Since the curtain opened on Act I: Scene I of the Hand’s Down Winner of this year’s Most Dystopian Play Award: “Covid-19 meets the world of 2020”, we here at Loma de Luz mission hospital in Honduras have tried to stay:
1.) well-informed
2.) proactive
3.) balanced in our preparations and response.
Now, looking back over the 8 months since we began to actively prepare, I can say:
1.) By God’s Grace, we have done a pretty good job of it. We have supported and worked hand-in-hand with the local & regional Public Health Officials (who I must say have done an extremely good job). We are by far the most active, the largest, and the referral hospital for Covid-19 (and most everything else) in this region. We have been the testing center for SARS CoV-2 in this region. We have been involved with or aware of nearly every test positive case of Covid-19, have seen and screened and sent home with treatment @ 100 test positive cases ( i.e. almost all of the test positives in the region in the entire time)…. And we have hospitalized and treated (in our entirely separate Covid Unit) all of the Severe & Critical patients (by WHO Criteria).
To date, there have been only a total of 23 Severe/Critical patients. Of those, 3 could be considered “Covid-19 Honduras- Related Deaths”. One died in-house and two after a protracted hospital stay, were sent home with family with the anticipation that they would die at home. All three of these had end-stage or near end-stage chronic disease prior to Covid (advanced age, CRF, COPD, advanced cardiac disease or obesity, or all of the above). But 20 recovered and went home. These also all had multiple comorbid risk factors. That is a mortality rate (in the Severe/ Critical group) of 8.7%. This compares pretty favorably with the often experienced Mortality rates of 39%-49% found in huge state of the art hospital centers early on.
2.) Having hospitalized and cared for all of the Covid-19 patients in our region (and some from outside of our region) which needed hospitalization and been aware of essentially all of the test positives in the area, we can also say that, for our region, from a disease standpoint – for all of the hype – Covid-19 has been pretty underwhelming.
For example: in the same period of time, we have seen and cared for over 5 times the numbers of Orthopedic injuries alone than all of the Covid-19 positives in the entire region put together. We have operated on and hospitalized more than 5 times the number of Orthopedic patients alone than all of the Covid-19 patients hospitalized. Last year’s nationwide dengue epidemic was a far greater public health threat than this year’s Covid-19 epidemic. The actual outcome has been “NOTHING EVEN REMOTELY APPROACHING THE MILLIONS OF DEATHS PROGNOSTICATED”. (As of 16 Oct., the date of this writing, there have been a total of 86,089 positive tests and 2,552 “Covid Related Deaths” in all of Honduras in the entire history of the disease…. Less than 1/1000th of what was originally prognosticated by SINAGER, Honduras’s National Risk Management System, officials in May of this year).
COVID Honduras: The Curve
Was this “pretty underwhelming” actual outcome because of the crippling extreme governmental lockdown mandates placed (and still in place)? Sadly, no. If you follow the epidemiology and published data of the disease experience here, the mandates certainly delayed the inevitable. And if the only sufficient excuse for lockdown is to “ flatten the curve”, to allow Public Health institutions and Medical treatment facilities to prepare… well that took us about 2 weeks… max. and it took the rest of the country maybe 4 to 6 weeks top end. If another argument is to prevent Medical Treatment Facilities from becoming “overwhelmed”… well the not so secret-secret is that Honduras’s Public Health medical treatment facilities run chronically & severely overwhelmed before Covid-19 had ever existed. (Just by way of example, the average time spent in Public Health Hospital Emergency Rooms, for acute ortho trauma patients, before leaving to find their way to Loma de Luz this year… has been between 10 & 14 days… leaving from the emergency room having never been treated or seen by a doctor).
No, at least in Honduras, the lockdowns didn’t “flatten the curve”, they just delayed it.
And, if you keep a close eye on the publicly published testing data… in many, perhaps most regions, this “wave” has already passed on downstream, and a “second wave” is unlikely. In many regions, the random seropositivity rates of (mostly asymptomatic) spot checks are strongly suggesting that the neighborhood/city/ region has already reached the nHIT, the % of a population which has been exposed to an infectious disease (like Covid-19), which constitutes the threshold for “Herd Immunity”, after which an infectious disease just can’t get passed on frequently enough to continue to spread. The 6 recent multi-neighborhood, multi-city random testing brigade studies on Roatan for instance found @ 55% seropositivity for SARS CoV-2… in each study. This, after 7 months of one of the most brutal complete lockdowns in the world.
And though it has officially slightly eased somewhat (today’s OxCGRT score for Honduras, with 100 being the worst possible is 84.26 compared to the USA at 62.5 or that bastion of freedom, the People’s Republic of China, at 54.17), and though wherever they can, the great majority of the people in the countryside are ignoring the lockdown, THE LOCKDOWN CONTINUES.
So, what HAS the lockdown accomplished in Honduras? It delayed the inevitable. But at what cost? Incalculable.
We began writing about this (the completely out of balance damage being done to the poor by the lockdowns) back in mid- April, highlighting us figuring out how to feed hungry people in our area that can’t get food (many hundreds-perhaps thousands of people in our area) due to this one-size-fits-all public policy lock-down approach. Then again at the end of April discussing how these universal lockdown policies in this developing nation are causing another, I’m sure unintended consequence: that of widespread suffering from blocking access to medical care.
In fact, after recognizing God’s faithful provision during these hard times, the single most constant theme of the LdL Times chronicling of our struggle through these “Strangest of Times“, has been the tremendous out-of-balance harm of “a one-size-fits-all Lockdown Policy”. As above, we called this out in April, then again like some boney old prophet of old, we were calling this out in May, June, July, and August.
Now finally, many experts and authorities around the world are joining in the chorus.
Since early on in the pandemic, the WHO recommended lockdowns as a means to keep the virus under control. Even as recently as July, they were contemplating that a “total lockdown” may be needed to halt the virus in certain regions. Just recently, however, the WHO took a considerable reversal on its lockdown stance, pleading for world leaders to instead apply layered policies and interventions in an organized and coordinated fashion to prevent the spread of the virus. Here at Loma de Luz, we are gratified that they have finally adopted a sensible public stance in response to managing the virus, one which aligns well with the messages we have been communicating over the past six months.
So, maybe we are no longer the lone Voice Crying in the Wilderness. But when David Nabarro (Director-General of the WHO) says “Look what’s happened to smallholder farmers all over the world. … Look what’s happening to poverty levels. It seems that we may well have a doubling of world poverty by next year. We may well have at least a doubling of child malnutrition.” And “Lockdowns just have one consequence that you must never ever belittle, and that is making poor people an awful lot poorer,” it doesn’t exactly make us want to stand up and cheer…. Because it is true… and those suffering are our neighbors… and billions like them around the world.
Please don’t mistake this post for an “I told you so”. Those are four hollow words… a meal of bitter herbs for all who share it. No, this is not an “I told you so.” This is another I’M TELLING YOU NOW. Because THESE POINTLESS, EXTREMELY HARMFUL LOCKDOWNS CONTINUE…. Here (where all schools but ours are shuttered closed, the public buses, the lifeline of the poor, are not allowed to run, and the common man is only allowed to travel the roads or enter the few businesses permitted open, 1 day a week, according to ID number) THE LOCKDOWN GOES ON. Maybe it goes on in some form or another in your part of the world. So maybe you could stand up and pass this on to your neighbor. Maybe they won’t be interested in what some nut on the edge of the jungle in some third world country says. But they might consider the recent public stance of the WHO’s Special Envoy on COVID-19. “ we really do appeal to all world leaders: stop using lockdown as your primary control method. Develop better systems for doing it.” Speaking as the Special Envoy for the nuts on the edge of the jungle in some third world country…. I second that emotion…. Pass it on & PTL… in all things.
God’s grace,
jcm
