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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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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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Disaster Risk Management Order No. 4, 2021 – Dated March 23, 2021 (& Amendment to Order No. 3)

The Gazette of Disaster Risk Management (Enforcement Measures) (No. 4) Order, 2021 containing the measures announced by Prime Minister Holness last Sunday (March 21, 2021) and spoken about in Parliament on Tuesday (March 23, 2021) was posted on the Office of the Prime Minister’s website yesterday (March 26, 2021).

Here is a copy of the gazetted order:

Also, for completeness, here is a copy of the amendment to the previous order – No. 3 2021 – dated March 12, 2021.


Disaster Risk Management Order No. 15 – Dated November 1, 2020

On October 28, 2020, Prime Minister Andrew Holness announced some changes to the Disaster Risk Management measures. The measures are detailed in the Gazette of Disaster Risk Management (Enforcement Measures) (No. 15) Order, 2020, a copy of which is posted below.

The gazetted Order has been posted on the Ministry of Health & Wellness website (scroll to the bottom of their page), but at the time of publishing this blog, it is not yet on the websites of the Ministry of Justice or the Office of the Prime Minister.


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New NIDS Bill to be Tabled in Parliament Shortly…and be Passed by Year End?

At the first session of the new Parliament on September 29, 2020, Prime Minister Holness made a statement about the National Identification System (NIDS) and laid out the timetable in which he hopes to see the new NIDS Bill passed into law. With legislation that will have such far-reaching impact and which has already been the subject of much controversy, it is important that adequate time is allowed for public review of the Bill before it becomes law.  I am concerned that the timetable laid out by the Prime Minister may not allow sufficient time for this much-needed public review.

In his statement in Parliament, PM Holness said that the draft Bill had been completed and was before the Legislative Committee (of Cabinet) and that it would be tabled in Parliament before the end of October. A Joint Select Committee of Parliament would then be established and it was his hope that the Bill would be passed by the end of the year.

In too many instances over the decades, the deadline given by Joint Select Committees for submissions hasn’t allowed adequate time for interested groups and individuals to review and analyse the draft legislation and prepare submissions. In the current situation, if the new NIDS Bill is tabled within the next two weeks, there would be only 7 to 9 weeks for the entire process to take place, if the Bill is to be passed into law before the end of December. That is,

  • for the Joint Select Committee (JSC) to be established to consider the Bill and make a call for submissions;
  • for the public to review the Bill and make submissions and appear before the Committee, if asked;
  • for the Committee to undergo its own deliberations, considering any submissions, and write and table its report to Parliament;
  • for both Houses of Parliament to consider the report and its recommendations and debate the Bill and pass it.

It may be that once the new Bill is tabled, it will have been so carefully drafted and will have addressed the concerns raised in the judgment of the Constitutional Court which struck down the old Act, and will have taken into consideration many of the concerns raised by the public prior to the passage of the old Act, that there will be few new or remaining concerns to be dealt with. But until we see the new Bill we will not know.

We can read the new NIDS policy that was published in April. We can read or listen to the PM’s statement to Parliament in September. But until the Bill is tabled, we will not know what it actually says and, to use the cliché, the devil is always in the details.

So, for example, the new policy and the PM have said that enrolment in the NIDS will now be voluntary, but how is this addressed in the Bill? Could a situation arise in which government or private sector entities could make the presentation of a NIDS card or number mandatory to access service, so that enrolling in NIDS becomes mandatory in fact or practice, if not in law? Need for discussion before passage into law?

Let’s not have a repeat of the previous experience where a self-imposed deadline drives the process by which the legislation goes through the Parliament. And whereas I agree with the PM that the process shouldn’t be boundless, it needs to be realistic in its allowance for genuine consultation and discussion. This allowance for adequate time before passage of the legislation may indeed forestall problems after its passage, as well as simply being in accord with good governance practices.

(Just to note that the PM spoke about a space on the NIDS website that will allow for public comments about the new Bill. This raises the need for other forums for public information and input before the Bill is passed.)

Relevant Documents

PBCJ recording of Sitting of House, September 29, 2020

https://www.youtube.com/watch?v=axnFC1Xet48

“…we intend to have the Bill through the Legislative Committee before the end of October. The Bill will come back to this House and out of an abundance of caution, I can state here that it will go to a Joint Select Committee, so that there is no opportunity for unnecessary delays and that if there are issues that arise in the traditional way, we deal with it in the Committee. And the public can have their say. At, you know, I don’t want to determine the Parliamentary process but one would expect that the process is not unlimited. There must be some bound to it. And therefore we would like before the end of the year, this year, that we should be seeking to pass the Bill into law. Madam Speaker, once the Bill is tabled in Parliament, as I said, we will have a Joint Select Committee to navigate it through the Parliament and we hope that the deliberations will proceed apace.” 

PM Holness’ comment re new NIDS Bill timeline – Transcribed from PBCJ recording of Sitting of the House, September 29, 2020


Prime Minister’s Covid-19 Statement in Parliament: October 6, 2020

In Parliament this afternoon (October 6, 2020), Prime Minister Andrew Holness made a statement about the current situation concerning Covid-19 in Jamaica and announced a number of changes to the measures pertaining to the management of the pandemic. These measures will be found in the Disaster Risk Management Order No.14, which is not yet available. Some of the measures went into effect at 6pm this evening; others go into effect tomorrow.

Below is the text of the Prime Minister’s statement and I have also included a link to the recording of today’s sitting of the House.

Two areas will have additional measures imposed because of a spike in the number of cases of Covid-19 that have been reported. They are Whitfield Town in Kingston and Waterford in St Catherine. The boundaries of the communities are given below:

The Public Broadcasting Corporation of Jamaica (PBCJ) recording of today’s sitting of the House can be found at this link and allows for the checking of the text of the PM’s statement against delivery.


Disaster Risk Management Order No. 13 – Dated September 23, 2020

The Gazette of the most recent Disaster Risk Management Order is now available and I have posted a copy below. Prime Minister Holness announced the new or amended measures at a press conference on Tuesday (September 22, 2020).

Checks this afternoon of the ususal Ministry of Justice and Office of the Prime Minister’s websites showed that the Gazette of the new Order was not posted there, but the Ministry of Health & Wellness tweeted out a link to Order No. 13 on its website, which was a surprise.


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Disaster Risk Management Order No. 11 – Dated July 31, 2020

The Gazette of the Disaster Risk Management (Emergency Measures) (No. 11) Order, 2020 is available. It contains measures announced by Prime Minster Holness in Parliament on Tuesday, July 28, 2020. Many of the measures will expire on September 30, 2020, unless amended prior to that date.

Disaster Risk Management Order No 11 cover blog pic

The Disaster Risk Management (Enforcement Measures) (No. 11) Order, 2020 – July 31, 2020

Order No. 11 is posted on the websites of the Ministry of Justice and the Office of the Prime Minister.

House of Representatives Sitting on July 28, 2020.

The Prime Minster’s statement begins at approx 3:42:35 of the recording.

 


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Gazette of Disaster Risk Management Order No. 8 – Dated June 15, 2020

The electronic copy of the Gazette of the most recent Disaster Risk Management (Enforcement Measures ) Order has now been posted on the websites of the Office of the Prime Minister and the Ministry of Justice. This is Order No. 8. The hard copy was not yet available from the Jamaica Printing Services when I called this morning (June 19, 2020).

Here is a copy of the Gazette:

Disaster Risk Management Order No 8 blog pic

The Disaster Risk Management (Enforcement Measures) (No. 8) Order 2020 – June 15 2020

Order No. 8 is firmly dated June 15, 2020, though it obviously wasn’t gazetted on that date. On Tuesday night (June 16, 2020), Prime Minister Andrew Holness brought the draft order to the House for discussion, as has been his practice. No copies of the draft order were circulated to the Members of Parliament, which has been the recent practice.

AG Malahoo Forte Parliament 16-6-2020 PBCJDuring the discussion, Attorney General Marlene Malahoo Forte responded to a question that had been posed by an Opposition MP and her preface to her response makes clear that the Gazette of Order No. 8 was not available at the time.

All right, so the Disaster Risk Management Enforcement Measures Number 8 Order was promulgated by the Prime Minister last week taking, took effect on the 15th, which was yesterday. This is the non-gazetted, it is being gazetted and should be completed by now, but this is it. You will see a number of improvement, clarity. Right, I’m just telling you. So, it, the law does not require the Order to be laid in the House, but it’s going to be brought here.

– Attorney General Malahoo Forte, Parliament, 16-6-2020

The PBCJ recording of the sitting of the House is available and the Attorney General’s comments begin at approx 5:47:40 in the recording.

Tracking when the Gazettes of the Covid-19 Orders become publicly available has really raised fo me the issue of the dating of the Gazettes containing these Orders, as the Gazette often carries a date prior to the date when it seems that the gazetting has actually taken place.

How is the date for the Gazette determined? Is it the date on which the measures are first broadcast by the Prime Minister, but not yet gazetted? Or the date on which measures come into effect, but not yet gazetted? Or when the final draft copy is sent for gazetting? Or when the Gazette is actually printed?

It is an obscure process, but can have some significant consequences. I will try to find out more.

I am also posting here a copy of an amendment that was made to the previous Order, Order No. 7. Just for completeness.

Disaster Risk Management Order No. 7 Amendment

The Disaster Risk Management (Enforcement Measures) (No. 7) (Amendment) Order 2020 – June 1 2020


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Information Sharing Events: #COVID19 #Jamaica

Yesterday (March 10, 2020) Jamaica announced that it had its first confirmed case of the coronavirus COVID-19, a young Jamaican woman who had arrived in the island from the UK…

“…on March 4, presented to the public health system on March 9 and has been in isolation since then.

Based on the patient’s travel history and symptoms, health professionals suspected COVID-19. A clinical sample was collected and sent to the
National Influenza Centre, where laboratory tests confirmed the diagnosis
today at approximately 11:00 am.”

Minister Tufton – Press Statement re Corona Virus March 10 2020

Today (March 11, 2020) the World Health Organization classified the COVID-19 outbreak as a pandemic.

“In the past two weeks, the number of cases of COVID-19 outside China has increased 13-fold, and the number of affected countries has tripled.

There are now more than 118,000 cases in 114 countries, and 4,291 people have lost their lives.

Thousands more are fighting for their lives in hospitals.

In the days and weeks ahead, we expect to see the number of cases, the number of deaths, and the number of affected countries climb even higher.

WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction.

We have therefore made the assessment that COVID-19 can be characterized as a pandemic.

Pandemic is not a word to use lightly or carelessly. It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.

Describing the situation as a pandemic does not change WHO’s assessment of the threat posed by this virus. It doesn’t change what WHO is doing, and it doesn’t change what countries should do.

We have never before seen a pandemic sparked by a coronavirus. This is the first pandemic caused by a coronavirus.

And we have never before seen a pandemic that can be controlled, at the same time.

WHO has been in full response mode since we were notified of the first cases.

And we have called every day for countries to take urgent and aggressive action.

We have rung the alarm bell loud and clear.”

WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020

Online link here

Within the last week there have been a number of events aimed at sharing information about the COVID-19 disease generally and about the disease in the context of Jamaica. Most of these events took place before the first case was identified in Jamaica and the situation is developing rapidly around the world and here as well. But I wanted to pull together in one place some of the information events here and that is the simple purpose of this blog post.

March 10, 2020 – Ministry of Health & Wellness Press Briefing on 1st Case of Coronavirus confirmed

MOHW Covid-19 press briefing 10-3-2020

Unfortunately the Public Broadcasting Corporation of Jamaica recording doesn’t start right at the beginning of the press briefing, but the full text of Minister Chris Tufton’s statement can be seen in the first document in this blog post. And there is a full recording on Prime Minister Holness’ Facebook page.

March 8, 2020 – Minister of Health’s National Statement: COVID-19 Comprehensive Response Plan

Minister Tufton COVID-19 National Statement 8-3-2020This National Statement was broadcast on Sunday night on most of the main radio and television stations. I cannot find the text of it on the Ministry of Health website, however. Perhaps they will post it at some point.

What I also haven’t yet seen is a published copy of the Comprehensive Response Plan document and I don’t yet know when or if the government intends to make it public. I think it should be made public.

March 5, 2020 – University of the West Indies (Mona) Faculty of Medical Sciences, COVID-19 Pandemic Preparedness Conference

UWI Faculty of Medicine COVID-19 conference 5-3-2020

Dr Tomlin Paul, Dean of the Faculty of Medical Sciences, chaired this conference at which seven presentations were made on a variety of aspects of the situation. The presenters were:  Professor Celia Christie, Dr Carl Bruce, Dr Sandra Jackson, Dr Karen Webster-Kerr, Dr Christine Clarke, Professor Wendel Abel, Professor J. Peter Figueroa and their presentations were followed by a Q & A session. It was a very informative event and was streamed live, which extended the reach greatly.

March 5, 2020 – Meeting of the National Disaster Risk Management Council

National Disaster Risk Management Council 5-3-2020

The Council is headed by the Prime Minister and at the meeting he and a number of other Ministers and agency heads made presentations focused on COVID-19.

The situation continues to evolve and the need for timely official information is ongoing.