COVID-19 Is Igniting A Public Health Emergency In Haiti, Despite Low Case Numbers

AUDIE CORNISH, HOST:

As COVID-19 restrictions wind down in many countries around the world, Haiti is trying to ramp up. For reasons that aren't clear, the small Caribbean nation had escaped relatively unscathed by the pandemic - that is, until now. The increase in cases and deaths in the last few weeks is threatening to overwhelm Haiti's fragile health care system. And the country, which is also suffering from gang violence and political upheaval, has not received any vaccine.

We're joined now from Mexico City by NPR's Carrie Kahn. She also covers the Caribbean. And, Carrie, just what is the situation like in Haiti right now?

CARRIE KAHN, BYLINE: It's extremely difficult, Audie. It's always the situation in Haiti when it comes to health care. The system is just so limited there to begin with. And in the last few weeks, daily case rates have been doubling. There are very few COVID beds. Drugs that have become routine now in fighting COVID are not available in Haiti. And one of the most difficult situation is just getting enough oxygen.

I spoke with Dr. Marc Edson Augustin. He's the medical director of the St. Luke's nonprofit hospital in Port-Au-Prince. That's the largest hospital treating COVID-19 patients in the country. He says the hospital can only generate a fraction of the oxygen it needs on site, and it has to go offsite at this facility to buy the rest of it. And that is in one of the country's most dangerous slums.

MARC EDSON AUGUSTIN: We sell three to four times a day on trucks. And right now with the gang violence, we cannot get to that area to get the necessary oxygen that we would need.

KAHN: Sometimes their trucks are attacked, the drivers are robbed, the facility is robbed. And he has to tell patients not to come because there aren't enough beds, and he also doesn't have a reliable source of oxygen.

CORNISH: This has been a big shift. Is there a sense of why it's gotten so bad?

KAHN: Haiti's had low numbers of cases and deaths since the start of the pandemic. Just compare it with other Caribbean nations; it's been doing well. The Dominican Republic right next door has 3,000 cumulative deaths compared to Haiti's 361. But scientists never really knew why Haiti did so well. There were peaks of cases, but nothing so bad. There was thoughts like, was it Haiti's younger population? Maybe enough asymptomatic cases provided immunity to a significant percentage of the population. But now there are two variants, particularly contagious ones, on the island, and transmission is clearly greater and more deadly.

Maureen Birmingham is the World Health Organization and PAHO representative in Haiti.

MAUREEN BIRMINGHAM: For reasons we don't quite understand, why - that we didn't see the intense transmission. And that went on into 2021. So because there was not a lot of overt cases, there weren't a lot of people being hospitalized, it's not illogical that people let down their guard.

KAHN: So you don't see a lot of people wearing masks or social distancing. People work in crowded markets, travel on crowded buses. And masks are expensive, so ramping up precautions is proving to be tough.

CORNISH: Chances that the country will get any vaccines anytime soon?

KAHN: Haiti cannot afford vaccines, so it's relying on donations and the World Health Organization-backed vaccine program, COVAX. The White House says it is actively engaging with Haitian government officials to get Haiti more vaccines as soon as possible. A spokesperson told NPR that today. But there's also great vaccine hesitancy in Haiti, especially when it comes to the AstraZeneca vaccine. And so, you know, that's going to be a big problem if vaccines do get to Haiti. The international community is saying it must get these vaccines as quick as possible there, but the question is, can the country's health care system handle it? And can a big vaccine program get shots into arms?

CORNISH: That's NPR's Carrie Kahn. Thank you.

KAHN: You're welcome. Transcript provided by NPR, Copyright NPR.