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Leadership in Grenada – A Cruiser’s Perspective – Updated September 2, 2020

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September 2, 2020 – (Update to March 31 post)

Five months since I first wrote this post, we are still in Grenada.  Ice Floe is on the hard in Clark’s Court Marina for hurricane season and we will resume sailing in November.  What began as the prolongation of our time in Grenada due to the airport closure, evolved into a decision to stay in a country where as George often comments “The Grenadian Prime Minister cares more about our health than our President does.”  We are living in a small apartment overlooking BBC Beach in Morne Rouge.

        The view of BBC beach from our apartment porch in Morne Rouge

To date, Grenada has confirmed a total of 24 cases and ably managed a limited outbreak of community spread infections through extensive contact tracing and quarantining.  There have been no deaths and are no known active cases.  Children are back to school, and most businesses are open and the amazingly efficient bus system is back in full service. Large gatherings are still prohibited and the Grenadian Carnival and Emancipation Holiday were canceled to reduce the chance of infractions.

Masks must be worn before entering businesses.  Upon entering, your temperature is often taken and hand sanitizer applied.  In restaurants, your name, phone number, and time arriving is recorded for contract tracing purposes.  International traffic to the island remains highly restricted.  We may hear some grumbling from time to time, but we have not witnessed a single instance of disrespectful behavior, let alone violence.  Adherence to these restrictions is very good – Grenada remains armed should Covid 19 return.

Sadly, in the United States, the pandemic rages on.  Our President applauds his success when the average daily number of deaths declines to 1000, and daily new infections drop to 40,000.  He continues to contradict the world’s leading experts on infectious diseases and the simple numbers a young child can understand.
Over six million people have been infected in the United States and 189,504 died from Covid 19 infections as of the instant I am writing these words https://www.worldometers.info/coronavirus/country/us/  .  Grave concerns about serious, long-standing, health issues in those who have survived the infection are continually being discovered. Our president offers, in an effort to minimize the tragic loss of life, “Half of the people who died were in nursing homes”, recommends less testing so we will have fewer confirmed infections, and threatens to take health insurance away from millions.

We plan to return to the United States in early spring of 2021.  At that time we expect to have President Biden shepherding our once great country through its recovery from the enormous damage wrought by the morally corrupt, deceitful, and self serving actions taken by Trump.

Until then, we remain grateful to Grenada leadership and Grenadians for the safe haven and hospitality they have afforded to us.

Original Post -March 31, 2020

Choosing to Quarantine in Grenada

As the inevitable invasion of Covid-19 infections reached the Caribbean islands, many cruisers raced to find a way to get back to their motherland.  My husband and I, having closely followed the news concerning Covidi-19 outbreaks in much of the world, elected to self-quarantine on our sailboat, anchored off a small, uninhabited, breathtakingly beautiful island in Grenada.  

We reasoned that a trip back to the US would require flying to JFK airport in New York and our coming in proximity with many hundreds of people from all over the world.  We would be putting ourselves at risk, as well as, potentially adding demand on already over-burdened health care professionals with insufficient resources

Can we save ourselves?

The magnitude of this tragedy today, is difficult to take in.  Near-term certainties of what lies ahead, should we fail to slow the progression of infections, will forever damn humanity for our short-sighted, selfish, and shallow priorities.
  
Tomorrow (April Fool’s Day), the number of deaths in the United States will exceed those in China.  Tomorrow, the deaths in Italy will exceed 12,000, with no hint of an inflection in the curve to suggest it will not continue to increase until exhausted by Italy’s vulnerable population.


And yet, leadership across much of the world, points fingers, debates, and seeks to secure some personal or political advantage; none more-so than in the United States.


What true leadership looks like

Presently, confined to our sailboat, in the relatively speaking tiny island nation of Grenada, we have had the opportunity to observe and remember how exemplary leadership can guide a nation through a crisis.  Grenada’s leaders have taken swift, decisive action, given unequivocal direction, spoken the truth, and conveyed empathy.

Before a single infection was confirmed in Grenada, increasingly more stringent directives, principally directed at reducing the immigration of potentially infected foreigners, were enacted.  The following are those relevant to cruisers, like ourselves.

18 – March. Ports of entry to Grenada reduced to two and health check and travel history taken prior to possibility of check in.
19 – March (12:00am). Foreign vessels checking into Grenada must fly a quarantine flag and all passengers be quarantined on their vessel for 14 days
20 – March. Persons on board foreign vessels in Grenada cannot set foot on land 
21 – March (11:59pm) Grenada closed to any foreign vessels not already cleared in
  • The first infection (an individual returning from the UK) tests positive.
22 – March. Grenada’s main airport, Maurice Bishop International Airport closed to commercial traffic

The announcement that those on foreign vessels could not set foot on land, was simultaneously accompanied by hand delivered details of how our need for resources (food, water, fuel, et al) would be met.  This service has been faithfully provided at no cost.  We feel much indebted to the Grenadian Prime Minister Dr. Right Honorable Keith Mitchell and Minister for Health Honorable Nickolas Steele and all Grenadians for continuing to provide us with safe haven and necessities.

Since the first individual in Grenada with a confirmed Covid-19 infection was identified on March 21, eight additional individuals are known to have been infected. All have ties to patient zero and we can only hope the infection has been contained.  In addition, a Limited State of Emergency was put in place, curfews were established and the need for social distancing, hand washing, not touching your face and remaining at home whenever possible was repeatedly emphasized.  

Grenada’s Leadership not afraid to take unpopular decisions

March 30th, a written announcement from Grenada’s Minister of Health, the Honorable Nickolas Steele included the following excerpts.

“Sadly, many have not heard us.  Many have ignored us.”

“In this regard, therefore, a mandatory curfew will be imposed beginning from 7:00 pm on Monday, March 30th, 2020, and ending 7:00 pm on the 6th day of April 2020.

During this period, every person shall remain confined to their place of residence (inclusive of their yard space), to avoid contact outside of their household; except as provided in the Regulations or as may be authorized in writing by the Commissioner of Police.”

Strict guidelines for the procurement of food were established.

“Shops which sell groceries, grocery stores and supermarkets in each Parish shall be open for business between 8am and 12 noon on select days specified by the Commissioner of Police.”

“One Person from each household shall be allowed to leave their residence once during a grocery day to attend shops which sell groceries…..in their own Parish”

All other places of business including restaurants and gas stations will be closed.

Strict guidelines for personal vehicles and busses were clearly spelled out.

Lastly, in my opinion, the most powerful and persuasive message issued from the Minister of Health, when addressing the nation live today was the following.

“Do not leave your house unless it is a food or medical emergency and you will have done your part to keep your household safe and your nation safe.”

Judging from the comments left by Grenadians following the publication of these directives, there is widespread support, despite the hardships imposed.

That is what True Leadership can accomplish!


Covid-19 What You Need to Know You Know and Don’t Know

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Quarantining in Grenada

George and I remain in quarantine on our Sailboat moored off Sandy Island, Carriacou, Grenada.  We currently do not have a means to return to the United States.  Travel between most of the Caribbean  islands is not possible due to restrictions each island has put in place and the Grenada airport is closed.
Our situation is not dire.  We are comfortable and the Grenadian government has been gracious in providing a means for us to obtain food and necessities.  Should means become available to return to the United States, we will need to assess whether we would feel safe to do so.
I am a scientist, now retired –  but the scientist in me still is struggling to decipher from the limited information we have, contradictory advice and predictions we receive, what I know and what I don’t know to be factual.  I believe you would be wise to be certain of this as well.  The information we receive is more than tainted by political beliefs, half-truths, and best guesses.

What I “know” about the extent of the disease

  1. Summaries of the number of infected individuals and number of deaths attributed to Covid-19 infection are posted daily at midnight GMT (8:00 EST) by country and by state. https://www.worldometers.info/coronavirus/country/us/
    • These numbers can change after initial posting as actual dates of deaths for some come later.
    • These numbers are subject to each state’s conventions for defining a death attributed to Covid-19.  For example, in some states, all deaths of individuals testing positive for the virus are counted.  In some, deaths with clinical symptoms characteristic of Covid-19 are also included.  In an extreme divergence from the norm, deaths in Alabama, including those for which the individual was Covid-19 positive, are reviewed by a physician who makes a determination of the cause of death.
    • The veracity of these numbers is compromised by the extent of testing and what was known about Covid-19 symptoms at the time of death.
    • Determining specific cause of death is challenging with individuals known to have significant pre-existing co-morbidities and a virus that compromises the function of multiple organs and causes blood clotting

Graph 1.  Number of reported deaths attributed to Covid-19 per day in the United States

These data are depicted on a logarithmic scale (on the vertical access, each incremental increase is a 10-fold increase).  When an increasing trend on a logarithmic scale is linear (straight), the rate of increase is said to be logarithmic.  Logarithmic, in this instance simply means the number of deaths per day (the rate of death) is steadily increasing with time.
The graph below depicts the number of deaths reported each day in the United States as reported on 29-April, 2020.
Graph 1.  https://www.worldometers.info/coronavirus/country/us/  (29-Apr-2020)

What does Graph 1 show?

  1. Through much of March, the daily number of deaths attributed to Covid-19 was doubling approximately every 3-4 days.  Had this rate been sustained, by mid-April the total number of deaths would have been approximately 1 million.
  2. Something changed around the end of March that slowed the daily number of reported deaths in the US attributed to Covid-19
    • My Guess –  large numbers of citizens or the most-susceptible citizens embraced social distancing
  3. From April 8th until April 29th, the daily number of reported deaths attributed to Covid-19 has oscillated between a high of 2683 per day and a low of 1156 per day with no appreciable trend up or down

Graph 2.  The Cumulative number of reported deaths attributed to Covid-19 over time.

These data are cumulative, which means each days total number of deaths is added to the previous day’s total.  This graph is depicted on a linear scale.  References of the cumulative number of deaths over time for several other countries are provided for comparison.
Graph 2.  https://www.worldometers.info/coronavirus/country/us/  (April 29, 2020)

What does Graph 2 show?

  1. Despite the fact that the daily number of reported deaths attributed to Covid-19 stopped increasing around April 8th, as depicted in Graph 1, the total cumulative number of deaths has been steadily increasing, from a total of 17,691 on April 8th to over 61,655 on April 29th.

Has the number of reported infections decreased over time?

The graph below depicts the daily number of reported infections in the United States increased throughout March and began to stabilize in early April.  It is very difficult to draw conclusions concerning this trend as guidelines prohibiting wide-spread testing and limitations in the ability to conduct tests is likely to have influenced the data, but it is suggestive that the number of highly symptomatic individuals (most likely to have been tested) has stabilized in the same approximate timeframe as the number of deaths have stabilized.
This should not be construed to suggest the number of infections are not increasing.  For the entire month of April, the number of newly documented Covid-19 infections in the US oscillated between 25,000 and 35,000 per day.
https://www.worldometers.info/coronavirus/country/us/ (29-Apr-2020)

One more thing I believe I “know”

In the early March to end of March timeline the majority of reported deaths attributed to Covid-19 came from New York State as depicted in the graph below.  Throughout April, the reported number of  deaths reported each day has appreciably declined.
As we know from the first graph in this opus, the daily number of reported deaths attributed to Covid-19 has not changed over the month of April.  This can ONLY mean the number of reported deaths attributed to Covid-19 have increased outside of New York.
https://www1.nyc.gov/site/doh/covid/covid-19-data.page  (29-Apr-2020)

Mythbuster

You hear people often say, “Covid-19 is less deadly than the flu and we don’t quarantine for that.”
The data for the total number of deaths annually due to Flu vs Covid-19
Annual Flu deaths deaths in the US – 55,672 (source https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf )
Covid-19 deaths, to date – 62,672 with unknown duration of the “season” (source https://www.worldometers.info/coronavirus/ ) up 1017 since I started writing this post

My Conclusions

Social distancing has very significantly curtailed the number of deaths and anyone with characteristics of the most susceptible should remain quarantined.  Anyone else who can remain quarantined without due hardship should do so as we do know deaths are not only occurring in those deemed most susceptible.
Deaths are increasing steadily as of April 29th at a rate of approximately one to two thousand each day and confirmed, newly infected individuals are increasing between 25,000 and 35,000 each day.
States other than NY are increasingly driving the numbers.
Projections of just how many deaths will occur due to Covid-19 are more dependent on our own behaviors than the virus itself and I do not believe any model can predict that.

Quarantined in Paradise Lost

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March 22, 2020

The sun set over Sandy Island as cruisers like ourselves enjoyed their last few minutes on land.

Foreign vessel restrictions in Grenada due to Covid 19 Coronavirus

Efforts in Grenada to keep the island free of the Covid 19 Coronavirus have become more stringent by the day since our arrival March 18.

  • March 19, 12:00am – any foreign vessel checking into Grenada must fly a quarantine flag and be quarantined on their boat for 14 days
  • March 20 – Foreign vessels in Grenada or Grenadian waters cannot set foot in Grenada
  • March 21 – At end of day, Grenada closed to any new foreign vessels
  • March 22 – Grenada’s main airport, Maurice Bishop International Airport closed to commercial traffic
We applaud the precautions the Grenadians are taking, but how I cried when the restriction was put in place that we could not touch land.  Poor Duhkxy lives for the time we take him to Sandy Island, often sitting wistfully gazing at the beach.
In an effort to establish a new routine for play we put out a ramp for Duhkxy off the swim platform.  Once we jumped in he was happy to join us but he headed immediately for shore, took a poop, and then swam back to the boat.
We were visited later in the day by Grenadian immigrations, customs, and coastguard.  They checked our papers to ensure we were checked in.  I asked if the land restriction included Sandy Island and was told we could go there. What a relief and how kind.
We have been assured that we will have assistance in obtaining provisions, water, and fuel as needed and have already been visited by gentlemen who will provide this service.  Our personal situation is not a hardship and we feel extremely grateful to be so fortunate.
My anxieties concerning the magnitude of this growing tragedy erupt without warning – concern for my loved ones at home, friends who are trying to get home, cruisers who have not found a home, the health care providers who risk their lives while not even being provided the most basic of protective apparel, the many hundreds of thousands of lives that could be cut short, the inexcusable delays in preparing for and managing the spread of this virus, businesses ruined and repercussions that we cannot even imagine.
In an effort to form my own conclusions regarding what we may expect from this pandemic, I have been tracking the number of deaths from the virus in several countries that have had the best to least success in managing the spread of the virus.  Death is the only way to compare countries as the rigor of testing is so varied.  At present, the United States appears to be on a trajectory similar to China.  Even if the most “draconian” measures implemented in China were adopted now, we will likely see several more thousand susceptible people die.  If unchecked, we can only hope the virus peters out.
Stay safe – stay isolated to the fullest extent you can, stay well.  Understand that each person who contracts the virus passes it on to others – some who will inevitably succumb to the disease.