previously), you should also have a glucagon kit available.
  6. Take some snacks with you.Some snacks can serve as a meal replacement while others help prevent low blood sugar. Discuss possible options with your dietitian.
  7. Protect your medication and supplies. Take proactive steps to protect your insulin, glucagon kit and other supplies before you head outdoors, regardless of the temperature. Consider a car cooler that plugs into a 12-volt car adapter to keep your supplies at the proper temperature. This will keep the temperature stable for some time. If you’re going away from your car for an extended period, you’ll need to take your supplies along with you. If you are on insulin pump, be sure to protect your insulin pump from high temperatures. Depending on the situation and how long your activity will be, you might simply need to monitor your glucose more often. In certain circumstances (if it’s extremely hot or you’re out for an extended amount of time) consider using a long-acting insulin temporarily along with meal insulin injection instead of an insulin pump.
  8. Avoid sunburn. You can get sunburned while skiing on the slopes or while hiking in the summer. Sunburn stresses your body and can raise blood sugar levels. Use a broad-spectrum sunscreen and wear protective eye gear.
  9. Finally, limit how much time you spend outside in extreme temperatures. “While I advise staying active during the peak winter or summer months, I also tell my patients to try to take advantage of outdoors activities when temperatures aren’t too extreme,” says Dr. Hamaty. By taking a few precautions, you can enjoy an active, healthy lifestyle in most any weather.

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Health

New COVID boosters get EMERGENCY USE thumbs up

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Dana Malcolm

Staff Writer

 

September 19, 2023 – The old bivalent vaccines are out and a new 2023-24 formula for residents 6 months and over, has been approved for use by the US Centres for Disease Control (CDC). The emergency use authorization comes as the CDC tries to protect the population against the latest variants and flu season approaches.

The announcement came a day after the US Food and Drug Administration approved the shots.

These vaccines contain the XBB.1.5 component, one of the offshoots of the Omicron variant and should be ready in time for fall. But concern is being expressed not just in the United States but in the UK and other countries over the emergence of the variants Eris (EG.5) and Pirola (BA.2.86).

Though XBB.1.5 is no longer the most circulating variant, they are related and the FDA says the vaccine neutralizes them (including EG.5 and BA.2.86) efficiently.

Pirola, as the variant is referred to online, is being watched closely because it is extremely mutated.

“The public can be assured that these updated vaccines have met the agency’s rigorous scientific standards for safety, effectiveness, and manufacturing quality. We very much encourage those who are eligible to consider getting vaccinated,” they FDA said.

It means the older Moderna and Pfizer bivalents are no longer authorized for use in the country. The two manufacturers are also the only ones approved to distribute the newer doses.

Approval has also been granted in the UK for a new shot that targets XBB 1.5. but only Pfizer has secured that nod.

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Bahamas News

Eleuthera Medical Center Marks 5 Years, Private community clinic ‘grows with the demand’, adds Dental and Dermatology to slate of services

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#Eleuthera, The Bahamas, September 19, 2023 – A Family Island clinic that started with a vision to serve the community with the best in private medical care and wellness regardless of a patient’s financial standing celebrated its fifth anniversary this month, announcing new services it said were those most strongly requested by patients.

Eleuthera Medical Center (EMC), the flagship of Bahamas Wellness Health Systems, marked its anniversary adding dental and dermatology to its growing list of medical specialties that includes primary wellness, vision, gynecology and pediatrics. Some services are offered on an ongoing daily basis provided by physicians at one of Bahamas Wellness Health Systems (BWHS) four clinics, others are offered on a rotating basis by visiting medical specialists and associates on a regularly scheduled rotating basis.

“When we opened our doors to this clinic in 2018, we knew there was a need for full-time medical care and especially attention to wellness in Eleuthera,” said EMC and Bahamas Wellness Health Systems founder Dr. Arlington Lightbourne. “But we underestimated how appreciative the community would be that there were always physicians on call, that in the case of an emergency we could respond, that we provided an ambulance and emergency care saving patients from having to be airlifted to Nassau or beyond.”

Lightbourne said the years have not been without challenges.

“For nearly 18 months, we endured COVID, conducting testing outdoors, trying to keep our spirits strong and staff well so they could care for others and yet in a small community like Eleuthera where you know someone in everyone’s family it’s hard not to feel the pain and suffering others feel,” said Dr. Lightbourne. “But we doubled down and said we are here for the long haul and whatever the path is to provide the best in care, to make that care affordable and to improve the wellness of the community overall, that is the journey we are on, and it has been an incredibly rewarding one.”

To support that emphasis on wellness, the clinic located in the settlement of Palmetto Point adjacent to Governors Harbour in the heart of central Eleuthera, offers regularly scheduled lectures and town meetings with a nutritionist and wellness expert who is part of the team. Lightbourne’s interest in well-being stems from his work in Emergency Care at both PMH and Doctors Hospital where the vast number of cases he treated were the result of non-communicable diseases and conditions including heart attacks, high blood pressure and cancer related to lifestyle – poor diet high in fats and low in nutrition and lack of proper physical exercise.

Today, he said he is seeing more interest in preventative care, a sign that Bahamians learned from Covid and its aftermath that wellness matters.

“We have a brighter future ahead of us and I am proud of what we are doing in Eleuthera and our other clinics to make a difference in The Bahamas with careful diagnoses and individual attention to how people conduct their daily lives when it comes to their overall wellness,” said Lightbourne, now the deputy director of the Bahamas Medical Association and an authorized NHI provider.

BHWS also operates clinics in Nassau, Spanish Wells and Lower Bogue.

 

Photo Caption: The Hon. Clay Sweeting, MP, Central and South Eleuthera, welcomes the Bahamas Wellness Medical Center’s ambulance. He is pictured with Dr. Jessica Moss, Emergency Medicine Specialist and Vice President & Medical Director at Eleuthera Medical Center, and Dr. Arlington Lightbourne, founder of the expanding clinic, which is celebrating its fifth anniversary serving the community by adding dental and dermatology to its growing list of specializations.

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