Christopher Tufton | Looking back, moving forward: Lessons from COVID-19

‘Likkle but wi tallawah’ is a Jamaican proverb that means “we are small, but we are strong”.

This was never more true of Jamaica than as we navigated the harrowing experience of the COVID-19 pandemic, with its ebbs and flows that exposed weaknesses in healthcare systems worldwide while also showcasing the resilience of our people and their capacity to adapt, innovate, and collaborate for the public good.

Ultimately, the experience of the pandemic, the most significant global health crisis in the last century, was also chock full of lessons learnt even as it has helped to accelerate our progress on the road to building a more resilient, transformed health system.

The pandemic tested the bounds of our capacity, our agility, our resolve. Still, we tackled head on its myriad challenges that were fuelled by, at times, high levels of uncertainty, anxiety, and fear within the population.

The lessons that have come from that experience are such that they serve us today and will continue to do so as we pursue the transformation of public health in Jamaica – from the multibillion-dollar improvements to the physical as well as the information communication and technology infrastructure now being pursued in our health facilities to work to increase the number and competencies of our human resources for health.

As we observe the fifth anniversary of the detection of the first case of COVID-19 in Jamaica on March 10, 2020, and come to terms with the 157,458 cases and 3,875 deaths since then, it is worthwhile to reflect on the lessons learnt and it is as timely as it is important to pivot from them.

NOTHING BEATS A PLAN

One of the first and, perhaps, most important lessons is that one must always have a plan.

• A plan helps to ensure that hospitals have what they need to function at their optimum, including trained staff and the necessary material resources, to ensure the best possible health outcomes.

• A plan helps you to account for the high levels of disruption of social and economic life that are likely to occur in a pandemic and, therefore, ensures that critical services – from emergency care to food distribution – are initiated and sustained.

• A plan, among other things, is also enabling to coordinated responses across governments, the private sector, and civil society actors.

Fortunately for Jamaica, at the time the COVID-19 pandemic struck, we had a pandemic influenza response plan, done in 2006, which we adapted for COVID-19. This plan – which turned on principles of rapid implementation of global and national actions as well as guidance from the WHO and dependence on early disease detection – informed our decision-making.

ACT EARLY

It is necessary to act early and with caution. While there were tremendous social and economic costs, there can also be no question that the early moves to do extensive contact tracing, close schools, have people work from home, and to quarantine individuals and communities as necessary slowed the spread of the virus in the early months of the pandemic.

HONOUR YOUR CAPACITY

It is vital to know your limits and to respect those limits, being careful not to over-extend even as you address new and emergent issues. Testing travellers as they landed, for example, was necessary to satisfy the population that their sacrifice to stay indoors and stick with other infection prevention and control measures was being honoured. However, it ultimately proved impractical, resulting in a backlog in the lab that took weeks to clear and which stretched our capacity.

TEAM WINS

Public health is a team sport, and we win together, never alone. We saw it in the collaboration between clinicians and administrative staff in our hospitals; between the Government and the private sector in our planning and coordination; and in the contributions of our bilateral country partners and international development partners – from information sharing, to leveraged capacities, resource mobilisation, task shifting, and vaccination implementation.

That being said, recognise that there will be moments when team members clash, particularly in high-stress situations, which COVID-19 was.

COMMUNICATE

From the beginning, the Government of Jamaica and the health team understood that Jamaicans would have to be provided with clear, concise, practical, and timely information for sound decision-making.

Looking back, we could have done better to explain some concepts in simple, more accessible terms. But we did a creditable job.

There were routine press conferences at the Office of the Prime Minister and the Ministry of Health & Wellness’ COVID Conversation series that provided the media and the public with access to our decision-makers while also providing a dedicated forum to ask questions and to hear of the progress of our response as well as to be read in on developing issues for informed decision-making.

There was extensive use of social media to help people keep pace with how things were progressing locally as well as globally while our communications team, including in the area of health promotion and education, was activated. They created hundreds of pieces of information, education, and communication collateral and undertook many media campaigns across platforms (traditional and new media) to ‘break down’ COVID-19 and the related issues for people while reminding of the need to keep pace with infection prevention and control measures.

BEWARE OF BURNOUT

Jamaica has a most excellent public health team, comprising individuals who go above and beyond the call of duty. In a crisis, they rise to the occasion, and our experience of COVID-19 was no different.

Even in the face of their own fears and anxiety, they went to work each day and provided their patients with care. In doing so, more than 50 healthcare workers – from all categories of the health team – made the ultimate sacrifice and numerous others got sick.

Only this past week, we unveiled the Healthcare Worker COVID-19 Monument at the National Chest Hospital in honour of those who died and thanked them and their loved ones for their service and for their sacrifice.

COVID-19 was hard on the health team, and as we take stock of the experience, we recognise that it is necessary, especially during such a crisis, to develop a predetermined crisis-staffing plan with built-in welfare provisions for team members.

Our people in health brought us through what was one of the hardest times Jamaicans have ever experienced. They are our heroes – heroes who had a supporting cast in the people of Jamaica without whose trust, endurance, and partnership we would not have been able to overcome and which now inspires our work to achieve greater resilience and transformation in health.

Dr Christopher Tufton is Jamaica’s minister of health and wellness and member of parliament for St Catherine West Central. Send feedback to cctufton@gmail.com or columns@gleanerjm.com.