On Sunday, The Bahamas begins what government officials have repeatedly characterized as the “reopening” of tourism. Tourists are permitted to come now, albeit with a strict quarantine requirement.
While November 1 marks the date when the so-called “vacation in place” or 14-day quarantine falls away, no one should be fooled into thinking our main industry will suddenly see any major signs of life again.
The new travel protocols require visitors and returning citizens and residents to obtain an RT-PCR test (the gold standard in the diagnosis of COVID-19) no more than seven days prior to their arrival in The Bahamas. The current requirement mandates a test within five days of travel.
To “ensure that travelers remain COVID-19-free” a rapid antigen test will also be conducted upon arrival and then again five days after arrival in The Bahamas. The cost of the rapid tests will be included in the cost of the health travel visa.
How ready are we for the implementation of these new measures and how effective are they likely to be?
The Ministry of Tourism said on Sunday that it entered a public-private partnership with Living with COVID Coalition (LWCC), a not-for-profit coalition within the Organization for Responsible Governance, to access as many as three million World Health Organization and Ministry of Health-approved rapid antigen tests. The tests will be provided by the medical solutions provider, Ports International, “at a low cost per unit”.
We understand that officials at Lynden Pindling International Airport (LPIA) are doing practice runs this week as they prepare to test visitors upon arrival, and Doctors Hospital will be responsible for conducting and processing the rapid tests.
Pan American Health Organization (PAHO) Director Carissa F. Etienne said the new affordable, reliable antigen diagnostic tests recently approved by the World Health Organization that can be performed anywhere are set to transform the region’s COVID-19 response by allowing health workers to carry out accurate, rapid testing, even in remote communities.
But there are drawbacks to antigen testing.
The Centers for Disease Control and Prevention notes, “There are limited data to guide the use of rapid antigen tests as screening tests on asymptomatic persons to detect or exclude COVID-19, or to determine whether a previously confirmed case is still infectious.”
In response to a recent Miami Herald inquiry, a PAHO official noted Nucleic Acid Amplification Testing (NAAT, including RT-PCR) is the recommended method to confirm COVID-19. Rapid antigen detection tests are an addition to, and not a replacement for NAAT.
Antigen tests may be used when NAAT is not available (remote or difficult access areas, or primary care health facilities, for instance) or when NAAT results are so late as to be unusable for clinical decision-making.
All over the tourism-dependent Caribbean region, countries are grappling with how best to deal with the COVID-19 travel risk.
In preparing for a new tourism environment, Bahamian officials have not yet identified where positive cases would be isolated after they are tested upon arrival or on the fifth day in The Bahamas.
PAHO officials have repeatedly spoken of the need for countries to improve their abilities to test, isolate positive cases, identify and quarantine their contacts.
Dr. Nikkiah Forbes, director of the National HIV/AIDS and Infectious Disease Programme, said last week she does not believe The Bahamas is anywhere near as prepared as it should be for welcoming tourists on November 1. On a scale of one to five, she placed the country at a one.
“You have to be able to have a robust system to test people, diagnose an infection early, quickly, isolate people who are positive, do contact tracing, and other surveillance mechanisms to see if you have a problem anywhere,” Forbes noted.
Bahamians are understandably anxious for the tourism industry to resume in earnest, but without the necessary resources pumped into adequately addressing the risks, reopening would do more harm than good for a country that is falling woefully short in managing the protracted health and economic crises.