Alfred Dawes | Where will we go when di quarantine ting done?

“Where will we go, when di quarantine ting done and everybody touch road?” asked Koffee in her anthem that resonated with so many suffering in the throes of cabin fever during the curfews and lockdowns. Now that the lockdowns are gone and our noses are far less likely to be interrogated before boarding a plane, what next? Where are we going as individuals and country? Have we emerged stronger, learning valuable lessons while changing our values for the better, or was this merely a culling and massive transfer of wealth from the poor and middle class to the wealthy?

As death stalked us and fear rode behind it, we should have learned what was important and what was not. The monied realised that their wealth could not protect them, or even guarantee good healthcare during the pandemic as COVID-19 killed indiscriminately. For those who contracted the disease and stared death in the face, their outlook on life changed as they confronted their own mortalities. What suddenly became the most important thing was time with loved ones – a common oversight during the rat race to a wealthy tomb. Hopefully, this will not be forgotten.

The education system is worst off. We have lost students who will never go back to school. We cannot quantify how many were left so far behind that it is near impossible for them to catch up with those who had the resources and support available to excel at homeschooling. The cracks in the education system have given way to a full-blown crumbling of the foundation – early childhood education. It will be years before a full realisation of the damage caused by the long lay-off from face-to-face classes will be evident. The need for early childhood education reform has never been so pressing given the crisis that has been building over the last two years. We must urgently effect the reforms needed to mitigate the impending disaster that will occur when children with a poor learning foundation are asked to rise to the levels demanded by high school and subsequently the working world.

CRIME

Crime. Ahh crime … what more needs to be said about crime? If with lockdowns and islandwide states of emergencies, the greatest efforts and last resorts we had, we were not able to make significant and lasting reductions in violent crime, then we are hopelessly lost. With the landmark ruling that the states of emergencies were unconstitutional in the single case reviewed to date, and the opposition party emboldened by the judges’ decision supporting their vehement opposition to the SOEs, we can put to rest the idea that SOEs will be the immediate crime suppression tactic while broader measures are allowed to materialise. The era of the national SOEs is over, at least until anarchy sets in and the State loses its slippery grip on law and order. As we move in the post-lockdown era, crime will continue to get worse until we realise that the real crime plan needed all along was one that would create the political will to enact the changes that will solve crime but, in the process, decimate the fortunes of the political class.

The largest injection of cash into the health sector in recent times happened during the pandemic. Between government spending and private sector donations, equipment and supplies poured into the facilities on the front lines. Critical care received a boost and lab capacity increased significantly. Before the pandemic, many sick patients died because we did not have enough ventilators on the island. Millions of dollars were donated towards the purchase of ventilators and over forty of the machines were handed over to the Ministry of Health and Wellness. This boosted our capacity significantly and should have a long-term effect on our ability to provide critical care to patients suffering from a wide variety of diseases and trauma.

Although field hospitals are not a permanent fixture and should shortly be dismantled, permanent structures that can be repurposed were erected to expand the infrastructure of some hospitals. Without COVID-19 there would never have been a capital budget, and this is one positive that has come from the pandemic. The infrastructural developments and additional equipment will soon be needed to deal with the surge in patients with complications from chronic diseases and conditions warranting elective surgery.

The lockdowns and emergency modes at health facilities resulted in scaled down clinics and surgical lists. Many patients were lost to follow up and the waiting list for surgeries, already over two years in some instances, grew significantly. Some who were awaiting elective surgery for prolonged periods ended up having emergency surgeries as their conditions deteriorated. As with the education system, we do not have an idea of the true effects of the scaled down clinics and hospital services. Chronic diseases were suboptimally treated over the last two years and the effect of this has not started to manifest fully. An urgent review of the state of elective surgeries is needed post-haste and efforts made to clear the backlog of elective procedures before they become life threatening emergency surgeries. At the same time, the identification and treatment of persons living with chronic non-communicable diseases should be prioritised to avoid an avalanche of medium- to long-term complications.

How we navigate health, security and education over the next few years will have lasting repercussions on an entire generation and the future of the nation. Wherever we go, we cannot afford to go wrong.

- Dr Alfred Dawes is a fellow of the American College of Surgeons, CEO of Windsor Wellness Centre. Follow him on Twitter @dr_aldawes. Send feedback to columns@gleanerjm.com and adawes@ilapmedical.com.