Across the world’s continents, the Omicron variant of COVID-19 has triggered a fourth wave of infections, at substantially higher rates. While the severity of cases is limited among those who are vaccinated, this is not the case for the non-vaccinated.
But in Haiti, as 2021 closed, this new variant still had not been detected in any great number, though it is very likely to be present, due to the very low screening carried out in the country. Since March 2020, only 149,525 tests had been recorded throughout the country, compared to nearly 2.6 million in the Dominican Republic (DR). Results of the analysis of samples are in progress in partner laboratories abroad to confirm whether the ultra-contagious variant Omicron is present.
Meanwhile, only 1.1% of the Haitian population received a first dose of the “Spikevax” vaccine from the MODERNA Laboratory and 0.6% have had two doses. Public health authorities would consider the scenario of Omicron’s presence with such a very low vaccination rate a recipe for disaster. Yet, that is not the case, as can be seen in the figure below showing the 7-day rolling average of new Covid-19 deaths (per 100,000) for the United States, Canada, India, DR and Haiti from April 2020 to December 2021.
Meanwhile, only 1.1% of the Haitian population received a first dose of the “Spikevax” vaccine from the MODERNA Laboratory and 0.6% have had two doses. Public health authorities would consider the scenario of Omicron’s presence with such a very low vaccination rate a recipe for disaster. Yet, that is not the case, as can be seen in the figure below showing the 7-day rolling average of new Covid-19 deaths (per 100,000) for the United States, Canada, India, DR and Haiti from April 2020 to December 2021.
The only spike in numbers that Haiti has experienced was in July 2021. Even then, the 7-day rolling average of new Covid-19 death rates was about the same as that of other countries.
Possible factors for the lower toll on Haiti
In my February 2021 column, I looked at COVID-19 information throughout nations and found out that Haiti had fared well, though the Haitian diaspora had suffered. Back then, cumulative infection and death rates in Haiti were respectively 12 and 14 times lower than the world rates. As of January 3, 2022, they were 16 and 10 times lower. So, the faring well pattern continues and stirs up a debate.
A variety of factors may explain this phenomenon. There’s the younger age of Haiti’s population, an average of 23, and we know that COVID-19 infections tend to be less severe in younger people; lifestyle of the population, where houses are typically left open with plenty of ventilation; long period of active time outside, which leads to exposure to vitamin D, a natural medicine; and significant number of people being infected during summer 2020 showing no symptoms; and built-up immunity, caused by limited exposure to visitors from other countries.
Another notable factor that stands out is the lower consumption of meat in Haiti. A recent study found that plant-based diets or pescatarian diets were associated with lower odds of moderate-to-severe COVID-19 in six countries — France, Germany, Italy, Spain, U.K., and U.S. It is well-known that, due to the poor economic situations of Haitian families, the dietary habits are mostly plant-based.
Drawing from the statistical database of the Food and Agriculture Organization (FAO) of the United Nations, it has been found that in 2017, meat consumption per capita was only 17.6 kg in Haiti, compared to 52 kg in the DR, 90 kg in Canada and 121 kg in the U.S.
While those statistics include pescatarian products, the latter generally represents a smaller proportion of protein intake from animals, mainly in developed countries. For example, they represent about one quarter (4.5 kg) in total meat consumption in Haiti and only 18% in the US.
Has Haiti dodged the COVID-19 bullet?
We are not sure yet because of two reasons. First, the total number of fatalities caused by the pandemic is likely higher in a country like Haiti and second, this disease is full of surprises.
Total number of COVID-19 deaths could be higher in Haiti because of 1) exclusion of victims who did not test positive for coronavirus before dying, and 2) lag in mortality data when civil registries process death certificates. One way to account for these issues is to use a simpler measure, known as “excess deaths”: take the number of people who die from any cause in a given period, and then compare it with a historical baseline from recent years. This has been done for more than 100 countries and regularly tracked. DR is part of this tracking, but not Haiti (probably due to lack of recent vital statistics). Excess deaths during the whole pandemic period in the US and Canada were respectively 314 and 44 per 100,000 population. They were virtually nil in the DR (up to Sept. 30, 2020). We don’t know yet what the excess deaths during the pandemic would be in Haiti compared to pre-pandemic.
Moreover, this disease is full of surprises. For example, after a span of time when it seemed India had been spared the worst of the virus, then came the catastrophic COVID-19 wave between May and June 2021 (see figure). The virus might behave in the same way in the future. Though it is highly unexpected, it is not known if a deadly surge may still be in Haiti’s future. With the daily many problems facing the country— corruption, kidnappings, armed gangs, political instability, wild fluctuations in the value of the local currency (the goud), poverty— let’s hope “excess deaths” are low, the Covid pattern will stay low and Haiti will continue to dodge the COVID-19 bullet in the future.