Basseterre, St. Kitts, April 09, 2020 (SKNIS): During an NEOC COVID-19 Daily Briefing held on April 08, Dr. Cameron Wilkinson, Medical Chief of Staff at the Joseph Nathaniel France (JNF) General Hospital, highlighted the four stages of viral transmission and the four scenarios that the World Health Organization (WHO) describes for countries affected by the COVID-19 pandemic. He noted that the St. Kitts and Nevis is now at Scenario two.
Dr. Wilkinson stated that the WHO advised that all countries should increase their level of preparedness and response to identify, manage and care for new cases of COVID-19.
“Countries should prepare to respond to different health scenarios recognizing that there is no one size fits all approach to managing cases and outbreaks of COVID-19,” he said. “Each country should assess its risks and rapidly implement the necessary measures at the appropriate scale to reduce both COVID-19 transmission and economic, public and social impacts.”
The four transmission scenarios for COVID-19 include: Scenario One, countries with no cases; Scenario Two, countries with one or more cases imported or locally detected, that is sporadic cases; Scenario Three, countries experiencing cases clustered in time, geographic location or from a common exposure called cluster cases; and Scenario Four, countries experiencing large outbreaks of local transmission, which is called community transmission.
“Countries should prepare to respond to all transmission scenarios,” said Dr. Wilkinson. “Even when we were at scenario one here in the federation with no confirmed cases, we were preparing for scenario four. It would be virtually impossible to hide from the public at which scenario we are at especially as it relates to scenarios three and four as there will be obvious clinical manifestations with patients showing up in or at our health institutions as we see playing out in countries and cities around the world.”
The Medical Chief of Staff stated that the approach of fighting the disease in the federation is “a whole of society coordination approach.”
“We are enlisting the help of all sectors of society in this fight. There is therefore no reason to conceal information to the public as we have been totally transparent at every step and we are enlisting their help at every step of the way,” he said. “We were, like all countries except China, at level one for a very long time until we had our first confirmed case on the 25th of March.”
Dr. Wilkinson said that the federation is now at Scenario two with 11 confirmed cases. “Eight of the cases had a clear personal history of travel and three were related to persons who had a history of travel. These were sporadic cases.”
Viral transmission and the stages of viral transmission are separate from the four scenarios, he said.
“Stage one refers to imported cases where the virus in brought into our country by someone who travelled from a high-risk country with COVID-19. Stage two is local transmission where the virus is transmitted only to those in close contact with an infected patient. The cases remain within close family members or acquaintances,” said Dr. Wilkinson.
“Stage three is what is described as community transmission, that is, the persons do not have a history of travel to a high-risk country or had a history of being in direct contact with an infected person to become infected. Here the circle of transmission becomes so huge that doctors cannot trace where or how this person became infected and that is what is described as community transmission and this continues to escalate then we get what is called an epidemic. This is where you have a widespread rampant disease in the country and it becomes a national health emergency,” said Medical Chief of Staff, Dr. Wilkinson.
