Right Steps & Poui Trees


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The Public Health (Emergency Measures) (Coronavirus COVID-19) Order, 2022 – dated March 18, 2022

On Thursday, March 17, 2022, Prime Minister Andrew Holness announced that the use of the Disaster Risk Management Act (DRMA) to implement Covid-19 emergency measures would end the following day. He said that a few of the measures that had been in place would instead be administered under the Public Health Act but that all others would come to an end.

The Ministry of Health & Wellness (MOHW) issued a press release about the revocation of the DRMA Covid-19 Orders and indicated that a copy of new Public Health Enforcement Measures Order was attached to the release.

However, although the press release was posted on the MOHW website, the attached Order doesn’t seem to have been posted there. It was posted on the Office of the Prime Minister’s website.

I have posted a copy of the Order below.

Some of the measures are scheduled to expire in a week’s time, on April 15, 2022 and the PM had indicated that a review is to take place to determine what will happen after that time. If the Covid data from the MOHW continues on the trend of the past few weeks, it is likely that the remaining measures will not be extended. The rising number of cases and hospitalisations in the UK, the USA and Canada is cause for concern, however, as in the past increases in those countries have been followed some weeks later by increases here in Jamaica.


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The Last of the COVID-19 Disaster Risk Management Orders – January 14 & 28, February 11 & 25 and March 18, 2022

In Parliament last week Thursday – March 17, 2022 – Prime Minister Andrew Holness announced the end of the use of the Disaster Risk Management Act (DRMA) for the issuing of measures to deal with the Covid-19 pandemic in Jamaica, after 2 years of use. This was generally expected and the Prime Minister indicated that while most measures, including the nightly curfews, would be ended outright, some would be kept in place via regulations under the Public Health Act. This includes the requirement to wear masks in certain enclosed indoor areas accessed by the public, which remains until April 15, 2022.

The Order ending the use of the DRMA, effective March 18, 2022, was displayed in Parliament but has not yet been posted online.

“With effect from the 18th day of March, 2022, the Disaster Risk Management (Declaration of Disaster Area) Order, 2020 is revoked.”

For completion, I am posting below the last 4 DRMA Orders, all issued in 2022. They are all posted on the Ministry of Justice website, though not all on the Office of the Prime Minister website.

Click here to view the PBCJ recording of PM Holness’ presentation in Parliament in which he spoke about ending the use of the DRMA to implement Covid-19 measures. The presentation was made during his Budget Debate presentation and begins about 37 minutes into the recording.

The Covid-19 pandemic use of the DRMA has come to an end and there is much worthy of detailed study and comment about it, including whether it was the appropriate method for the issuing of these measures for such an extended period of time; the amount of power it placed in the hands of the Prime Minister; how the issuing of the Orders was actually handled; the way in which the details of the Orders and gazetted copies were disseminated to the public and the scope of the measures contained in the Orders and the impact they had on life in Jamaica. It will be worth looking at what lessons, if any, have been learned for next time…whatever that next time turns out to be…


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A Week Later & for the Prime Minister, the Argument is Still Done

A week ago, on Sunday, January 9, 2022, Prime Minister Andrew Holness held a press conference to announce a Zone of Special Operations (ZOSO) in Parade Gardens in Central Kingston because of the levels of violent crime occurring in the area. When the press conference had been called the evening before, many wondered if it was being called because of the increase in Covid-19 cases that was happening as the 4th wave picked up momentum.

During the question and answer period, Gleaner reporter Tenesha Mundle asked PM Holness this question:

“Are we planning to return to lockdowns and, if lockdowns are off the table, what other strategies will be implemented to halt the current Covid-19 wave?”

PM Holness replied:

“I wasn’t planning on turning this into a Covid Conversation. But I know there is great tension in the air. And what it says to me is that people are not listening to what I have said. I’ve been very clear, in Parliament, very clear, absolutely, gone overboard to say we are not going back to lockdowns. So, be calm! And I’ve said what the strategy is. It is now in your hands! Go and take the vaccine! That is the strategy. We can’t hold you down and put the needle in your hand. If you get sick, you tek that responsibility. There is an option; we have vaccines all over the place. We have sites all over the place. I don’t hear one person complain that they can’t get the vaccine anywhere. Go and get vaccinated! Argument done!”

Argument done. Go and take the vaccine. That is the strategy.

In the week that followed, the situation has worsened:

  • We have had the highest reported number of new confirmed cases in a 24-hour period since the start of the pandemic (1968 on Jan 15, 2022)
  • We have had the highest positivity rate since the start of the pandemic (68.6% on Jan 13, 2022) and on 5 days of last week , the positivity rate was over 50%.
  • The number of people hospitalised with confirmed cases of Covid-19 moved from 294 at the start of the week to 446 by the end of the week.
  • In Parliament on Tuesday (Jan 11, 2022) in a statement in which he extended existing Covid measures without changes for another 2 weeks, PM Holness noted that although the country’s Covid bed capacity of 700 beds had not yet been reached, hospitalisations were increasing sharply and Covid beds might soon be full. (The slide he shared was a reminder that hospital beds are occupied by both people with confirmed Covid cases and those with suspected cases, who are awaiting test results. The daily reports from the Ministry of Health & Wellness give the number of people hospitalised with confirmed cases only; so the number actually is always higher on the ground.)

During the week, the heads of regional health authorities and some hospitals were in the news detailing some of the challenges that were being experienced in the health system:

In a Jamaica Observer article on Thursday (January 13, 2022), – University hospital under pressure from Covid patients – Chief Executive Officer at University Hospital of the West Indies (UHWI) was quoted commenting about the situation at the hospital:

Chief executive officer of UHWI Kevin Allen told the Jamaica Observer that the operations at the institution were becoming difficult as the fourth wave of the virus shapes up to wreak havoc. He reported that the system is further strained as roughly 90 nurses are at home, sick.

For patients and staff, Allen said the situation is “stressful, frustrating and difficult”. He encouraged staff to “hold it because the worst is yet to come”.

“We are putting systems in place and we are working to see how best we can ensure we hold it. We are not in breakdown days yet, but it is rough,” he said.

“The last report I have seen, we have some 90 nurses out of the system and that is crippling our operations. We have roughly 880 nurses and about 10 per cent have come down with the virus,” Allen added.

“We were already operating short with these skill sets, so to lose so many will impact on the quality of care. All the areas that we operate are full. The field hospitals are full, isolation is full, emergency is full with patients. We had to revert to using tents.”

On Friday (January 14, 2022), UHWI issued a press release notifying the public to expect delays at the hospital.

On Saturday (January 15, 2022), Minister Tufton posted a series of tweets about the situation at a number of hospitals he had visited, including Bustamante Hospital for Children, which was being affected by an increase in Covid-19 cases and reduced staff, due to infection and quarantine.

In an article in Loop News that same day – Covid Surge: Highest number of paediatric cases at Bustamante hospital – Senior Medical Officer, Dr Michelle-Ann Richards-Dawson was quoted as saying:

“We are currently in the fourth wave of the pandemic. We have been through three before but this one is different. The pace at which people are getting infected and symptomatic is alarming and therefore it is important that we vaccinate to protect ourselves and our loved ones”.

The Jamaica Medical Doctors’ Association (JMDA) issued a release expressing their concerns about the current situation…

…which was endorsed today by the Medical Association of Jamaica (MAJ)…

So with this and more having occurred in the last week, many people wondered if Covid-19 would be on the agenda of the Office of the Prime Minister press conference announced last night. However, it wasn’t.

This morning, PM Holness told the country that a ZOSO had been declared for some sections of Westmoreland, which has been plagued by violent crime. At the end of the press conference, the ususal question and answer segment took place. The final question was asked by Ricardo Brooks of Nationwide News Network.

Ricardo Brooks: Good morning, Prime Minister. The country’s positivity rate has topped 60% and hospitalization, the situation there is deteriorating. Do you still hold to the point that “Argument done”?

The Prime Minister answered: You have said it. Thank you!

That was all. And then the press conference ended.

At the point we are at in the 4th wave, this is not an adequate or appropriate response from Jamaica’s Prime Minister. We are told that the peak of the wave is not expected for another two or more weeks. The health care system is already on the verge of being overwhelmed by the increased number of cases and the staff shortages. The strategy that PM Holness offered last week – “Go and take the vaccine! That is the strategy.” – will not slow this current surge. He may feel he has spoken enough; he may feel frustrated; he may have had another appointment to go to. But this was a national press conference he called, to talk about another issue, yes. But he must have expected that he would be questioned about the Covid-19 situation and it would have been good if he had used the opportunity, on a Sunday morning, to have said something more useful.


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Cases Reported of a Possible Exposure to Covid-19 in Schools?

During his statement in Parliament on Tuesday (Nov 16, 2021), while announcing changes to the Covid-19 measures, PM Andrew Holness briefly mentioned cases of children with possible exposure to Covid-19 and how this was dealt with by schools.

Speaking about the country as a whole, he said:

“We are being very cautious in reopening and, just to be clear, we are not going to shut down again.”

He then went on to say:

“So, Madam Speaker, we have reopened our schools. We have seen cases reported of a possible exposure to Covid-19. We haven’t shut them when they have opened. We tell them to sanitise, clean up, isolate the child, keep them at home. But we are not going to close the schools again.”

These cases referred to by the Prime Minister – of possible Covid exposure in children in schools – haven’t been reported in the media nor to general public by the Ministry of Education, Youth and Information (MOEYI) or by the Ministry of Health and Wellness (MOHW). In his statement, PM Holness gave no other information about these cases…what schools or parishes they occurred in, when they occurred or how many children or schools were affected, for example.

Other questions needing answers include:

  • Has information about these cases been reported to the parents, guardians or families in the schools where these cases occurred?
  • Were the children who were possibly exposed to Covid-19 tested to see if they actually had Covid-19?
  • Were the other children and teachers in their class or in the school also tested?
  • Was any contact tracing done?

And a more general question needs to be asked about what exactly the protocol is when schools have a child in attendance who was possibly exposed to Covid-19, beyond what PM Holness mentioned…”We tell them to sanitize, clean up, isolate the child, keep them at home.”

There is very little specific information in the MOEYI’s Manual for the Reopening of Educational Institutions – Version 3, August 2021 on how suspected/confirmed cases of Covid-19 in students or staff are to be dealt with. And there is no mention of testing. Perhaps it is set out in detail elsewhere. It would be good to know.

PBCJ recording of the sitting of the House of Representatives on November 16, 2021


Covid Reflections: Time for one of Dr Bisasor-McKenzie or Dr Webster-Kerr’s Covid-19 Updates

I’ve seen or heard pieces of information in the media about where we now are in the 3rd wave. For example, last week in an interview on Nationwide News Network, National Epidemiologist Dr Karen Webster-Kerr spoke about the expectation that the peak of this wave would occur in 2 weeks’ time and she gave projections for deaths in the coming weeks. During a discussion on Nationwide on Wednesday, Prof Winston Davidson mentioned that the reproductive number was now at 1.1. (For full disclosure, I was one of the other participants in the discussion.) In today’s Gleaner there is an article that refers to information said to have been obtained from Dr Webster-Kerr and the Ministry of Health and Wellness (MOHW):

“A hair-raising 250 COVID-19 deaths occurred in August, with another 60 fatalities still under investigation, said Dr Karen Webster-Kerr, national epidemiologist. Scores of other deaths reported in August occurred months earlier.

August 26 was the deadliest day for the month, with 20 persons succumbing to the COVID-19.

However, the 296 COVID-19-related deaths for March outstripped August’s.

Data from the Ministry of Health and Wellness obtained by The Gleaner showed that another 20 deaths in March are under investigation.

With the country recording a total of 69,054 COVID-19 cases as at September 2 and a total of 1,568 deaths as a result of the disease, the ministry is reporting that the overall (2020 to 2021) COVID-19 case death rate is 2.3 per cent.

The death rate in August (1.6 per cent) plunged only because infections soared almost fivefold, month-on-month, to more than 15,300.”

At the Office of the Prime Minister’s (OPM) press briefing on Wednesday (1-9-21), Prime Minister Holness included 3 of the slides that are normally included in the MOHW PowerPoint updates and he commented on them, something which he has done before, though moreso in Parliament. Although both the Chief Medical Officer (CMO) Dr Jacquiline Bisasor-McKenzie and Dr Webster-Kerr were present at the press briefing, neither spoke from the podium or gave the ususal update.

(Perhaps this was in keeping with the brief nature of the press briefing…only 3 slides, and only two questions allowed in the Q&A.)

The last of these MOHW Covid-19 updates that I can find is the one given at the OPM press briefing on August 19, 2021, by Dr Bisasor-McKenzie.

That is now more than two weeks ago, two weeks in which we have moved towards the peak of the 3rd wave. In that time there have been dramatic increases in the number of cases, the number of hospitalizations, the number of deaths. But we are being told that with the reproductive rate reducing and the positivity rate down from the high of 54%, there may be glimmerings of hope. This is exactly the time at which we need a full update from the CMO or the National Epidemiologist. To place us now in the context of indicators that the MOHW has used for so long.

Why haven’t we had one of these updates, at one of the times when we perhaps need it most, since the start of the pandemic?

We have been getting these periodically. They have been a useful way of tracking changes. Whatever problems some may have with aspects of the data, this is a way of following what the MOHW says the position is, what they are using to base decisions on, what the government is basing decisions on.

There was no MOHW Covid Conversation yesterday; Thursday is the ususal day for them if they are being held. No presentation at the OPM press briefing on Wednesday. No presentation at Parliament’s Joint Select Committee dealing with Covid-related matters on Tuesday; Parliament is on summer break. These are the three places that the public usually gains access to these updates. A presentation with commentary by Dr Bisasor-McKenzie or Dr Webster-Kerr would be best. But if that’s not going to happen, post the PowerPoint online on the MOHW website. In fact, press briefing or no press briefing, Covid Conversation or no Covid Conversation, Joint Select Committee or no Joint Select Committee, post it at regular intervals on the MOHW website.

During a crisis such as this pandemic, information to the public is crucial. With this Delta-variant-fueled 3rd wave, with our public hospitals not offering anything but emergency services, with bed capacity overwhelmed, with dangerous oxygen shortages, we are in a crisis within the crisis. We need more information, not less.


Covid Reflections: With Public Hospitals Accepting Emergencies Only, We Have Entered Another Phase in Our 3rd Wave

Yesterday Jamaica’s Ministry of Health and Wellness issued a press release stating that the country’s public hospitals would be accepting emergency cases only, until further notice. The large number of people confirmed with or suspected of having Covid-19 who need hospitalisation has resulted in the hospitals exceeding their Covid-19 isolation capacity. So other hospital spaces and resources have to be dedicated to treating people with Covid-19. General hospital service has been suspended, including elective surgeries, and people who can be cared for at home are being discharged. The Chief Medical Officer (CMO), Dr Bisasor-McKenzie, is quoted as saying that “The rising demand for oxygen also threatens to overwhelm the supply.”

Curiously, this press release has not (yet) been posted on the MOHW website.

This decision by the MOHW signals that the country has entered into a new phase in the 3rd wave of Covid infections in Jamaica but it does not come as a surprise if you have been following the news and numbers in the past couple of months. And the news and numbers over the last week or two have clearly shown the deepening crisis.

People in government and outside of government have been speaking about the increasing numbers of Covid-19 cases, the increasing numbers of hospital admissions, the pressure for space within the hospitals, the pressure on staff within the hospitals. These comments and information have come through official statements at government press conferences, through media interviews, in press releases, on social media.

A small sampling of examples…

Dr Melody Ennis of MOHW was speaking with Dionne Jackson Miller on RJR
Nurse Patsy Edwards-Henry, President of Jamaica Nurses Association, was speaking with Sanjay Lewis on Power 106
MOHW PS Dunstan Bryan speaking with RJR
Slide shown at OPM press conference on August 9, 2021, while PM Andrew Holness spoke & said “I want us to pay attention to this graph. It shows our daily confirmed cases of Covid-19 in blue, while the red line shows the 7-day moving average of new hospitalisations. You can see that our daily hospital admissions are now at the same level as our previous peak in March/April 2021. We now have approximately 500 of 700 beds allocated for Covid-19 occupied islandwide and a number of our large hospitals are over capacity.”
(Transcribed from PBCJ recording of OPM press conference, August 9, 2021.)
Slide presented at MOHW press conference August 12, 2021. CMO Dr Bisasor-McKenzie said: “We can see now, compared to last week, that our bed occupancy now is at over 600 beds occupied with both confirmed cases and suspected cases…Our peak, March/April, we were at just over 700 and now we are just over 600.”
(Transcribed from PBCJ recording of MOHW press conference.)
In a report on August 17, 2021, JIS covered this point made by Dr Bisasor-McKenzie, where she said “We are fast approaching that peak, which will put us in a very dangerous zone in terms of the care for COVID patients in our hospitals. It puts us in a very high level of pressure on the hospital system.”
Dr Andrew Manning, Medical Association of Jamaica President, in a news report on RJR, August 16-8-21 – MAJ Alarmed at Record High COVID Positivity Rate
Slide showing hospital capacity – OPM press briefing on August 19, 2021 – CMO Dr Bisasor-McKenzie said. ” And this is what is happening in our hospitals. Across the regions, what we are seeing is that the four regions are in an alert phase in terms of Covid capacity. For the southern region, we have gone over the capacity for Covid beds; we’re at 162% occupancy. For the western region, 142%. For the north east region, 125% and for the south east region at 97%. It means that most of our major hospitals, our main hospitals, are really full….As you can imagine, our health care workers are tired, they’re frustrated, they’re overworked, they’re stressed.”
(Transcribed from PBCJ recording.)
This week Wednesday (August 25, 2021) All Angles on TVJ did a special report about the Savanna-La-Mar Hospital, which is struggling with an influx of Covid-19 patients. Dionne Jackson Miller interviewed members of staff – doctors, nurses, a porter, the CEO – about conditions at the hospital. It was a harrowing and moving programme.

And today a number of media houses have carried reports that there is a severe shortage of medical oxygen in the country, which is now affecting the supply to hospitals, some of which are said to be out of oxygen. There has not at this point been an official statement on this from the Ministry of Health & Wellness.

There is an urgent need for a press conference to be held focusing on the dire crisis in the hospitals. Despite the many warnings that this was where we were heading, now that we are here, the public of Jamaica deserves a full update. This is particularly urgent in light of the fact that the Dr Karen Webster-Kerr, National Epidemiologist, has said that this 3rd wave won’t peak for another two weeks. That thereafter it is likely to take several months to come down from that peak. That, although she is reluctant to give predictions about deaths, we are likely to see 140-150 deaths over the next week and an additional 10-20 on top of that number the following week. (She was speaking in an interview on Nationwide News Network on Thursday, August 26, 2021). This means that the pressure on the hospitals is likely to continue for weeks to come, increasing further before it decreases.

It is Saturday night. The curfew started at 6pm. For the next 3 days, Jamaicans are under 24-hour curfews, with the curfew ending at 5am Tuesday morning. Tomorrow – Sunday – would be a good time to hold a press conference. Let us know what time. Most of us will be at home…


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Covid Reflections: Delta Variant Confirmed & Deaths Increase Sharply in August

We are in our third wave of Covid-19 in Jamaica.

MOHW slide – OPM press briefing 19-8-21

The Delta variant, which for some time has been assumed to be in Jamaica, has now been confirmed to be here.

The number of new cases and hospitalisations have been been rising steadily.

In the third week of August, new cases were over 500 per day on all days but one, the positivity rate was over 40% on 5 days of the week and hospitalisations had gone from 204 on August 1 to 573 on August 21.

At a press conference called by Prime Minister Holness last Thursday (August 19, 2021) to announce changes to the Covid-19 measures, Chief Medical Officer Dr Bisasor-McKenzie gave a presentation, which has been variously called sobering, alarming, frightening. Covid-19 indicators are all going in the wrong direction, with our vaccination levels too low to have any significant collective impact on the effects of this wave.

MOHW slide – OPM press briefing 19-8-21

The slide below from her presentation set out some sobering, alarming, frightening projections for increases in confirmed cases and deaths, if the reproductive rate remained at 1.4, and for daily hospital admissions, if the reproductive rate remained at 1.3.

MOHW slide – OPM press briefing 19-8-2021

The deaths reported by the Ministry of Health and Wellness (MOHW) during August have been going up at a steadily increasing rate. For the first week, 26 deaths were reported, 78 for the second week and 88 for the third. The totals for weeks 2 and 3 are already above the weekly reported deaths seen during the height of the 2nd wave in March this year. And we are not yet at the peak of the current wave….

The parishes with the highest reported deaths so far in August are Kingston & St Andrew (KSA) and Westmoreland, with 47 and 28 respectively.

(I want to make clear that I describe the numbers as REPORTED deaths because it is often not possible to tell from the Clinical Management Summaries the day on which deaths actually occurred.)

Compiled from MOHW daily Clinical Management Summaries

I have included a map of Jamaica showing the parishes, for ease of reference.

Map of Jamaica showing parishes

The report issued today, with yesterday’s data (Sunday, August 23, 2021) saw a record number of new cases being confirmed – 879, the highest single day total since the start of the pandemic. (The highest number prior to this was 878, recorded on March 7, 2021, during Jamaica’s 2nd wave.) Hospitalisation have reached 607 and 14 additional deaths were reported.

The days of lockdown announced will hopefully help to bring the numbers down. But they will not affect the deaths already likely to result from the high numbers of infections in the past few weeks. The increase in deaths typically lags behind the rise in cases by a few weeks. As Prof Peter Figueroa said in an interview on Nationwide News Network last Friday :

“We have a very serious surge of COVID cases, a lot of persons in hospital. The hospitals are close to being overwhelmed with the number of persons being admitted with COVID. This surge is looking worse than the last surge  that we had that peaked in March of this year.”

Prof Peter Figueroa, Nationwide News Network interview, 20-8-2021

Our hospitals and medical personnel are being overwhelmed. And as Prof Figueroa and other medical and public health professionals have said…it is going to get worse before it gets better. Actions taken now, by the government and the people, can help to reduce further infections and further deaths. But downplaying what’s happening, wishing it weren’t so or ignoring the science will not.


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Covid Reflections: What has happened to genome sequencing test results?

A few months ago, as the media reported on the surge of Covid cases caused by the Delta variant in first the UK and then the USA, some of us in Jamaica began asking whether the variant was present in Jamaica. There is a great deal of travel to Jamaica from these two countries – residents, members of the diaspora, tourists – and it seemed only a matter of time before we got cases of the Delta variant here. Was testing being done for the variant by the Ministry of Health and Wellness (MOHW) and, if so, what had been found?

Responding to a question at the MOHW Covid-19 press conference on July 1, 2021, Chief Medical Officer Dr Jacquiline Bisasor-McKenzie said the following:

“The Delta variant is something that we really are watchful for. We certainly don’t want to have that in country because we recognise that there is an increased transmissible rate and also that there is an increased chance of admission. And so in our population that is vastly not vaccinated, it does put us at risk. 


In terms of the testing for the variant, we did, we sent off 200 samples to PAHO testing laboratory in Brazil last week. We have another 92 samples that we have sent off to the CDC. I’m not absolutely sure that that went off this week, but that was the plan, to send off another 92 samples to the CDC and another hundred samples to PAHO to be tested in Panama. 


So we have three arrangements in place now. We really have had some problems in terms of getting the genomic sequencing done. And a lot of that delay has been because of transportation, not because we have not had willing partners to do the testing. But the transportation problems have delayed us getting the samples out, even to the extent that transportation routes, because they have to be longwinded, have resulted in damage to the samples that made not all of them at some times suitable for testing. So we believe that we have worked out something now, a more reliable transport method to get these samples out and we have three partners – the PAHO, CDC and CARPHA – to do the testing. So we do expect that at least every two weeks we should be getting out at least a hundred samples for testing.


The turnaround time once they receive the sample for PAHO, we have been told, is two weeks. The samples last batch went out last week. They are in receipt of the samples, so we are hopeful. We know that sometimes we get times and it may not turn out to be exactly that but we are hopeful that in another two weeks we will have that first set of results. And thereafter we should have results coming after.


We also have started to do some in house testing using kits that are donated by PAHO that enable us to choose the samples better for testing. So we have now a method in place where we can pick up whether or not there are mutations. So mutations can be quite varied and can sometimes not be of any significance at all. But we can now pick up if there are any variations from the normal wild type and those are the samples that we have been sending for testing for genomic sequencing to see if those mutations show any variants of interest or variants of concern.”

(Transcribed from PBCJ recording of July 1, 2021 MOHW press briefing)

This left me hopeful that, despite previous problems that had affected testing for variants, there was now a new system in place that would mean faster results that could help to inform government decisions and responses and help the public to better understand what we were facing. The time lag was still not optimal, but seemed better until we had the equipment needed to do genomic sequencing here.

However, there seemed to be a delay in the hoped for two week turnaround time for the results from PAHO and in a presentation on July 20, 2021, at the Joint Select Committee of Parliament dealing with Covid-19 and related matters, National Epidemiologist Dr Karen Webster-Kerr included this slide:

It showed that results had been received for samples sent to the CDC, but that no results had at that time been received for the samples sent to PAHO.

(I wrote about that presentation in Parliament in a post I made on July 22, 2021 – On the Verge of a Third Wave? – Jamaica’s Current Covid-19 Situation.)

And to date we have not had any clear update on what has happened regarding those and any other subsequent samples sent to any of the three labs for genomic sequencing. The most we have heard is comments during various media interviews or at press briefings that we are still awaiting results from overseas partners. And that there is no confirmation through testing that the Delta variant is here, but that from other indicators we can assume that it is.

At the press briefing on Monday, August 9, 2021, held to announce the latest changes to the Covid restriction measures, Minister Tufton said, in response to a question from Jamila Maitland about test results and the Delta variant:

“As it relates to the test for the variant strain, I think we are on record of saying that we do believe that it is here based on the movement between countries where it is the dominant strain. We have not yet confirmed its presence based on the test results that we have gotten to date. However, those results up to this point were results that were a little dated because it takes a while to get back the results from where we send them. We are anxiously anticipating the results of tests that would hopefully reflect more what is present in the population. But we continue to advise caution.”

Minister Chris Tufton, at OPM press briefing, August 9, 2021 (transcribed from PBCJ recording)

It is now nearly six weeks since Dr Bisasor-McKenzie outlined the new arrangements for genomic sequencing testing and it is three weeks since the presentation and discussion at the Covid Joint Select Committee in Parliament. We really need a clear update on what has happened with the new arrangements and why it is that we haven’t seen any further results other than the CDC results shown on July 20.

I assume that the MOHW will be holding a press briefing on Thursday and that would be an appropriate opportunity for a full update. Some questions I would hope to hear answered would be:

  • Since the list shared shared on July 20, 2021, have the results of any samples sent for genomic sequencing been received from PAHO, CDC and CARPHA?
  • If so, when were these results received and what did they show?
  • If any results were received, what were the dates on which those samples were collected?
  • What samples have been sent for which results are still outstanding?
  • What has been the cause of the delay in receiving the results for samples sent? What has been or is being done to remedy this?
  • What impact do delays such as this have on the Ministry’s ability to make plans and decisions?
  • Specifically, is it still the case that there is no confirmation by testing that the Delta variant is present in Jamaica?
  • What is the current status of plans to be able to do genomic sequencing here?

Let’s see.

PBCJ Recording of MOHW press conference held on July 1, 2021

PBCJ Recording of OPM press conference held on August 9, 2021


“…while there’s no confirmatory test, I am prepared to say that we should assume that the [Delta] variant is here…” – Minister of Health, Jamaica

At the Ministry of Health and Wellness (MOHW) press conference on Thursday, July 22, 2021, more data and information was presented indicating that Jamaica is beginning to experience a third wave of infections in the Covid-19 pandemic. The first wave peaked in terms of number of confirmed cases in September of last year and the second wave in March of this year.

From left to right: Permanent Secretary Dunstan Bryan, Minister of Health & Wellness Chris Tufton, Chief Medical Officer Dr Jaquiline Bisasor-McKenzie, National Epidemiologist Dr Karen Webster-Kerr

In her presentation, National Epidemiologist Dr Karen Webster-Kerr indicated that all of the main Covid-19 indicators were moving in the wrong direction:

MOHW slide – press briefing 22-7-2021

“And so the final slide is a summary of where we are for our main indicators. Our geographical spread level is medium. The bed occupancy is at high pressure. The Positivity is at high transmission level. The reproductive rate is increasing and we see this is exponential increase in both cases and hospitalization. Our vaccination level, where it is now, is too low to have an effect on transmission or significant effect on transmission.”

– Dr Karen Webster-Kerr, National Epidemiologist, MOHW press briefing, 22-7-2021 (transcribed from PBCJ recording)

Among the things noted in the presentation, were that:

  • one third of the communities across the country have cases of Covid-19, with Kingston & St Andrew, St Catherine and Hanover being the parishes with the highest numbers at this time
  • the level of hospital bed occupancy by confirmed and suspected Covid-19 patients had been falling but then plateaued recently and has climbed into the high level again in the past few days
  • the Reproductive Rate of transmission has increased from 1.1 in the previous week to the rate last week of 1.2, indicating an increasing rate of exponential spread; the rate of hospitalisations is also increasing exponentially
  • the Reproductive Rate has increased since the relaxation of interventions, which began on June 3 and were increased on July 1; the rate is now at 1.2.

It was in his comments following Dr Webster-Kerr’s presentation that Minister Tufton said that we could assume that the Delta variant was now in Jamaica:

“We do not have any evidence of the Delta variant being here from the tests that have been done but these tests are ongoing. We send samples out every week and while there is no confirmatory test, I am prepared to say that we should assume that the variant is here. And I am prepared to say that because the probability of it being here is probably greater than it not being here, based on the border access and the travel restriction removal, including coming from countries where the Delta variant is now the dominant variant – the UK being one or a main one but also now the United States. I am not talking about any particular sector. It’s not about tourism because the truth is as Jamaicans we travel very frequently, the diaspora. So once we have that kind of interaction, particularly in this case with a highly contagious variant of this virus, as outlined by the scientists, it is very likely. But from the tests that have been done we have not yet confirmed. But results will continue to come in and as soon as we confirm, we will make it known.” 

 – Minister Chris Tufton, MOHW press briefing, 22-7-2021 (transcribed from PBCJ recording)

Chief Medical Officer Dr Jacquiline Bisasor-McKenzie spoke about the rising indicators which signaled the increased pressure that is likely to affect the health system, the plans to meet this increased pressure and the challenges being faced.

Dr Bisasor-McKenzie’s presentation begins approximately 21 minutes into the press conference. See PBCJ recording below.

Minister Tufton advised that the Cabinet Sub-Committee dealing with Covid-19 was scheduled to meet on Saturday, July 24, 2021 and that the decisions made would be announced this week. We wait to hear the outcome of these deliberations, which is likely to have significant impact on how the 3rd wave of infections in Jamaica plays out.

PBCJ Recording of MOHW Covid-19 Press briefing 22 -7-2021


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On the Verge of a Third Wave? – Jamaica’s Current Covid-19 Situation

At the meeting of the Joint Select Committee on the Covid-19 Pandemic and Related Matters that was held at Parliament this week Tuesday (July 20, 2021), National Epidemiologist Dr Karen Webster-Kerr gave an update on Jamaica’s Covid-19 situation, using data as of July 19.

A copy of the slide presentation presented by Dr Webster-Kerr is available here:

Dr Webster-Kerr noted the increase in the number of new cases and the positivity rate that has been seen in the past couple of weeks.

She pointed out that the Reproductive Rate of the virus is once again over 1, now being at 1.1. This means that Jamaica is again experiencing exponential spread of the virus, albeit at a slow rate of spread. This rate could easily increase sharply without preventative measures.

One of the questions that has been asked frequently in recent weeks is whether the more contagious Delta variant is now present in Jamaica, particularly since it has now become the main strain of Covid-19 being seen in the UK and the USA, both being countries which see a lot of air travel with Jamaica. In Parliament last week, Minister of Health Chris Tufton said that genetic sequencing test results from samples sent to the CDC had not shown the presence of the Delta variant. When asked by Opposition MP Morais Guy, however, he was unable to say when those samples had been collected.

A slide in Dr Webster-Kerr’s presentation dealt with the samples sent for genome testing since December 2020 and indicated that the most recent results received were still those from the CDC.

However, in response to MP Guy’s question about how recent the samples were that had been sent for testing, Dr Webster-Kerr said that the samples sent to CDC on June 8, 2021, were mostly taken in May, with three from April and two from June. The samples sent to PAHO’s lab in Brazil on June 24, 2021, were mainly from April and May with a few from June.

This highlighted the point that the samples from which we have received results are too old to give any clear indication of whether or not the Delta variant is now in Jamaica.

Minister Tufton also responded on the issue of the samples and the Delta variant:

I think we have to be as straightforward with the country as possible, not just on the evidence based on the tests done but on the likelihood based on projections and circumstances. I think you raised an important point, Member [Morais Guy], on questioning the recency or age of the samples that were collected. And I think it’s quite clear that based on the dates around those samples the likelihood of picking up the Delta variant at that time would be less than it would be presently. And I think the most recent samples, the ones that are to go off, which would contain samples of June and hopefully July, would be our key insight, if you will, into whether the Delta variant is here.

These things normally not advisible to give a personal view but certainly based on the interactions that we are having as an open society with other geographic spaces that have the Delta variant as a dominant feature of those populations, I certainly believe that it is just more a matter of time before we detect that that variant is here. And I think the true, the same could be said for other populations throughout the world. This is the nature of the virus, this is how it spreads and once you are exposed with borders that are open of necessity, for trade or otherwise, you are going to have that level of exposure.

So I do believe that a more accurate reflection of what is present in the population as it relates to variant strains will come from the most recent batch of samples collected and I think the country should be advised of that and should continue to observe the protocols in anticipation that we are likely to have the Delta variant.

Minister Chris Tufton, Covid Joint Slect Committee, July 20, 2021 (Transcribed from PBCJ recording)

The Clinical Management Summary posted by the Ministry of Health and Wellness (MOHW) yesterday, giving the figures for Tuesday (July 20, 2021) added to the concerns being expressed. The number of new cases recorded was 111, which was the first time since May 27, 2021, that the number of new cases recorded in a day had gone over 100; it was 108 on that day. Also, the positivity rate was 16.1%; a rate higher than that had not been recorded since May 5, 2021, when it was recorded at 18.7%

In Parliament on Tuesday, Prime Minister Andrew Holness made a statement regarding the Covid-19 situation and indicated that the Cabinet Covid-19 Sub-Committee would be meeting on the weekend and that if the trends continued, tighter restrictions might be announced. Such an announcement might be made next week Tuesday.

In an interview with Dionne Jackson Miller on RJR’s Beyond the Headlines yesterday evening, epidemiologist Professor Peter Figueroa expressed concern about the point that Jamaica is now at, with an increase in cases and a Reproductive rate of 1.1.

We are facing an imminent surge of the Delta, it’s probably the Delta variant and that can be very swift with an increase in cases. We need measures immediately….I’m concerned because we cannot afford to watch and wait. When you look at the data, when you start to get an increase in cases, it rises rapidly.

Professor Peter Figueroa, Beyond the Headlines, July 21, 2021 (Transcribed from recording)

There seems to be a general consensus that if the Delta variant is not actually here yet, it will be sooner or later. And there are many who see the recent increases as an indication that we are already on the verge of a third wave of Covid-19 in Jamaica.

PBCJ RECORDINGS OF PARLIAMENT

Meeting of Joint Select Committee on the Covid-19 Pandemic and Related Matters – Tuesday, July 20, 2021

https://www.youtube.com/watch?v=A0YqkijcuaQ

Sitting of Parliament at which PM Holness made statement about current Covid-19 situation in Jamaica – Tuesday, July 20, 2021

https://www.youtube.com/watch?v=rAjn-ewhgoI&t=391s