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Covid-19: the end of the beginning

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The permanent Covid-19 test site for travellers in Hamilton at the Perot Post Office on Queen Street (File photograph by Akil Simmons)

Just six weeks ago, on October 5, Bermuda had a total of two active Covid-19 cases, the lowest number since the pandemic took hold.

As of yesterday, there were 19 active cases, but the number had risen to as high as 27 at one point this month. Fortunately no one had required hospital care and mercifully there had been no deaths related to the virus since May 13, when the island recorded its ninth.

Nonetheless, the steady growth in cases since early October is cause for concern as countries around the world experience new waves of infections and lock down their populations.

The mortality rate has not yet soared in the way that it did in March and April, but the virus remains a lethal threat. If anything has been learnt from the peak of the crisis, it is that those countries that moved early and decisively to flatten the curve of infections suffered least and emerged from social distancing sooner. Those who delayed and took half-measures suffered longer and more deeply.

Bermuda has already seen flights to Britain, and therefore Europe, cut for the month. In the meantime, infection rates in the United States are soaring, as they are in Canada. Deaths are also rising in both countries, although not yet at the same rate.

Vigilance and the importance of practising social distancing remain as vital as ever.

The main concern now for Bermuda is that it seems that more infections are being identified on either the fourth or eighth day of testing. It takes only one asymptomatic person who does not test negative until they may have been in the community already and may have exposed others to the virus to set off a wave of community transmission.

David Burt, the Premier, and Kim Wilson, the health minister, stated they were confident that Bermuda’s testing requirements for air passengers and the test-and-trace system were robust enough to minimise this risk.

In that context, the Government’s decision to require visitors to get a negative Covid-19 test no more than five days before departure, down from seven, seems wise. This is particularly true as testing in North America and Britain becomes more accessible.

At the same time, they admitted they were fearful about returning residents who are not required to be tested before boarding a return flight and who may flout the quarantine requirements. It takes only one person, after all.

Viewers of Tuesday’s press conference will have noted a slight tension between Mr Burt, who made it clear that he would like to prevent travellers who have not had a test from returning to the island, and Ms Wilson, a lawyer, who has noted the constitutional challenges of preventing a Bermudian, in particular, from returning to their homeland. For now, this debate is academic. But clearly this could change.

The hope appears to be that as Bermuda establishes more pretesting availability in the US — and the Government seems to be close to signing a deal with a large retail chain for exactly this — that most people will be able to get a preflight test. But the onus remains with the traveller.

For that reason, now is not the time for anyone to let their guard down. The need for appropriate social distancing, mask wearing and hygiene remain as strong as ever.

Against that is the problem of “ Covid fatigue”, in which people’s natural desire to return to a normal life is constricted by requirements that seem overly stringent when the number of cases, despite them rising, remain relatively low and when there is no community transmission and has not been for several months.

But the reason Bermuda is in this enviable position is because the community has indeed adhered to good public health and scientific advice. In addition, while much more about Covid-19 is known now than in March and April, just how the virus affects people or mutates, especially as cooler temperatures arrive, is still uncertain. The question for individuals and governments is how much to risk while the wait for a vaccine continues.

Even the news that several vaccines are showing very promising results is no reason to relax vigilance, although the temptation to do just that will grow.

But even if one of the vaccines closest to being approved does prove to be highly effective and is released for general use, supplies will be inevitably limited.

Ms Wilson has expressed confidence that the vaccines being tested by pharmaceutical companies Pfizer and Moderna will be available to Bermuda through the Covax facility organised by the World Health Organisation. But it is not yet clear that Covax has in fact signed agreements with either company.

Nonetheless, Bermuda has been promised enough vaccines for 20 per cent of the population as a result of the agreement, while Britain will provide a proportional number of vaccines to those being used for England’s population.

Britain has signed agreements with the two companies and also has an agreement for a vast number of does with AstraZeneca, the third company with a promising vaccine.

But even if Bermuda gets the doses promised in the early stages, that will still leave the island far short of the number required for so-called herd immunity. This number is not in fact known but would be generally expected to require between 80 per cent and 95 per cent of the population to be vaccinated and to have the Covid-19 antibodies.

Even assuming the vaccine works, it will presumably take many months for Bermuda to get to that level.

Winston Churchill, speaking after Britain won the Battle of Alamein in the Second World War, said: “Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.”

The same might be said of the Covid-19 crisis. Bermuda has weathered the first spike and so far has been less affected than many other countries by the second spike. An end is possible with the emergence of several promising vaccines.

But the pandemic is far from over. There may well be reverses and disappointments in the future, with the risk of students returning from university and bringing the virus with them the next great threat. To get to the end requires the community continuing to work together so it can reach that point with as little pain and as few deaths as possible.

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Published November 20, 2020 at 4:48 pm (Updated November 20, 2020 at 4:47 pm)

Covid-19: the end of the beginning

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