Right Steps & Poui Trees


350 Words or Less: A Picture Worth Some Number of Words…

While on Twitter today, I saw a photo attached to a Ministry of Health & Wellness tweet…

…that I thought was worth some number of words, if not a thousand. Here it is…

L to R : Minister Chris Tufton, Permanent Secretary Dunstan Bryan, Dr Karen Webster-Kerr, Professor Peter Figueroa, Dr Joy St. John

It was taken on September 15, 2022, at the opening ceremony of the recently held 66th Health Research Conference of the Caribbean Public Health Agency (CARPHA), which took place in Jamaica.

Note who in the front row are wearing masks and who are not.

Wearing masks: National Epidemiologist, Professor of Public Health, Epidemiology & HIV/AIDS at the University of the West Indies, Executive Director of Caribbean Public Health Agency

Not wearing masks: Minister of Health & Wellness, Permanent Secretary in the Ministry of Health & Wellness

Interesting.


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Reintroducing the Mask Mandate…Yes, but When?

On March 17, 2022, when the use of the Disaster Risk Management Act (DRMA) for Covid-19 management orders ended, the general mask mandate ended.

On March 18, 2022, under the Public Health Act – Public Health Enforcement Measures (Coronavirus Covid-19) Order 2022 – a mask mandate for enclosed spaces came into effect and was scheduled to expire on April 15, 2022.

On March 22, 2022, Minister of Education Fayval Williams confirmed to Morning Agenda host Jodi-Ann Quarrie that the wearing of masks was no longer mandated for schools. Highly recommended but no longer mandated.

On April 15, 2022, the mask mandate under the Public Health Act Covid-19 Order expired and was not renewed.

On May 18, 2022, at a Ministry of Health & Wellness (MOHW) press briefing, Minister Chris Tufton officially confirmed what others had been saying, that Jamaica was now experiencing a 5th wave of Covid-19. He said the wave was probably caused by the highly transmissible Omicron BA.2 subvariant and had an inflection point of around April 20, 2022.

At the May 18, 2022 MOHW briefing, Minister of Education Fayval Williams confirmed that an increase in Covid-19 cases in schools was being reported.

On May 19, 2022, via a General Bulletin, the Ministry of Education and Youth (MOEY) informed school administrators that “the wearing of masks is mandatory at school effective immediately and until further advised.” The general public learned of this reintroduction via the media…social and traditional.

On May 20, 2022, while speaking at a handover ceremony in St James, Prime Minister Andrew Holness said that “It is going to be a requirement shortly for all of our citizens to return to wearing their masks.” This was widely reported in the media, with clips of the PM’s words.

On May 22, 2022, Jamaica Information Service (JIS) published a report about the PM’s statement titled “Gov’t To Reintroduce Mask Mandate”.

But here we are, on May 30, 2022, ten days later, with no mask mandate reintroduced and with no indication when…or if…this reintroduction of the mask mandate will take place.

Quite frankly, this inaction and lack of certainty is unacceptable. We have heard nothing further since Prime Minister Holness spoke about it. Was it an off the cuff statement to ease the pressure at the time but with no substance to it? Or has the PM changed his mind since? Or have the public health experts at the MOHW advised that the reintroduction of a mask mandate isn’t necessary, advice which they have supported with scientific data or references?

The PM has left us hanging. Not a comfortable position to be in at the best of times. And a Covid-19 wave, however gentle when compared to previous waves, is not the best of times. The public is entitled to some clarity on this. PM Holness? Minister Tufton? CMO Bisasor-McKenzie?

(And, yes, I know that we keep being told that these are policy decisions. And advice from the technical experts to the Cabinet is privileged. And that is the convention. But I increasingly question this convention, as decisions on serious public health matters during a pandemic are being made, with the public not entitled to know if our government’s decisions are in line with or contrary to the advice being given by public health experts.)

Below is a chart showing some of the MOHW numbers for the past 2 weeks.

And the report for yesterday has just been released…

View reports on the MOHW website


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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.


Two Events in 24 Hours: A Signal of the Level of Covid Concern?

Yesterday evening (December 15, 2021), the Ministry of Health and Wellness (MOHW) held its first Covid Conversation press conference in nearly two months; the last one was held on October 26, 2021. This morning, Parliament’s Joint Select Committee on the Covid-19 Pandemic and Related Matters, chaired by Minister Tufton, met for the first time since July 20, 2021, five months ago. (If they’ve met more recently than that, I would stand corrected.) After months of these events not being held, two within 24-hours. That signals a level of concern about what is likely to be happening with Covid come the new year and a desire to signal this concern before the news and information lull that comes with the Christmas holidays.

We are right now in a comparatively good place regarding Covid-19 in Jamaica. Today National Epidemiologist Dr Webster-Kerr noted that for the first time in months the 7-Day Average for our Positivity Rate is below 5%. It is 4.9%.

She also said that we have now come out of our 3rd wave, which peaked in September, and that we are in what could be considered an inter-wave period. The number of confirmed cases has been coming down steadily, though there might be a little leveling off, she said.

Additionally, the pressure on hospitals at this time is not from Covid-19 patients, with all four of the health regions being well below 50% of their Covid-19 related capacity.

In almost all of the Covid-19 indicators, we have been moving in the right direction. Dr Webster-Kerr said:

“This is the picture. It’s looking good at this time but we have to be careful, in that for most of the indicators we are above where we were in between the 2nd and 3rd waves. So we can still increase rapidly, if we are going into the 4th wave.”

She did also note that the vaccination level is too low to have an effect on transmission, though it is having an effect on severe disease and deaths.

For weeks we have had warnings from many quarters, including the Prime Minister, the Minister of Health, the Chief Medical Officer, various medical bodies, individual doctors, epidemiology and public health experts, that we should expect a 4th wave, most likely starting in January. The identification of the new Omicron variant in late November has made this likelihood more of an inevitability.

The warnings were repeated at both the Covid Conversation yesterday and at the Joint Select Committee (JSC) meeting today. The holding of the two meetings in such quick succession signals the level of concern that there is about the 4th wave and the need to give the country an update before Christmas, with its associated activities that are likely to contribute to that wave.

In the discussion about the Omicron variant at the JSC today, Minister Tufton said:

“I would venture to say, and at the risk of appearing to be an alarmist, that’s not my intention, but I would venture to say, given what we know of this season and the interactions that are likely to take place, cross border interactions, whether diaspora or tourism related, it is highly likely that if the virus isn’t here already, it is highly likely that it will be here after the holiday season. And I think we have to be frank about this, I think we have to make it clear to the country, which is why we have continued to emphasize the wearing of the mask, physical distancing, the observation of the protocols around gatherings and indeed, where one is in doubt because they have symptoms or feel exposed, they should get tested. It is part of the preparation for the 4th wave because we do not believe that we, as an open society where we depend whether on trade or travel in one form or another, that it is going to be a permanent situation to keep the variant out. It’s just not practical. And I suspect the holiday season will only serve to add a greater risk or probability of that happening.”

So two events in 24 hours. After months without them. With everyone on the verge of pivoting to Christmas and year end activities. Let it not be said, however, that the year ended without these two mechanisms being resurrected to warn about the 4th wave and update about the preparations for same.

PBCJ Recording of Joint Select Committee on the Covid-19 Pandemic and Related Matters, December 16, 2021


In Parliament, a Question & an Answer About Covid-19 Testing in Schools

In Parliament last week Tuesday, November 30, 2021, Minister of Health and Wellness Chris Tufton made a statement in Parliament about the current situation regarding Covid-19 in Jamaica.

One of the questions put to him following his statement was from MP Julian Robinson:

“Minister, I just have one question and really recommendation. As we move forward to reopening schools, I believe it is imperative that we allow and provide testing in the schools. What is going to happen without testing in the schools, when the children get sick, their parents can’t afford the significant fees to privately test them. They’re going to keep sending them to school because they don’t have either the support at home to keep them at home. So gonna have sick children continue to go to school. It might mean doing the antigen test which is cheaper than the PCR test. But as we move to reopen the schools, we must have some capacity particularly in larger schools. I mean Excelsior in my constituency is 2200 students, right? You’re bound to have sick children infecting others and right now it is too difficult, it is too expensive, for persons to get tested.”

MP Julian Robinson, Parliament, November 30, 2021 (transcribed from PBCJ recording)

Minister Tufton responded:

“So, Madam Speaker, I think it’s a…there’s no difference of opinion there. The reality is that the school population is going to be a point of vulnerability, not so much, to be totally frank, for the students, who could weather the storm, so to speak, in terms of the virus, because they are stronger, stronger immune systems, but more so for those they take it home to. Their parents and grandparents. And we still have a large unvaccinated population among that older age cohort. Which is why we have to pursue a dual strategy – promote vaccination among the older population and offer protection to our young people to get to face-to-face.

Testing will be available based on an assessment of conditions or symptoms and I am prepared to ask too for some amount of random testing as part of sort of just sampling a population. And I think that can be easily organised because contrary to popular opinion that I have seen on social media and so on, the government provides free testing. I do appreciate that you can’t just go and request it because it is given based on a doctor’s assessment. Now where a school has a sick bay or otherwise – because we’re always in touch with the schools, we’re putting protocols in place – and a child displays the slightest symptom, then they’ll be automatically tested and a conclusion drawn in order to protect the rest of the population. So, I’m with you on that.” 

Thank you, Madam Speaker.

Minister Chris Tufton, Parliament, November 30, 2021 (transcribed from PBCJ recording)

So Minister Tufton says that testing will be done on children who are symptomatic, though it is known that many people who have Covid-19 are asymptomatic. No mention is made of rigorous testing protocols in schools where a child has tested positive or where a child has been exposed to Covid-19 in a setting other than school. What level of contact tracing will be done where a child does test positive? And what notification protocols are in place to inform other students, parents/families and staff when there has been a confirmed or suspected case in a school? And what level of testing is meant by “some amount of random testing as part of sort of just sampling a population”? Perhaps Minister Tufton could be more specific.

Additional resources

In Parliament on that same day, Minister of Education Fayval Williams delivered a statement dealing with the expansion of face-to-face classes in more schools. Below is a copy of the text of her statement:

Also, here is the link to the PBCJ recording of the sitting of Parliament that day – November 30, 2021.


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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


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Jamaica’s #COVID19 Vaccination Plan: Two documents posted by the Government today

At a press briefing this morning (March 2, 2021), the Ministry of Health and Wellness representatives gave more details about Jamaica’s plans for vaccinating people against Covid-19. The first batch of vaccines is slated to arrive in the country this week and vaccination is planned to begin soon thereafter.

Left to right: Permanent Secretary Dunstan Bryan, Minister of State Juliet Cuthbert-Flynn, Minister Christopher Tufton, Chief Medical Officer Dr Jacqueline Bissasor-McKenzie. Also participating Dr Melody Ennis, Director of Family Health Services (Pictured at top right Antoinette Aiken, providing sign language interpretation)

Now posted on the Ministry of Health & Wellness website are an updated copy of the National Covid-19 Vaccine Deployment & Vaccination Interim Plan Version 1.0 and the Interim Vaccination Logistics plan. I have posted copies of both documents below:

Also here is the link to the PBCJ recording of the press briefing.


So Much Happening So Quickly! #COVID19 #Jamaica

A friend called me late Friday afternoon (March 13, 2020) simply to share her feelings of unease. We agreed that it felt as though we were on the brink of a major event or shift, that it felt as though we were living into a period of grave change. Much has happened since that call that bolsters the feelings we were experiencing that Friday the 13th afternoon.

Somewhere in the wee hours of that day, Jamaica’s Ministry of Health & Wellness had issued a press release giving a delayed update regarding the status of Covid-19 cases in the country, indicating that there were six new cases on the island.

MOHW press release - covid 19 update 13-3-2020

Jamaica has confirmed six new cases of the Coronavirus Disease 2019 (COVID-19) on the island.

The cases, which bring to eight the number of confirmed cases, include:

  • Two males, aged 63 and 67, who came into the island on March 7 from Trinidad, having travelled from Malaysia by way of Dubai and London. They presented at hospital on March 11.
  • One male, 36, who travelled from Manchester, England. He was taken to hospital from his hotel via ambulance on March 11.
  • One male, 31, a Jamaican overseas ship worker who came in from the Canary Islands via Portugal and Miami. He arrived in the island on February 25 and presented to hospital with symptoms on March 10.
  • One male, 58, who is the father of the first patient who was confirmed with COVID-19. He was discovered ill at home on March 11.
  • And one female, 34, who is a close contact, also of the first patient who was confirmed with COVID-19 on the island.

The Minister of Health and Wellness Dr the Honourable Christopher Tufton will meet with the media on Friday afternoon to provide further details. He is currently examining the level of preparedness for COVID-19 in western Jamaica.

Ministry of Health & Wellness Press release, March 13, 2020

https://www.moh.gov.jm/jamaica-confirms-6-new-covid-19-cases/

I had watched the rather bizarre press conference held by the US President at the White House that afternoon, which once again illustrated the problematic nature of the federal response to COVID-19 in that country. I had seen reports of the Cayman government’s measures announced that afternoon, in the context of their first confirmed case. (He was a passenger on a cruise ship, who had been hospitalized in Cayman with serious heart problems, who later showed symptoms of COVID-19 and unfortunately died. Medical staff were exposed to the virus while caring for him before he showed symptoms and the hospital has now been closed for two weeks.) The measures included no cruise ships being allowed for 60 days, schools being closed until April 27 and gatherings of 50 or more people being banned.

I had been waiting for the promised press conference by the Jamaican authorities to update the country on the new confirmed cases, initially announced for 2pm, but which got underway after 6pm. You can watch the full recording on the PBCJ YouTube page or on Prime Minister Holness’ Facebook page.

Holness covid 19 - 13-3-2020

Prime Minister Andrew Holness at COVID-19 Press Briefing, March 13, 2020

Some major developments were announced at that press briefing, at which the following officials also spoke: Minister of Health & Wellness Chris Tufton, Chief of Defence Staff of the JDF Rocky Meade, Commissioner of Police Antony Anderson, Chief Medical Officer Dr Jacquiline Bisasor-McKenzie, Attorney General Marlene Malahoo Forte, Permanent Secretary in the Ministry of Health & Wellness Dunstan Bryan, Minister of Foreign Affairs & Foreign Trade Kamina Johnson Smith, Minister of Local Government & Community Development Desmond McKenzie, Minister of Science, Energy & Technology Fayval Williams, Minister without Portfolio in the Ministry of Economic Growth and Job Creation with responsibility for Land, Environment, Climate Change and Investments Daryl Vaz and Minister of Tourism Edmund Bartlett.

Some of the developments announced included:

  • the declaration of the entire Jamaica as an area of disaster
  • the quarantining of the communities of Seven & Eight Miles, Bull Bay, St Andrew, because of need to check for evidence of community spread of COVID-19 (related to the first confirmed case in the country)
  • the adding of the United Kingdom to the list of countries on which travel restrictions have now been placed
  • the expansion of isolation areas across the country
  • efforts to increase the number of medical professionals to deal with the situation, including 21 specialist nurses arriving from Cuba on March 24 & requests for retired nurses to return to service
  • the restriction of visits to government golden age homes and infirmaries for the next 15 days
  • special arrangement for increased trucking of water to areas experiencing water shortagescovid 19 seven miles quaratine graphic

 

Since Friday, there have been additional developments related to COVID-19 here:

March 16, 2020 – 5 More Preliminarily Confirmed

In a press release sent out shortly after midnight this morning, the Ministry of Health & Wellness notified that there were 5 more preliminarily confirmed cases in the country. With the two cases confirmed yesterday (March 15, 2020), this brings the current total of confirmed cases in Jamaica to fifteen.

MOHW Covid-19 press release 16-3-2020

March 15, 2020 – 2 More COVID-19 Cases Confirmed; 17 test negative

Press Release from the Ministry of Health & Wellness

“The Ministry of Health & Wellness is reporting that two new cases of COVID-19 have been confirmed in the island. This is following the results from the National Influenza Centre, where 19 tests were conducted in the last 24 hours. Seventeen (17) of the cases tested were negative.

The country now has a total of 10 confirmed cases. One of the new cases was identified through contact tracing relating to the index case (Patient 1), while the second patient presented at hospital with a travel history to Trinidad and Tobago and had symptoms similar to COVID-19. Both persons were isolated and samples collected and tested.

The seventeen (17) other patients, who tested negative, included persons who are from Kingston and St. Andrew, St. Ann and Clarendon and who were identified through contact tracing from confirmed cases, where a similar protocol was observed to isolate and test.

Up to Saturday, March 14, 2020, 27 patients were in isolation facilities. They remain stable, including patients 1 and 2, who no longer have symptoms. Patients whose test results are negative will be released shortly.

The Ministry wishes to remind all persons, who suspect that they have had exposure to COVID-19 and are displaying symptoms to self-isolate immediately and contact the Ministry of Health & Wellness at 888-ONE-LOVE (663-5683) or 888-754-7792 for further instructions”

https://www.moh.gov.jm/2-more-covid-19-cases-confirmed-17-test-negative/

We’ll see what today and the week ahead bring.