Right Steps & Poui Trees


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

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

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

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

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

A small sampling of examples…

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

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

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

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


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“…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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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.