Fear won’t work

Last week’s relatively low turnout of healthcare workers to receive their COVID-19 vaccination during the rollout’s first phase, is a classic example of what happens when government treats key professionals as though they are incidental to what is essential.

It also speaks to a fundamental failure in how government approached its vaccine rollout process, that the segment of the population considered best equipped to digest the science and its implications, was unwilling in large numbers to take the jab during a phase where they were priority in name only.

Whether through a lack of evidence given to support restrictive measures that at times smacked of favoritism; a lack of consultation with essential workers; or a lack of adherence to emergency orders by the Competent Authority and some ministers, the Bahamian people over the last year have been consistently treated as though they are mere actors in the government’s pandemic show.

Instead of using reason and evidence-based appeals to help quell anxieties and temper frustrations during the country’s pandemic response, the government routinely resorted to the psychology of fear – a tactic that is counterproductive because when fear becomes generalized, people begin to avoid situations even when they do not pose a threat.

In a culture of vaccine hesitancy, the nation’s healthcare workers play as important a role as the prime minister and his minister of health, because nurses and doctors are the trusted voices of their patients and the public, who will look to them for advice on the invasive medical procedure of COVID-19 vaccinations.

And lest we forget, healthcare workers are people too, with their own personal health concerns that must be respected, and with procedural questions that must be addressed since they administer vaccines, and treat and monitor patients who suffer any adverse effects thereof.

Yet, when questioned by reporters on government’s

failure to consult with groups representing the country’s nurses and its junior and senior physicians about the vaccine rollout, Health Minister Renward Wells said “the most important persons” were consulted.

Wells’ response was not only arrogant, but one that displayed a level of ignorance about the role of all healthcare workers in a national vaccination effort that is not befitting the political head of the country’s public healthcare system.

Last week’s lower than anticipated turnout of healthcare workers reportedly led to an earlier-than-planned expansion of the rollout process to vaccinations of those in the general public aged 65 and older.

The relatively low turnout of healthcare workers to receive the jab in the first phase sent a message to the general public that if many doctors and nurses do not want to be vaccinated, the vaccine must pose more of a threat than the country’s politicians are admitting to.

Though some see public doubt as having reached an inane pitch, the reality is that fear shaken in the test tube of active public distrust has created a reaction of suspicions so intense that many have discounted even the prime minister’s televised inoculation, questioning whether he in fact received the AstraZeneca vaccine at all.

As we pointed out last week, vaccinations are medical procedures, therefore, the decision to be vaccinated is a medical and not a political one.

One of the most detrimental aspects of the COVID-19 pandemic has been the extent to which politics has polluted science, wherein the politics of the day has become a deleterious influence on scientific initiative, and where medical professionals face undue pressure to give advice or support political decisions that run counter to science or best practices.

If government is desirous of maximizing the potential of its mass vaccination exercise, it must stop behaving as though the country’s nurses and doctors are underlings in this process, and instead take the sensible approach of engaging in regular and productive consultation with healthcare worker groups.

Failure to have established such relations well ahead of the vaccine rollout has already harmed public perception of the process, and will continue to cause harm to overall vaccination objectives.

A regional perspective

In a March 14 statement, the Office of the Prime Minister (OPM) announced that vaccinations would begin on Grand Bahama last Wednesday, but the island’s batch of vaccines did not arrive until last Friday, with the start of the inoculation process now scheduled for Monday.

OPM advised yesterday that over 1,500 people have been vaccinated thus far.

Jamaica’s COVID-19 vaccination program began on March 10 with its donation of AstraZeneca vaccines from India.

The country’s Ministry of Health and Wellness in a statement posted one day after its vaccination launch said, “With a target to inoculate approximately 3,280 members of the priority group…83 percent of the target for [the] day was met.”

Healthcare workers were the first priority group of the launch, and the percentage reached amounted to 2,718 healthcare workers being vaccinated on day one.

The ministry said various heads of associations representing nurses, senior and junior doctors received their vaccinations at the start of the rollout, a stark contrast to what occurred here at home.

Barbados is said to be the most vaccinated country in the region to date, and its first phase of inoculations was administered to healthcare workers and those in the tourism sector.

The country administered 2,863 vaccinations in the first two days of the country’s rollout and, like Jamaica, engaged healthcare workers throughout the planning stages of its vaccination launch.

India earmarked over a half-million vaccines for donation to the region, and has already made donations including 100,000 doses to Barbados; 80,000 to Guyana; 70,000 to Dominica; 50,000 to Jamaica; 40,000 to St.Vincent and the Grenadines; 40,000 to Antigua and Barbuda; 30,000 to the Dominican Republic, and 25,000 to St. Lucia.

The Bahamas received a donation of 20,000 doses.

COVID-19 Vaccine Consultative Committee chairperson Dr. Merceline Dahl-Regis recently advised that if The Bahamas does not receive additional doses of the AstraZeneca vaccine by the end of the month, the Ministry of Health would hold off on vaccinations until it receives an additional shipment.

Regional prime ministers are taking a proactive approach to securing additional vaccines, with Antigua and Barbuda’s prime minister Gaston Browne writing to United States President Joseph Biden, requesting that CARICOM countries be provided some of the US stockpile of AstraZeneca vaccines.

A report in the New York Times stated that the US has “tens of millions” of AstraZeneca doses on stockpile, with the US recently indicating plans to provide millions of doses to Mexico and Canada.

The US Food and Drug Administration (FDA) has not yet granted emergency use approval for the AstraZeneca vaccine.

In his appeal to Biden, Browne urged the US president “to take account of the Caribbean – the third border of the US – in his plan to make the US safer by contributing to the safety of its neighbours”, according to a report in the Jamaica Gleaner.

Prime Minister Dr. Hubert Minnis has not indicated whether The Bahamas will approach the US to request doses of the AstraZeneca vaccine, considering the uncertainty of when shipments via the COVAX facility and elsewhere, will be obtained.

Given that the number of vaccines currently in hand can provide AstraZeneca’s two-dose regimen to only 2.5 percent of the population, approaching the US would be a sensible move.

Tying vaccination to

one’s livelihood

Minnis recently stressed that if Bahamians refuse to take the vaccine, fewer visitors will come to The Bahamas.

While in Andros last week he said, “If we are disciplined and take the vaccine, our country will be even more attractive to travelers. If we refuse the vaccine and there is a resurgence of the virus, fewer visitors will come to The Bahamas.”

Here again is an example of using fear to compel action, as opposed to using evidence-based appeals.

It is important to recognize that research on whether COVID-19 vaccines prevent transmission of the virus is still inconclusive, which is why vaccinated people are advised to maintain all existing safety protocols when in the general population.

What peer-reviewed studies strongly suggest is that the vaccines can significantly reduce the risk of serious illness should you contract the virus.

For over a year, Bahamians have exhibited both discipline and the ability to sacrifice, and when the worst of the local outbreak was triggered after a relatively long period of minimal hospitalizations and no deaths, it was bad policymaking, and not a lack of public discipline, that sparked what became the country’s second wave.

Submitting to an invasive medical procedure, unlike submitting to mask-wearing and social distancing, is not simply a matter of subjective discipline.

Vaccination initiatives ought to be guided by the medical community, and should be undergirded by what ought to have been an effective, coordinated nationwide educational campaign with healthcare workers fully engaged and at the forefront of the effort.

Had government disciplined itself to accomplish this, it would not need to resort to untenably pitting one’s fear of vaccination against an individual’s need to provide for self and family.

There is no evidence thus far that tourists are seeking a benchmark of vaccinations in a destination before choosing to travel thereto, and in our largest tourism market, only approximately 13 percent of Americans have been fully vaccinated, and approximately 25 percent have received a single dose of vaccination.

Further, since vaccination is being tied to shoring up the tourism product, the government should explain why it has only assigned vaccines to two islands thus far, with no indication of when vaccinations would start on Family Islands which also have a robust tourism product.

Why would healthcare workers on those islands not be afforded the same immediate opportunity for protection as their colleagues in the nation’s capital and second city?

Since the prime minister said 20,000 single-dose administrations will occur initially, certainly that number could have been proportionally split between the islands so that Family Islanders would not have to be spectators thus far in what is supposed to be a nationwide effort.

Fear will not work to convince Bahamians to become vaccinated, and the word of politicians in the current climate of public disaffection will do very little to combat vaccine hesitancy.

Messages of doom or threats of punitive restrictions are more likely to turn people off from the vaccination process, and engender resentment such that the competent authority and his method of pandemic management would be seen as more of a threat to progress, than a choice not to be vaccinated.

Politics versus science

Returning to our thesis on how insensible pandemic approaches have caused immeasurable harm, one of the more prominent examples of this is seen in restrictions placed on burials and funerals.

Burial rites are integral to starting the healing process in one’s grief, and for many loved ones, that process was traumatically disrupted by being unable to pay final respects either at a funeral, or at the graveside.

The competent authority insisted that church funerals and graveside burials in excess of 10 attendees would contribute to the spread of COVID-19, and he maintained those restrictions on several islands even after case numbers showed a consistent downward trend.

Yet, in the midst of case numbers increasing on several islands, he has opted to liberalize the protocols, which appears to have been done to lessen pressure arising from public complaints about the size of campaign events.

If more people can attend graveside funerals and weddings when cases and hospitalizations are on an increase, it discredits Minnis’ primary rationale for imposing stringent limits on funerals, burials and weddings, and demonstrates that in the unseemly battle between politics and science, politics shall emerge the winner.

As for vaccinations, more people are likely to decide to take the jab in time, though nationwide uptake projections are yet to be put forward.

Politicizing the process – that is, making politicians or their perceived supporters the prominent faces and voices of the initiative – will undermine efforts to boost uptake.

And choosing not to employ the sensible approach of bringing and keeping healthcare workers around the table, will undermine that effort even further.