Painful and rapid spread of new virus in Caribbean

Go Lean Commentary

“Crap happens”, declares the book Go Lean…Caribbean (Page 23).

Virus 1The Chikungunya virus scare in the foregoing news article represents the sum of all fears for the Caribbean in terms of tourism and public health threats. This emphatically highlights the need for a regional security pact for Caribbean assurances.

The virus in this article has been identified in the Dominican Republic, Dominica, Saint Martin, and French Guiana; therefore, this is a cross-border threat. This re-enforces that there is a need for a super-national disease-medical sentinel in this security pact.

While other security pacts (for example NATO – North Atlantic Treaty Organization) may be based on defense against military aggression, the Caribbean security pact must focus more on public safety measures. This is one of the prime directives of the proposed Caribbean Union Trade Federation (CU). Naturally, the focus starts with economics, but the resultant engines can be seriously impacted by public safety/health threats. The book Go Lean… Caribbean, serves as a roadmap for the introduction and implementation of that regional sentinel, the CU. The complete prime directives are described as:

  • Optimize the economic engines of the Caribbean to elevate the regional economy.
  • Establish a security apparatus to protect the resultant economic engines.
  • Improve Caribbean governance to support these engines.

The Go Lean roadmap immediately calls for the establishment of a Homeland Security Department, with an agency to practice the arts and sciences of Emergency Management. The emergencies include natural disasters like hurricanes, earthquakes, tsunamis, volcanoes, flooding, forest fires, and droughts. Emergencies also include the man-made variety as in industrial accidents (oil spills, factory accidents and chemical spills), explosions, terroristic attacks and prison riots. The type of emergency described in the foregoing article requires a hybrid response of the Emergency Management agency and the CU’s Department of Health Disease Control & Management agency. Medical expertise would be required to contend with systemic threats of epidemic illness and infectious diseases.

The CU does not possess sovereignty for Caribbean member-states; so CU participation must be invited. This is why the CU is described as a deputized proxy organization. This invitation is equivalent to dialing “911”, a declaration of an emergency – thus granting a timed lease of limited authority to the CU agency, terminating with an “all clear” determination.

By: Ben Fox, AP

SAN CRISTOBAL, Dominican Republic (AP) — They suffer searing headaches, a burning fever and so much pain in their joints they can barely walk or use their hands. It’s like having a terrible flu combined with an abrupt case of arthritis.

Hospitals and clinics throughout the Caribbean are seeing thousands of people with the same symptoms, victims of a virus with a long and unfamiliar name that has been spread rapidly by mosquitoes across the islands after the first locally transmitted case was confirmed in December.

“You feel it in your bones, your fingers and your hands. It’s like everything is coming apart,” said 34-year-old Sahira Francisco as she and her daughter waited for treatment at a hospital in San Cristobal, a town in the southern Dominican Republic that has seen a surge of the cases in recent days.

The virus is chikungunya, derived from an African word that loosely translates as “contorted with pain.” People encountering it in the Caribbean for the first time say the description is fitting. While the virus is rarely fatal it is extremely debilitating.

“It is terrible, I have never in my life gotten such an illness,” said Maria Norde, a 66-year-old woman confined to bed at her home on the lush eastern Caribbean island of Dominica. “All my joints are in pain.”

Outbreaks of the virus have long made people miserable in Africa and Asia. But it is new to the Caribbean, with the first locally transmitted case documented in December in French St. Martin, likely brought in by an infected air traveler. Health officials are now working feverishly to educate the public about the illness, knock down the mosquito population, and deal with an onslaught of cases.

Authorities are attempting to control mosquitoes throughout the Caribbean, from dense urban neighborhoods to beach resorts. There have been no confirmed cases of local transmission of chikungunya on the U.S. mainland, but experts say the high number of travelers to the region means that could change as early as this summer.

So far, there are no signs the virus is keeping visitors away though some Caribbean officials warn it might if it is not controlled. “We need to come together and deal with this disease,” said Dominica Tourism Minister Ian Douglas.

One thing is certain: The virus has found fertile ground in the Caribbean. The Pan American Health Organization reports more than 55,000 suspected and confirmed cases since December throughout the islands. It has also reached French Guiana, the first confirmed transmission on the South American mainland.

The Pan American Health Organization says seven people in the Caribbean with chikungunya have died during the outbreak but they had underlying health issues that likely contributed to their death.

“It’s building up like a snowball because of the constant movement of people,” said Jacqueline Medina, a specialist at the Instituto Technologico university in the Dominican Republic, where some hospitals report more than 100 new cases per day.

Virus 3Chikungunya was identified in Africa in 1953 and is found throughout the tropics of the Eastern Hemisphere. It is spread by two species of mosquitoes, aedes aegypti and aedes albopictus. It’s also a traveler-borne virus under the right circumstances.

It can spread to a new area if someone has it circulating in their system during a relatively short period of time, roughly 2-3 days before the onset of symptoms to 5 days after, and then arrives to an area with the right kind of mosquitoes.

For years, there have been sporadic cases of travelers diagnosed with chikungunya but without local transmission. In 2007, there was an outbreak in northern Italy, so health authorities figured it was just a matter of time before it spread to the Western Hemisphere, said Dr. Roger Nasci, of the U.S. Centers for Disease Control and Prevention.

“With the increase in travelers the likelihood that something like this would happen goes up and eventually it did,” said Nasci, chief of a CDC branch that tracks insect-borne diseases. “We ended up with somebody at the right time and the right place infecting mosquitoes.”

The two species of mosquitoes that spread chikungunya are found in the southern and eastern United States and the first local transmissions could occur this summer given the large number of U.S. travelers to the Caribbean, Nasci said. Already, the Florida Department of Health has reported at least four imported cases from travelers to Haiti, the Dominican Republic and Dominica.

“What we’re seeing now is an increase in the number of infected travelers coming from the Caribbean, which is expected because there’s a lot of U.S. travel, a lot of vacation travel, a lot of work travel,” he said.

Around the Caribbean, local authorities have been spraying fogs of pesticides and urging people to remove standing pools of water where mosquitoes breed.

An estimated 60-90 percent of those infected show symptoms, compared to around 20 percent for dengue, which is common in the region. There is no vaccine and the only cure is treatment for the pain and fluid loss.

One consolation for those suffering from the illness is that unlike dengue, which has several variants, people only seem to get chikungunya once.

“The evidence suggests that once you get it and recover, once your immune system clears the virus you are immune for life,” Nasci said.

Associated Press writers Ben Fox in Miami; P. Solomon Banda in Fort Collins, Colorado; David McFadden in Kingston, Jamaica; and Carlisle Jno Baptiste in Roseau, Dominica, contributed to this report.

Associated Press News Wire (Retrieved 05-22-2014) –

The Go Lean roadmap immediately calls for the coordination of security monitoring and mitigation in the Caribbean; referring to viruses as well. This point is declared early in the Go Lean book, commencing with this opening pronouncement in the Declaration of Interdependence (Page 12), as follows:

xvi. Whereas security of our homeland is inextricably linked to prosperity of the homeland, the economic and security interest of the region needs to be aligned under the same governance. …[to ensure] the functioning of the wheels of commerce for all the citizenry, the accedence of this Federation must equip the security apparatus with the tools and techniques for predictive and proactive interdictions.

Go Lean … Caribbean therefore constitutes a change for the Caribbean. This is a roadmap to consolidate 30 member-states of 4 different languages and 5 colonial legacies (American, British, Dutch, French, Spanish) into a Trade Federation with the tools/techniques to bring immediate change to the region to benefit one and all member-states. This includes the monitoring/tracking/studying the origins of common and emerging viruses. This empowered CU agency will liaison with foreign entities with the same scope, like the Pan American Health Organization, US’s Center for Disease Control (CDC) and the World Health Organization (WHO).

Virus 2A lot is at stake!

Tourism is the primary economic driver in the region. The realization, or even the unsubstantiated rumor, of viral outbreaks can imperil the tourism product. We must therefore take proactive steps to protect our economic engines. But, we must not curtail freedom of movement among our visitors. We are, in effect, extending an “Open House” to the world to come enjoy our hospitality. Come… they will. So there are additional responsibilities for the stewards of the Caribbean economy, to impact the Greater Good. The CU invites this role, to promote this community ethos.

The book details that there must first be adoption of such a community ethos, the appropriate attitude/spirit to forge change in the region. Go Lean details this and other ethos; plus the executions of the following strategies, tactics, implementations and advocacies to impact the region’s public health:

Community Ethos – Privacy versus Public Protection Page 23
Community Ethos – “Crap” Happens Page 23
Community Ethos – Lean Operations Page 24
Community Ethos – Cooperatives Page 24
Community Ethos – Non-Government Organizations Page 25
Community Ethos – Ways to Improve Sharing Page 35
Community Ethos – Impact the Greater Good Page 37
Strategy – Vision – Non-Sovereign “Unified” Proxy Entity Page 45
Strategy – Customers – Residents & Visitors Page 47
Strategy – Agents of Change – Globalization Page 57
Tactical – Confederating a Permanent Union Page 63
Tactical – Fostering a Technocracy Page 64
Separation of Powers – Emergency Management Page 76
Separation of Powers – Disease Control & Management Page 86
Implementation – Ways to Pay for Change Page 101
Implementation – Security Initiatives at Start-up Page 103
Implementation – Ways to Deliver Page 109
Implementation – Ways to Foster International Aid Page 115
Implementation – Ways to Benefit from Globalization Page 119
Planning – Ways to Improve Failed-State Indices Page 134
Planning – Ways to Measure Progress Page 148
Advocacy – Ways to Grow the Economy Page 151
Advocacy – Ways to Improve Healthcare Page 156
Advocacy – Ways to Improve Governance Page 168
Advocacy – Ways to Better Manage the Social Contract Page 170
Advocacy – Ways to Foster Cooperatives Page 176
Advocacy – Ways to Improve for Natural Disasters Page 184
Advocacy – Ways to Improve Emergency Management Page 196

The foregoing news article introduces the threats of the Chikungunya virus. This is today’s issue. New issues will emerge tomorrow and the days after. This establishes that there is need for a permanent union – a sentinel – to provide efficient stewardship for Caribbean economy, security and governing engine. Change has come to the region.

How would the region pay for this change, these elevations? The Caribbean Union Trade Federation hereby submits for this job, no payment necessary! The region is hereby urged to lean-in to this Go Lean roadmap, to fulfill the vision of making the Caribbean region a better place to live, work and play.

Download the Book- Go Lean…Caribbean Now!!!

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