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Ministry seeks $350-m deal to treat people with chronic health problems privately

Senior staff reporter

Thursday, March 26, 2020

THE Government is seeking to forge an estimated $350-million public-private partnership agreement with private health providers to treat some 75,000 Jamaicans battling chronic health diseases.

This would ease the burden on public health facilities and hospitals should the country begin to experience community spread of COVID-19.

Health Minister Dr Christopher Tufton, making the disclosure yesterday during a virtual press briefing, said the arrangement was in answer to the question of how the health sector would fare under the added numbers.

“The very short but important history of the virus tells us those who die tend to be the older population and those who have underlying conditions — cardiovascular disease, diabetes, and hypertension — and as a consequence we are very mindful of community spread among that vulnerable population.

“We have taken a decision that in the following weeks we are going to engage private sector interests under a public-private partnership arrangement to outsource some of the services that are being carried out in public health facilities and hospitals,” Dr Tufton said.

“We are going to take out the two highly vulnerable groups of persons who have chronic hypertension and diabetes; this numbers about 75,000 persons across the country. The idea is to outsource the sessional visits by this population to private practitioners who would see them once or twice per month for four months in the first instance,” the health minister outlined.

Noting that the move was “something we have been thinking about for some time because we understand the crowding effect on our health centres across the island”, Dr Tufton said the decision was taken to fast-track the arrangement due to concerns about community transmission.

Yesterday, Chief Medical Officer (CMO) Dr Jacquiline Bisasor McKenzie said Jamaica is not yet at the stage of community transmission of the virus.

“So what we see are clusters of cases, meaning we have cases that have arisen out of linkages to the first cases. The World Health Organisation has identified three stages, the first stage is no cases, and then sporadic cases and then clusters of cases. Cluster is where we can see definite linkages to the imported cases and we are seeing more than one or two of these relationships. Right now we would have about four such clusters; the largest would be from our first case and it is not a large cluster,” she said, noting that there are about five cases related to the first case.

She, however, noted that “the fact that we have these confirmed cases across the island suggests that there may be other cases that may have come into the country that we may not be aware of”.

Said the CMO: “The next level is where we have community transmission, where they come up in places that we are unable to identify a link to an imported case. Many may have come in undetected by the surveillance systems; they may have been in communities and had contact with other persons who may have travelled to other areas and so, at the point of them presenting to a health-care facility with symptoms suggestive of COVID-19 and maybe testing positive, there is no definite link we can trace.”

“Once we start seeing that, even if it is one or two cases it increases the risk of more transmissions across the country and it is more than likely we will be seeing an increase,” she warned.

And Dr Bisasor McKenzie said with regard to general surveillance, to determine whether there is community transmission the health ministry has been conducting tests on all severe acute respiratory cases admitted to hospitals; health-care workers with influenza-like illnesses, a number of persons who present to hospitals with influenza-like symptoms even if they might not have had contact with confirmed or suspected COVID-19 infected persons. She said this will provide a network of samples representing all parishes, which would allow them to detect whether there is community transmission.

She further assured the country that there are sufficient materials to conduct tests at this time.

“We have received materials to do about 3,000 tests from the Pan American Health the event of a spike, our testing methodology will change and the reagents we currently have will double the number of tests we are able to do. In either case we have two months' supply of testing material. We have requested from PAHO additional kits that we will receive within that time,” Dr Bisasor McKenzie informed.

In the meantime, she said the health ministry was exploring the idea of the use of rapid test kits and should, within the next three days, decide on the type of kits appropriate.

Meanwhile, health officials have already tested 160 samples, with 26 persons testing positive, 124 testing negative and 18 results pending. Seventeen persons are now under quarantine in government facilities, 142 under quarantine at home, and 254 have been released from quarantine arrangements. This number does not include those in the Bull Bay and Seven Miles areas who will on Saturday, March 28 be released from their quarantine.