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…
Jamaica’s Ministry of Health & Wellness (MOHW) had established a practice of weekly Covid-19 press conferences, usually held on Thursday evenings. For the past few months, however, this weekly practice has been less reliable, with gaps of a week or more occurring between press conferences. This was particularly problematic during the height of the current wave of the pandemic; fueled by the Delta variant, it has been the worst of the three waves Jamaica has experienced.
Yesterday was Thursday and I tweeted the MOHW a question about whether there would be a Covid Conversation (what the press conferences have been called for some time) and they responded saying no. This actually wasn’t much of a surprise, given that there had been a press conference last week and that the Ministry had been facing a lot of pressure and criticism from the public and in Parliament this week.
What was a surprise was to learn last night, via a Twitter thread by Gleaner journalist Jovan Johnson, that CMO Dr Bisasor-Mckenzie had given a recorded Covid-19 update, which was sent to the media by MOHW. This is not a common practice.
I am glad that this update was given. It is not a true substitute for a live press conference, but it does give the public some additional important information. Neither the text nor the video recording of the update has yet been posted online on the MOHW website. It was said that the video recording would be released by the Jamaica Information Service(JIS), but I have not seen a link on the JIS website. This all shows immediately the difference in access by the public compared to when MOHW press conferences are carried live by Public Broadcasting Corporation of Jamaica (PBCJ) and immediately posted on their YouTube channel. PBCJ has actually used some of the CMO’s recording in their news roundup today and in a special report.
I have posted here a copy of the text of the CMO’s update:
To illustrate the way in which these updates add to the information given in the daily MOHW Clinical Management Summaries, I will refer to this chart I compiled using some of the figures given in these summaries.
The hospitalization numbers in the daily reports show a strong downward trend but in her update yesterday, CMO Bisasor-McKenzie noted that daily hospital admissions have been increasing in the past week.
And she made the added comment, “This means that despite the trending down of hospitalizations, if the trend for admissions going up continues, our bed occupancy will increase.” This changes the perspective of our current situation somewhat.
Also of particular note in yesterday’s update are the comments about the delay in the availability of the 2nd dose of the Pfizer vaccine.
With so many ongoing issues, questions and concerns, it would be useful for MOHW to return to regular, weekly press conferences.
For convenience, I have included the statement below as well.
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.)
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.
Last week nearly 5000 new cases of Covid-19 were reported by the Ministry of Health and Wellness. One hundred and sixteen (116) deaths were reported, a figure which doesn’t reflect the exact number of deaths for the week, as it includes a number of people who died prior to last week and doesn’t include all those who died that week. Hospitalizations reached a high of 739, with many people reported as being moderately, severely or critically ill. The MOHW announced on Friday that all public hospitals would be accepting emergency cases only and general services would be suspended until further notice; this was because of the overwhelming increase in numbers of Covid-19 patients needing to be hospitalised. On Wednesday’s edition of All Angles on TVJ, staff at the Savanna-La-Mar Hospital spoke about the shortage of oxygen being experienced at that facility. In a press release this afternoon, the MOHW confirmed reports in traditional and social media that hospitals were short of oxygen and some had actually run out. (Press release is posted below.)
With the crisis now facing the health sector, with hospitals unable to cope with the numbers of Covid-19 patients, with resources being stretched thin and staff being overwhelmed, there are those who want to push a narrative that this could not have been foreseen; that it is hindsight to say that wrong decisions were made in relaxing the Covid restrictions in the way that they were relaxed in June and July. That we couldn’t have known how bad a 3rd wave would be.
When I hear that narrative, I think back to the presentation that CMO Dr Jacquiline Bisasor-McKenzie made at the MOHW’s Covid-19 press briefing on April 29 this year. At the time I took it as a public warning to the country – politicians and the public at large – of what science, medicine, public health were indicating about a 3rd wave. A warning that we needed to maintain strong restrictions and not open up too quickly, if we were to avoid a disastrous 3rd wave.
She spoke about the importance of bringing the reproductive number down to below 1, in order to reduce transmission of the virus, and the importance of strong public health measures to achieve this.
“That is what we want. No transmission. A reproductive rate that is tending towards zero. And that is why we had to have stronger measures put in place to bring down the numbers quickly because we were surpassing what our health system could manage.”
“So this graph is a little bit fussy but what it shows is the effect of the measures that we had put in place and how it is that after we had imposed restrictions on public gatherings, in terms of the use of places of amusement, when the reproductive number was high, close to 2, we would have introduced those measures and you would see the blue line would have dropped down below 1. When we would have increased our curfew hours – the curfew hours are in the orange – and you would see that when we increased the curfew hours as well, the blue line is down. However, when the curfew hours are decreased, when the measures – and ususally what happens is that we see that whatever we are doing is working – the restrictions are working, the numbers start trending down and then we start to feel that we need to open up and we need to allow more movement. And as soon as we do that, we see the reproductive rate going up and then shortly after the reproductive rate starts going up, then our numbers start going up again. So it is very important that we recognize that the use of restrictions, the use of curfew has positively impacted the decrease in the number of cases and to get the epidemic under control.”
“And what will happen if we do not maintain our restrictions? There is the possibility of a 3rd wave. We see that several countries have gone into a 3rd wave. I mean countries like Italy, Germany, Hungary, France, Poland, Spain, India, Pakistan, Bangladesh, Indonesia, Phillipines, Brazil, Peru, Iran; they have all gone into third phases.
And why has that happened? Because as soon as there was a decrease in the number of cases, persons started to become complacent and we started to lift restrictions. More movement. Persons started to feel that they had to have the freedom to have gatherings and there were mass gatherings in many of these countries. We can see very, very clearly what has happened in countries like India, where with the release of restrictions in February, they have now gone into a 3rd wave. It can happen to us.
It can happen to us because, as Minister has said, the test results have come back; it does indicate that we have quite a bit of the UK strain in country, which means that there is a high level of transmisssion coming up out of that strain. We have seen that the exposure in the 20-29 and the 30-39 age group is pretty high with a large number of infections. So if it is that we are not careful and do not continue to have measures that decrease exposure, then we can go into a 3rd wave.
And what will a 3rd wave look like? Our starting point is not going to be as low as it was in August last year or even in December of last year. We’re going to have higher starting points that are going to result in possibly very, very high rates…
Dr Bisasor-McKenzie laid out some of the indicators of what a 3rd wave could look like; she laid them out back at the end of April, 4 months ago. As many as 10,700 cases in a peak week, 180 deaths one week after a peak week and 1900 beds needed 2 weeks after a peak week.
Last week Thursday (August 26, 2021), National Epidemiologist Dr Karen Webster-Kerr said in an interview on Nationwide News Network that we were about 2 weeks away from the peak of this 3rd wave that we are now in. She said that in the coming week we could have as many as 140-150 deaths and a number 10-20 deaths higher the week after that.
And what are our numbers currently? Using the figures given in the daily MOHW Clinical Management Summary reports for Sunday, August 21 – Saturday, August 28, 2021, last week we had:
Total new cases: 4830 (This has exceeded the peak week of the 2nd wave, which had 4082 new cases; Saturday’s number of 929 is the highest single day total since the start of the pandemic.)
Positivity rate: Ranged from a low of 41.3% to a high of 50.7%, the first time it has gone above 50%. (The high in 2nd wave was 39.8%)
Hospitalisations: Went as high as 739 (This is confirmed cases only; the number in slide presentations combines confirmed and suspected cases, so would be higher than this.)
Deaths: 116 (This is the number of deaths REPORTED during the week; it includes some deaths which ocurred earlier than last week but were only reported last week. Also some deaths that occured last week have not yet been reported.)
All these indicators are going in the wrong direction.
It is clear that the scenario now playing out during this 3rd wave was certainly contemplated as being possible for Jamaica. Our Chief Medical Officer described what could happen during a 3rd wave, what could lead to a 3rd wave and what needed to be done to reduce the chances of a 3rd wave. At the time, the variant she spoke about was the UK or Alpha variant, which caused our 2nd wave. Within short order, it became clear that the more transmissible Delta variant (which originated in India and caused their devastating 3rd wave) was likely to be carried to Jamaica, probably from the US or the UK. The CMO, the National Epidemiologist, the public health professionals at the MOHW certainly would have forseen what would come with our 3rd wave.
Others in the society also warned about what could result from relaxing the restrictions too early, too fast and too far. It is possible to debate the reasons for the relaxation of the measures, the competing arguments around the decision. But let us not pretend that it is only with hindsight that one could say that the decisions made were wrong.
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.”
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…
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…
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.
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.
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.)
I have included a map of Jamaica showing the parishes, for ease of reference.
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.
The early narrative about SARS-CoV-2 and Covid-19 offered us some comfort at the time; at least it didn’t seem to affect children as much and we were thankful. As the pandemic continued, we saw that though children were infected at lower rates than adults and if infected generally had milder symptoms, it was clear that some children who caught the disease could have severe enough symptoms to be hospitalised and some children died. Others had serious side effects that lasted beyound the acute phase of the disease. But still we took what comfort we could from the fact that these severe outcomes affected children at a significantly lower rate than they did adults.
The Delta variant of Covid-19, which is becoming the dominant strain of the virus in many countries, is changing the narrative. Children are contracting the disease at higher rates and are being affected more seriously. Countries such as the USA are seeing more children being hospitalised and more children dying.
Although Jamaica still has had no genomic sequencing results to confirm the presence of the Delta variant here, we have been told we can assume that it is here. We have been told this by the Minister of Health and Wellness, by the Chief Medical Officer and, most recently, by the Prime Minister. They have pointed to the increases in the various Covid indicators and to the travel between Jamaica and countries experiencing surges due to the Delta variant, primarily the UK and the USA.
Jamaica is in the early stages of a third wave and the indicators are surging.
The daily number of confirmed cases has been rising sharply. Last week Sunday the number of newly confirmed cases was 281; on Saturday there were 656 new cases. At a press conference last Thursday, August 12, 2021, CMO Dr Bisasor-McKenzie shared a slide of the hospital admissions and pointed out that the average number of admissions (shown by the pink line in the graph below) was now just over 70 per day. She pointed out that this rate was already higher than the rate of admissions at the peak of the surge in March/April this year.
Many of the hospitals are already beyond their Covid bed capacity and their ICU beds are full. The pressure on the hospitals is at an extremely high level.
One of the hospitals that has exceeded its Covid capacity is the Bustamante Hospital for Children, the only hospital in Jamaica dedicated specifically to children. On Thursday, Director of the South East Regional Health Authority (SERHA) Errol Green said that the hospital is over capacity, which poses a problem, as patients can’t easily be transferred elsewhere. Various measures are being used to reduce numbers, including discharging children who can be sent home and not doing elective surgery, only emergency surgery.
So what exactly is the situation with children so far during this surge?
There have been references by officials to more younger people and children being treated for Covid-19. There have accounts of children and babies being admitted to hospital. And if the Covid beds at Bustamante are full, it signals an increase in the number of cases. But we need some specific information from the MOHW.
How many children have been confirmed with Covid-19 in the past 6-8 weeks?
Is this an increase in the rate that the data has shown perviously? If so, by how much? (The daily Clinical Management Summaries refer to babies as young as 1 day old among those confirmed with Covid-19, but the figures don’t tell us how many children are among those infected. Could a breakdown by age be done on a regular basis?
How many children have been admitted to hospital with Covid-19 in the past 6-8 weeks? Is this an increase over the rate of admissions seen previously? How many cases have there been of critically ill children?
Have any children died of Covid-19 in the past 6-8 weeks? Are any children’s deaths under investigation for Covid-19?
How many Covid beds are there at Bustamante Hospital? How many paediatric ICU beds?
How many paediatric Covid beds are there at other facilities across the island? And paediatric ICU beds?
Is life sustaining equipment for treating children in adequate supply at Bustamante Hospital? Is it available at other facilities across the isaland?
With Bustamante Hospital full, are children still being transferred there for treatment?
How is the Covid-19 situation affecting treatment of children with non-Covid conditions?
At the MOHW press conference last Thursday, it was announced that a shipment of Pfizer vaccines is due to arrive in Jamaica this week. Because this is the only vaccine currently cleared by WHO for children, priority is being given to children in its roll out. Children 12 and older with co-morbidities and children 15 and older with parental consent will be allowed to get vaccinated. This is scheduled to start on August 23, 2021. This is an important development. It does not come in time, however, for children to be fully vaccinated before the scheduled start of the school year in September. And it does not cover children under the age of 12.
But with the surge in Covid cases not yet at its peak, it is not likely and not advisible that face-to-face classes start in September as previously planned. And that raises a whole additional round of questions and concerns. For another time.
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.
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?
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.
In her presentation, National Epidemiologist Dr Karen Webster-Kerr indicated that all of the main Covid-19 indicators were moving in the wrong direction:
“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 PBCJrecording)
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.
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
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.
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
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.
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 shortages
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.
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”