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Covid-19 Trickles Into Haiti: ‘This Monster Is Coming Our Way’ Covid-19 Trickles Into Haiti: ‘This Monster Is Coming Our Way’
(about 13 hours later)
The man stood in line, shaking with fever, one of countless others trying to cross the border and return to Haiti.The man stood in line, shaking with fever, one of countless others trying to cross the border and return to Haiti.
A doctor screening them for coronavirus infection pulled him aside. Like thousands of Haitians, he had been laid off in the Dominican Republic, which has been hit hard by Covid-19, the disease caused by the coronavirus.A doctor screening them for coronavirus infection pulled him aside. Like thousands of Haitians, he had been laid off in the Dominican Republic, which has been hit hard by Covid-19, the disease caused by the coronavirus.
Now he and the other Haitians were returning home, threatening to bring the virus with them.Now he and the other Haitians were returning home, threatening to bring the virus with them.
The coronavirus has been slow to come to Haiti, partly because protests and political violence virtually shut down tourism and drove away the foreigners who could have brought the disease to the country.The coronavirus has been slow to come to Haiti, partly because protests and political violence virtually shut down tourism and drove away the foreigners who could have brought the disease to the country.
A month after the first case was announced, there have been only 58 confirmed cases and four deaths. Prime Minister Joseph Jouthe last week congratulated the country and announced that factories would reopen at reduced capacity, a rare bit of encouragement for a nation that has been lashed by tragedy — with a deadly hurricane, a cholera outbreak and a horrific earthquake in just the past decade.A month after the first case was announced, there have been only 58 confirmed cases and four deaths. Prime Minister Joseph Jouthe last week congratulated the country and announced that factories would reopen at reduced capacity, a rare bit of encouragement for a nation that has been lashed by tragedy — with a deadly hurricane, a cholera outbreak and a horrific earthquake in just the past decade.
But with the influx of workers returning from the Dominican Republic, where there have been 5,044 cases and 245 deaths from Covid-19, the odds are stacked against Haiti and its weak health system, warned a presidential panel run by Dr. Jean William “Bill” Pape, a widely respected doctor who is racing to set up centers to treat Covid-19 patients.But with the influx of workers returning from the Dominican Republic, where there have been 5,044 cases and 245 deaths from Covid-19, the odds are stacked against Haiti and its weak health system, warned a presidential panel run by Dr. Jean William “Bill” Pape, a widely respected doctor who is racing to set up centers to treat Covid-19 patients.
“This monster is coming our way,” said Dr. Pape, who runs Gheskio, a large AIDS and TB clinic in Port-au-Prince, the capital. “If a place like New York can be so overwhelmed, how is Haiti going to deal with this?”“This monster is coming our way,” said Dr. Pape, who runs Gheskio, a large AIDS and TB clinic in Port-au-Prince, the capital. “If a place like New York can be so overwhelmed, how is Haiti going to deal with this?”
Most Haitians lack access to clean water, let alone soap, and many live in tightly packed slums where self-isolation is physically impossible. Protests over government corruption shut down the country last fall, barricading roads and crippling the already fragile economy, leaving even fewer people with enough resources to quarantine.Most Haitians lack access to clean water, let alone soap, and many live in tightly packed slums where self-isolation is physically impossible. Protests over government corruption shut down the country last fall, barricading roads and crippling the already fragile economy, leaving even fewer people with enough resources to quarantine.
The nation’s health care system is so threadbare that Haitians regularly die of easily treatable ailments like diarrhea, and public hospitals often have to charge patients for basics like syringes and gloves.The nation’s health care system is so threadbare that Haitians regularly die of easily treatable ailments like diarrhea, and public hospitals often have to charge patients for basics like syringes and gloves.
The sick man pulled aside at the border crossing had to be quarantined at a vacant building, since an adequate area had not been set up yet.The sick man pulled aside at the border crossing had to be quarantined at a vacant building, since an adequate area had not been set up yet.
Dr. Daniel Fitzgerald, who works with Gheskio and is the director for the Center for Global Health at Weill Cornell Medicine, said he expected tens of thousands of people to become sick in Haiti.Dr. Daniel Fitzgerald, who works with Gheskio and is the director for the Center for Global Health at Weill Cornell Medicine, said he expected tens of thousands of people to become sick in Haiti.
“It’s just a question of time,” he said.“It’s just a question of time,” he said.
Dr. Pape’s team has been feverishly drafting a treatment protocol that is both effective and realistic for a country like Haiti. Learning from the experience of the United States, where the majority of patients on ventilators have died, Dr. Pape is focusing on treating hospitalized patients with oxygen.Dr. Pape’s team has been feverishly drafting a treatment protocol that is both effective and realistic for a country like Haiti. Learning from the experience of the United States, where the majority of patients on ventilators have died, Dr. Pape is focusing on treating hospitalized patients with oxygen.
Dr. Pape estimates that the country will need 6,000 beds dedicated to Covid-19 patients. “Now, I have not even 100,” he said.Dr. Pape estimates that the country will need 6,000 beds dedicated to Covid-19 patients. “Now, I have not even 100,” he said.
But the plan, which requires trained staff, personal protective equipment, as well as oxygen, is costly. Dr. Pape estimates the first month alone will cost about $30 million — about half of what the Haitian government spends on health care a year. Dr. Pape and panel co-chairman Dr. Lauré Adrien, who is the director of the Ministry of Public Health and Population, are sorting out details and funding.But the plan, which requires trained staff, personal protective equipment, as well as oxygen, is costly. Dr. Pape estimates the first month alone will cost about $30 million — about half of what the Haitian government spends on health care a year. Dr. Pape and panel co-chairman Dr. Lauré Adrien, who is the director of the Ministry of Public Health and Population, are sorting out details and funding.
The International Monetary Fund announced $111 million in financing to help Haiti with “health-related expenditures and income support” to ease the impact of Covid-19. The State Department and the U.S. Agency for International Development committed $13.2 million.The International Monetary Fund announced $111 million in financing to help Haiti with “health-related expenditures and income support” to ease the impact of Covid-19. The State Department and the U.S. Agency for International Development committed $13.2 million.
Local businesses have donated, and some foreign nonprofit organizations are raising money that, given the recent U.S. ban on exporting medical supplies, and the increase in costs that followed, needs to stretch further.Local businesses have donated, and some foreign nonprofit organizations are raising money that, given the recent U.S. ban on exporting medical supplies, and the increase in costs that followed, needs to stretch further.
“It’s more expensive but it was the only way we could do it,” said Geoffrey Boutros, a Miami-based broker who arranged for masks and gloves to be shipped to Gheskio directly from China.“It’s more expensive but it was the only way we could do it,” said Geoffrey Boutros, a Miami-based broker who arranged for masks and gloves to be shipped to Gheskio directly from China.
A big challenge is convincing Haitians the epidemic poses a real threat.A big challenge is convincing Haitians the epidemic poses a real threat.
A month after Haiti’s president announced an emergency, banning gatherings of more than 10 and closing schools, tap taps — the converted pickup trucks that run as private buses — are still jammed with people.A month after Haiti’s president announced an emergency, banning gatherings of more than 10 and closing schools, tap taps — the converted pickup trucks that run as private buses — are still jammed with people.
And while the upscale supermarkets that cater to Haiti’s elite now offer customers hand-cleaning stations and demand they wear masks, the open markets that serve the country’s poor remain a cacophony of jostling humanity.And while the upscale supermarkets that cater to Haiti’s elite now offer customers hand-cleaning stations and demand they wear masks, the open markets that serve the country’s poor remain a cacophony of jostling humanity.
“People don’t believe it because it’s coming from the government,” said Karl Jean-Louis, a Haitian entrepreneur who interviewed workers and vendors along Port-au-Prince’s crowded streets. Some claimed the epidemic was a ruse for the government to make money from aid agencies. Others said staying home was impossible, as they had to work to feed their families.“People don’t believe it because it’s coming from the government,” said Karl Jean-Louis, a Haitian entrepreneur who interviewed workers and vendors along Port-au-Prince’s crowded streets. Some claimed the epidemic was a ruse for the government to make money from aid agencies. Others said staying home was impossible, as they had to work to feed their families.
More than half of the population lives hand-to-mouth, earning less than $2.41 per day, according to the World Bank.More than half of the population lives hand-to-mouth, earning less than $2.41 per day, according to the World Bank.
While recovering from Covid-19, a couple in Haiti’s rural south became so stigmatized that Dr. Inobert Pierre, director of St. Boniface Hospital, sent a car with loudspeakers blaring: Covid-19 is not a crime; it can strike anybody; prevention is the best cure.While recovering from Covid-19, a couple in Haiti’s rural south became so stigmatized that Dr. Inobert Pierre, director of St. Boniface Hospital, sent a car with loudspeakers blaring: Covid-19 is not a crime; it can strike anybody; prevention is the best cure.
To his own scared staff, Dr. Pierre explained “this is like a war” and “we are the soldiers.”To his own scared staff, Dr. Pierre explained “this is like a war” and “we are the soldiers.”
Dr. Pape has trained more than 1,000 people to go door-to-door, seeking out anyone with symptoms and urging them to go to the hospital. Crews are delivering tubs of water and hand soap in the slums, where people normally buy water by the bucket. And through loudspeakers, they’re asking: Wash your hands, or lave men in Creole.Dr. Pape has trained more than 1,000 people to go door-to-door, seeking out anyone with symptoms and urging them to go to the hospital. Crews are delivering tubs of water and hand soap in the slums, where people normally buy water by the bucket. And through loudspeakers, they’re asking: Wash your hands, or lave men in Creole.
Experts say Haiti’s current low number of infections partly reflects the country’s dysfunction. Protests and gang warfare drove away would-be visitors, and with them the potential of importing the virus. Kidnappings have become so chronic that the United States issued a “do not travel” warning in early March.Experts say Haiti’s current low number of infections partly reflects the country’s dysfunction. Protests and gang warfare drove away would-be visitors, and with them the potential of importing the virus. Kidnappings have become so chronic that the United States issued a “do not travel” warning in early March.
But those conditions are changing. Over recent weeks, thousands of Haitians have flooded back home each day from the Dominican Republic, said Giuseppe Loprete, the chief of mission for the International Organization for Migration in Haiti. Doctors have been screening at four official border checkpoints, but not at dozens of illegal crossings.But those conditions are changing. Over recent weeks, thousands of Haitians have flooded back home each day from the Dominican Republic, said Giuseppe Loprete, the chief of mission for the International Organization for Migration in Haiti. Doctors have been screening at four official border checkpoints, but not at dozens of illegal crossings.
As Dr. Pape and his team furiously prepare a countrywide response, hospitals have been left to their own devices.As Dr. Pape and his team furiously prepare a countrywide response, hospitals have been left to their own devices.
In Port-au-Prince, a century-old French hospital that had been caught in the crossfire of gang warfare for two years shut down altogether after the first suspected case hit the emergency room.In Port-au-Prince, a century-old French hospital that had been caught in the crossfire of gang warfare for two years shut down altogether after the first suspected case hit the emergency room.
Updated June 12, 2020 Updated June 16, 2020
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“The situation created a panic,” said Dr. Jean Venèse Joseph, the medical director at the hospital. “Coronavirus came and worsened a situation that was already bad.”“The situation created a panic,” said Dr. Jean Venèse Joseph, the medical director at the hospital. “Coronavirus came and worsened a situation that was already bad.”
Not far away, the founder of St. Luke Hospital, Father Richard Frechette, converted an old hospital building — last used to treat cholera patients — into a 40-bed Covid-19 ward. Instead of face shields, he outfitted staff with the snorkels and welders’ masks he found at a local market. He has commissioned tailors to fashion 15,000 masks out of bathrobes for use in the hospital’s non-Covid areas.Not far away, the founder of St. Luke Hospital, Father Richard Frechette, converted an old hospital building — last used to treat cholera patients — into a 40-bed Covid-19 ward. Instead of face shields, he outfitted staff with the snorkels and welders’ masks he found at a local market. He has commissioned tailors to fashion 15,000 masks out of bathrobes for use in the hospital’s non-Covid areas.
“Rich countries are hoarding all the stuff,” said Father Frechette, who is also a doctor and built the country’s only children’s hospital.“Rich countries are hoarding all the stuff,” said Father Frechette, who is also a doctor and built the country’s only children’s hospital.
Until recently, he hoped the country would be spared by the unpredictable virus, which seemed to strike rich northern countries, and was said to not flourish in the heat and humidity of countries like Haiti.Until recently, he hoped the country would be spared by the unpredictable virus, which seemed to strike rich northern countries, and was said to not flourish in the heat and humidity of countries like Haiti.
But watching it erupt in the Dominican Republic next door, he worries it could become comparable to the cholera epidemic that, starting in 2010, ripped through Haiti’s slums and burgeoning tent camps, infecting more than 820,000. That came months after an earthquake that left between 220,000 and 316,000 people dead.But watching it erupt in the Dominican Republic next door, he worries it could become comparable to the cholera epidemic that, starting in 2010, ripped through Haiti’s slums and burgeoning tent camps, infecting more than 820,000. That came months after an earthquake that left between 220,000 and 316,000 people dead.
Although billions of dollars and aid workers poured into Haiti, vowing to “build back better,” the dreams of planned communities, public health care and free schools remain dreams 10 years later, leaving many Haitians bitter and skeptical.Although billions of dollars and aid workers poured into Haiti, vowing to “build back better,” the dreams of planned communities, public health care and free schools remain dreams 10 years later, leaving many Haitians bitter and skeptical.
This time, as countries around the world fight their own battle against the virus, Haitians do not expect aid.This time, as countries around the world fight their own battle against the virus, Haitians do not expect aid.
“We do not have hundreds of NGOs here and there, doing things. It’s not the same,” said Franck Généus, president of the association of private hospitals that provides about 40 percent of Haiti’s health care. The group has offered 300 beds to coronavirus patients, at a cost of $200 a day.“We do not have hundreds of NGOs here and there, doing things. It’s not the same,” said Franck Généus, president of the association of private hospitals that provides about 40 percent of Haiti’s health care. The group has offered 300 beds to coronavirus patients, at a cost of $200 a day.
“Basically we are alone,” he said. “For once, we need to solve this ourselves.”“Basically we are alone,” he said. “For once, we need to solve this ourselves.”
Harold Isaac contributed reporting.Harold Isaac contributed reporting.