Right Steps & Poui Trees


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Chief Medical Officer’s Covid-19 Update for Oct 7, 2021

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.

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Covid Reflections: Children and this third wave

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.

Information taken from Ministry of Health & Wellness (MOHW) daily Clinical Management Summaries posted online.

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.

Slide from MOHW press briefing August 12, 2021

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.

Slide from MOHW press briefing August 12, 2021

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?
The chart on the MOHW jamcovid19 website doesn’t report children as a separate group, as seen in the 10-19 group and it doesn’t allow for observing trends over time.
  • 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.