CABINET NOTES: March 10, 2021

The Cabinet of Antigua and Barbuda met both virtually and face-to-face for almost seven continuous hours. Missing from this meeting was the Minister of Works who is recuperating at the MSJMC; all of his vitals are normal.

It is the practice of the Gaston Browne-led Cabinet to invite experts and officials to its meetings each week in order to enhance decision-making; two groups were invited to the meeting.

1. The Chief Medical Officer (CMO), the Principal Nursing Officer (PNO), The Director of the MSJMC Laboratory, the Person On Staff who has Responsibility for Organizing (POSRO) the services at the vaccine centers, and the Director General of Information (DGI) were all invited to Cabinet to provide updates and to be questioned by the Cabinet.

i. The CMO informed that 852 Covid-19 cases have been recorded in the state thus far; while 74 cases were detected in January 2021, 545 cases were detected in February 2021, and 75 cases thus far in the ten days of March 2021. The number of infections is not decreasing, the CMO reported. Obeying the protocols is a first step in decreasing infections, especially the wearing of masks.

ii. More than 18,000 doses of the AstraZeneca vaccine have been injected in the arms of the elderly, teachers, hotel workers and other select groups since February 17, 2021, when the first dose was administered; only 22,000 doses remain in stock. AstraZeneca is a two dose vaccine; and, since 40,000 doses were imported, and since no precise date for delivery of a second batch of the AstraZeneca is fixed, the CMO proposed that one half of the total be stored so that the second dose can be on hand to be administered in May and in June 2021.

iii. The Cabinet debated this important proposal and decided otherwise. Seven to ten thousand additional doses will continue to be applied, with the expectation that at least 14,000 doses will be secured through COVAX of PAH0/WHO by the end of April 2021. Antigua and Barbuda has contracted and paid COVAX for 40,000 doses; the AstraZeneca is in very high demand globally.

iv. The deaths which Antigua and Barbuda has experienced from Covid-19 have been complicated by NCDs (Non-communicable Diseases) which are prevalent among the adult population, the CMO reported. It is for this reason why those men and women older than 65 years have been selected for special treatment. Attention must continue to be paid to reducing NCDs among the population, the CMO asserted.

v. The Director of the MSJMC Clinic reported that the Covid-19 disease is not only respiratory but also cardio-vascular. Covid-19 infections will also affect the functioning of the heart and the system of veins which deliver blood to all organs. The administered vaccine tends to lower the chances of hospitalization and death. The challenge posed by waiting for the delivery of the next batch of vaccines is that people who are inoculated could be saved by not falling ill, may not require hospitalization, and may even continue to live. Administration of doses, that may be placed in storage, could save lives. However, not administering the second dose when  due is also risky, since the efficacy may be lost (and that is unknown) and the inoculation may only work for a short period (and that is unknown). Based on an indication from the PAHO/WHO COVAX communications of delivery of 14,000 doses in weeks, the Cabinet determined that 7,000 to 10,000 of the 20,000 stored vaccines will continue to be applied to the elderly, the most vulnerable, and frontline employees from various sectors.

vi. The Director also noted that if the administration moved to import the vaccines that are now available–to wit: SputnikV, Sinopharm, Sinovak–their availability and cost would prove to be within Antigua and Barbuda’s means. If the nation waits until these vaccines have the approval of the WHO, they would then be gobbled-up by the large, well-endowed states and those vaccines would be placed outside of Antigua and Barbuda’s means. Now is the time to import them, the Director reported. The Working Group which he chairs acts in an advisory capacity and does NOT grant approvals. The approvals for use come from the Pharmaceutical Council. The Director indicated that he is aware of the dilemma faced by the Cabinet. These choices would not occur during “normal times”, he said; these times are not normal, it was agreed.

vii. The Minister of Health spoke of the calculated risk which the Cabinet must take. The Cabinet would be required to manage the risk.

vii. The Principal Nursing Officer addressed the need of a small number of nurses to receive remuneration that has been significantly delayed. The Prime Minister immediately called the Accountant General, confirmed that the warrants were in the Treasury’s possession, and elicited a promise to settle the issue within a few days.

2. Four members of the Pharmaceutical Council were invited to Cabinet to secure an Emergency Use Authorization (EUA)  for two Chinese vaccines and the Russian vaccine — Sinopharm and Sinovac, and SputnikV, respectively. The Chairman of the Council addressed the Cabinet on the antiquated nature of the 1995 law which provides for the Council to either approve or disapprove the use of a particular drug; the law does not specifically provide for the EUA as requested by Cabinet, the Chairman asserted. Data on the three phases of trial of the vaccines had not been forthcoming; hence, the Council required data in order to properly provide an approval.

i. A debate followed in which it was agreed that the use of the vaccines could be separated from the importation of the vaccines. Permission to import would be provided, it was agreed, and after the data (in English) had been provided, permission to use would subsequently be granted.

ii. The Council reported that it had received requests from private medical practitioners for licences to import the Covid-19 vaccines. The provision of licences to doctors to import was not the function of Council, it was asserted. The Council is empowered to provide licences to pharmacies and pharmacists for distribution to authorized dispensers. The doctors would then apply to those pharmacies for the imported supply which they required.

3. The Cabinet recalled that the current conditions under the State of Emergency are scheduled to expire on March 15, 2021, or in five days. The executive body therefore took the decision to provide more space to certain businesses by altering the curfew hours. Beginning March 15, 2021, curfew would commence at 8:00 pm until 5:00 am. All other measures continue until April 15, 2021, when a review of circumstances will determine what changes could reasonably be implemented should the infection rate continue to decline. Masks are therefore to be worn when entering into a public space; social distancing of 3 feet to six feet will continue to be enforced; the sanitizing of hands is to continue by all persons upon entering into shops, businesses, churches and all government offices. Church services, funerals and weddings may not exceed 25 persons; and gatherings on the streets or in other public spaces cannot exceed 5 persons.

4. The Cabinet accepted a proposal put forward by the Director of the Ecclesiastical Council to hold A NATIONAL DAY OF PRAYER virtually on April 11, 2021, from 6:00 am to 6:00 pm. The format is to be agreed; however, it will not involve congregating anywhere but a virtual experience.

5. Parliament will convene on Thursday, March 11, 2021, at 9:30 am, to consider amendments to a number of existing laws.

i. There will be a formal Launch of the Civil Registry on Friday, March 12, 2021, the Minister of Information and Technology announced. The use of digital technology to achieve registration puts Antigua and Barbuda ahead of its OECS counterparts, it was revealed. The Business Registry and the Land Registry have already been digitized.

ii. The Minister of Sports announced that the Double Decker Stand is to be dismantled beginning in April. The vendors will be placed north of the Printery in the green space next to the ticket booth of the CWI. After the demolition, the newly-created space in the Antigua Recreation Grounds will remain open for a short time before re-construction commences.

iii. More than EC$1.5 million dollars have been contributed by the private sector to the acquisition of Covid-19 vaccines for the population. The Cabinet expressed its thanks to those whose principals made the contribution to the Treasury of Antigua and Barbuda in order to ease the burden on government at a time when revenues are at an all-time low.

iv. The beaches will be off-limits on Good Friday and Easter Monday 2021, in keeping with the Regulations under the State of Emergency.

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