The Bottom, Saba- With Saba in a mandatory lock-down since April 12, Island Governor Jonathan Johnson in his most recent message urged people to continue to show understanding and patience in these trying times where everyone experienced occasional frustrations.

Johnson informed the people of some developments that would take place on Tuesday, April 21. The semester of the Saba University School of Medicine has ended and students have been leaving the island. In the morning hours, another group left the island, and Johnson told people not to be alarmed if they saw large groups of students waiting to be picked up to go to the airport.

On Tuesday afternoon, two residents returned to Saba. These persons, as the measures prescribe, went in quarantine right away. As everyone in quarantine, they will be tested at the end of the 14- day quarantine period. A number of persons in quarantine were asked to come to the drive-in clinic at the hospital on Tuesday for testing. These persons had permission from government to go to the appointment.

Johnson urged people who experience flu-like symptoms to contact the hospital. This also counts in case people know someone who shows these symptoms but doesn’t want to alert the hospital.

He said it was very important to trace and test every lead to check the extent of the spread of COVID-19 in the community. “During times like this, it is vital that we are honest about the state of our health in order to allow the medical teams to take the necessary steps to contain the spread of COVID-19.”

Johnson called on people to stay positive. “As we continue to navigate through this uncertain time, many changes and developments will occur, which naturally causes a feeling of unrest. So take a moment each day to clear your mind of negativity and focus instead on things that bring you joy.”

Ask Dr. Koen

Saba still has two confirmed COVID-19 patients and one suspected patient, who was transferred to St. Maarten. All three patients are doing well, said Head of the Public Health Department Dr. Koen Hulshof in an interview with Saskia Matthew of the Government Information Service on Monday. The government last week introduced an informative audio format, named Ask Dr. Koen, in which Hulshof answers questions. The public was requested to send their questions, and many did so.

In the second edition of Ask Dr. Koen, Hulshof provided an update and answered a number of questions relating to testing, the spread of the coronavirus and the symptoms of COVID-19. Hulshof confirmed that the number of persons who were tested was 44, of which 35 tests came back negative and seven are pending. A total of 58 persons are quarantined, mostly as a result of the direct contact they had with one of the three patients.

Responding to a question as to why (some) test results are taking so long, Hulshof explained that there were two types of tests: the molecular test and the blood test. So far, the tests that local authorities have been reported on concern the molecular test, which consists of a nose and throat swap. The test samples go to St. Maarten or Guadeloupe for analyzing. Molecular test results from St. Maarten typically come back in one to two days. Guadeloupe takes longer.

Test prioritization

Because the testing capacity in St. Maarten is limited, a prioritization is done of which tests are performed in St. Maarten and which go to Guadeloupe. The samples of the persons on Saba who were at the end of their quarantine were deemed a lower priority and were sent to Guadeloupe. Hulshof said that with the expected increase in testing capacity in St. Maarten by the end of this week, more tests can be analyzed there instead of having to send them to Guadeloupe.

As for the blood test, Hulshof explained that this test is used to check for anti-bodies after someone has had the virus. The blood test is not to check whether a person has the virus at that particular moment. There are some technical difficulties with the current blood test which is still new. “There is no reliable version as yet. This is the problem with the testing of the third Saba patient who went to St. Maarten.”

Asymptomatic

Hulshof addressed a question that many persons had: are there people on Saba that are without symptoms (asymptomatic) or with mild symptoms, and how does government deal with this? “Sadly, this is true. We may have people walking around asymptomatic or with mild symptoms. For people with mild symptoms, we urge them to call the hospital. And, there is always a chance that a person has the virus and doesn’t know. That is why the stay-at-home measure is so important. This contains the spreading. People simply need to stop moving around.”

Local authorities are in the process of trying to find out how wide-spread the virus is on the island. Much more testing was done last week to help determine that. Also, authorities have been talking to persons who returned to Saba just before the borders closed to find out how the virus came to the island.

“First indications are that the virus is not widely spread, but it is too soon to draw strong conclusions, and any exit strategy can only be discussed in the Management Outbreak Team after we have more clarity on the spreading,” he said. Important factors too are how the situation develops in St. Maarten and the status of health care on Saba’s sister island.

The coronavirus will be around for quite some time. “People need to realize that this pandemic will be going on for a long time. We will try to contain the virus as much as possible. We also have to weigh the negative effects of the current measures. For many, it causes extra stress and financial problems, and children should not be out of school for too long. And, we also need to provide regular health care to the people,” said Hulshof.