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Global Medical Response ambulances parked outside the COVID-19 triage area at the Port-of-Spain General Hospital yesterday.

With 1,068 COVID-19 cases, Trinidad and Tobago broke its record for daily confirmed COVID-19 cases yesterday, beating the previous record of 984 cases reported on December 3, 2021.

Yesterday’s count was the first time for the pandemic to date the Ministry of Health had confirmed and reported to the public over 1,000 cases in a day. On November 15, 2021, Technical Director, Epidemiology, Dr Avery Hinds, had said if the then-current rate of infections continued, T&T would record 1,000 new cases in a day.

In the last 24 hours, the ministry also reported that 18 more people had died to COVID-19, two of whom were young adults and four of whom had no underlying health conditions. There were also eight elderly males, two elderly females and six middle-aged patients among the deaths.

As of yesterday, there were 17,349 active COVID-19 cases, the highest for the pandemic to date, accounting for one in every 80 people in the country. Staff at county health offices responsible for contacting these patients will be put under further strain as active cases increase, potentially resulting in further delays of reporting test results and a lack of check-ins from ministry personnel.

The already exhausted hospital system will be put under further pressure as cases increase. Severe COVID-19 cases continue to overwhelm intensive care units (ICUs) with an occupancy averaging near 89 per cent, meaning nine out of ten beds across the nation’s ICUs are filled. Overall hospital occupancy as of yesterday stood near 60 per cent.

COVID-19 daily cases can be counted based on the date when someone is swabbed or sample collection, and it is also measured based on when those samples test positive. In T&T, the latter is published by the Ministry of Health daily, while the former is collected by epidemiologists and reported by Dr Hinds at the COVID-19 media briefings. While not outrightly reported by the ministry’s daily statistics, this would be T&T’s second time crossing 1,000 cases in a day.

Around November 28, 2021, T&T crossed this recorded 1,000-cases-a-day milestone based on the date of sample collection, verifying Hinds’ predictions. However, January 20, 2022, now holds the record for the highest reported daily cases for the pandemic to date.

Based on the current positivity, though, the worst still may be yet to come. Yesterday’s case figures came from samples collected from January 13 through 19, while Wednesday’s 918 cases were from samples taken from January 11 through 18.

In the last 20 days, 43,173 samples have been submitted for testing at private and public laboratories, averaging 2,158 samples submitted for testing per day. This figure exceeds the public testing capacity of approximately 1,200 samples being processed per day. As of January 17, 2022, this month’s positivity rate stands over 70 per cent.

On January 10, both the Chief Medical Officer Dr Roshan Parasram and Dr Hinds indicated that the country is in the embryonic stages of community spread of Omicron.

“So we are looking at early community or local spread for sure and it will only be a matter of time before we get what has happened in the other countries.”

Parasram said then the ministry estimated there could be an increase in COVID-19 cases within two weeks.

“We are waiting to see that increase, at least coming out of the samples,” he said.

The country has recorded 28 cases of the Omicron variants of concern. However, according to Dr Hinds, eight of these were found within the community and are still under investigation.

He said, “As we are continuing the epidemiological investigations and the observations of what’s going on in the population, we are seeing where there are increasing proportions of these cases that don’t seem to be linked to importation and are therefore linked to what we call hidden chains of transmission.”

With just three Omicron cases in Tobago, Dr Tiffany Hoyte, acting County Medical Officer of Health, said, “We have ongoing community spread.”

Tobago’s first Omicron case had no links to travel or a COVID-19 positive individual, while the second was an unvaccinated minor who returned to Tobago after transiting through Trinidad. Details on the third case have not been released at this time.

Infectious disease specialist Dr Nathaniel Duke, during Wednesday’s Tobago House of Assembly’s post-Executive Council media briefing, said, “So this variant, which is now circulating in the Tobago space, as of today they have recorded three, so epidemiologically, we can multiply that by 100 and that will probably be the amount of Omicron-positive patients circulating in our society. So, therefore, a surge is about to come, so we have to be prepared for that surge that is on our doorstep.”

Based on the latest genetic sequencing data from the Ministry of Health and the University of the West Indies, Omicron accounted for approximately 25 per cent of samples submitted for sequencing, with Delta accounting for the other 75 per cent. However, data and estimates from GISAID show that Omicron may already be the dominant strain.

Generally, hospitalisations spike within days of a surge in cases, but deaths lag up to two weeks after. However, vaccinations are expected to stem the tide of hospitalisations and deaths, as noted by global data. Epidemiologist Dr Hinds has said the death rate locally is 15.6 times higher among the unvaccinated than the vaccinated. As of January 19, 2022, 2,659 of the 3,256 COVID-19 deaths were amongst the not-fully-vaccinated population.