Right Steps & Poui Trees


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

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

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

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

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

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

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

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

Interesting.

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Covid Reflections: Delta Variant Confirmed & Deaths Increase Sharply in August

We are in our third wave of Covid-19 in Jamaica.

MOHW slide – OPM press briefing 19-8-21

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.

MOHW slide – OPM press briefing 19-8-21

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.

MOHW slide – OPM press briefing 19-8-2021

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.)

Compiled from MOHW daily Clinical Management Summaries

I have included a map of Jamaica showing the parishes, for ease of reference.

Map of Jamaica showing parishes

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.


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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


UWI Mona Faculty of Medical Sciences Covid-19: Approaching Code Red Teleconference, April 19, 2020

Yesterday (Sunday, April 19, 2020) the Faculty of Medical Sciences at the Mona Campus of the University of the West Indies (UWI Mona) held a very timely and informative teleconference on Covid-19. This teleconference was held in collaboration with the Mona Information Technology Services and was live streamed and the recording of the teleconference is now available online.

Dr Tomlin Paul, Dean of the Faculty of Medical Sciences, was the moderator for the teleconference and he referred in his opening remarks to the previous conference the Faculty had hosted on March 5, 2020 – Covid-19 Pandemic Preparedness Conference. At that time Jamaica had not yet had a confirmed case of Covid-19, but shortly afterwards the pandemic emerged in the region. As Dr Paul said, the context for yesterday’s teleconference was one in which there were now cases throughout the region and the focus was on where things currently stood – nationally, regionally and globally – and relevant actions to be taken.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 b

The first presenter was Dr Karen Webster-Kerr, National Epidemiologist for Jamaica and she spoke about monitoring and assessment of Covid-19 in Jamaica and the current status of the epidemic the country.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 c

Presentation begins at approx 5:30 minutes into the video recording

Next was Professor Celia Christie, Professor of Pediatrics (Infectious Diseases, Epidemiology and Public Health), whose presentation was titled “Unraveling the Natural History of Covid-19”.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 d

Presentation begins approx 16 minutes into the video recording

The third speaker was Dr Kelvin Ehikhmetalor, a lecturer in the Dept of Surgery, Anaesthesia and Intensive Care, who is the Director of the Intensive Care Unit of the University Hospital of the West Indies (UHWI). He spoke on Therapeutics and Pharmacological Treatment of Covid-19.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 e

Presentation begins approx 35 minutes into the video recording

Then Dr Josh Anzinger of the Department of Microbiology (Virology) gave his presentation: Who to Test, What Lab Test & When?

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 f

Presentation begins at approx 1:10:00 in the video recording

The fifth presenter was Professor Peter Figueroa, who is Professor of Public Health, Epidemiology and HIV; he spoke on Success Stories in the Containment and Control of Covid-19.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 g

Presentation begins at approx 1:33:00 in the video recording

Professor Figueroa was followed by Dr Sandra Jackson, a lecturer in the Department of Microbiology. Her presentation was on the Behaviour of Sars-Cov-2 from Wuhan to Jamaica.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 h

Presentation begins at approx 1:54:00 in the video recording

The seventh presenter at the teleconference was Professor Denise Eldemire-Shearer, Professor of Aging and Public Health. Her presentation was titled: Protecting the Vulnerable – Seniors and Pre-existing Conditions.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 i

Presentation begins at approx 2:16:00 in the video recording

The next presentation was given by Pro-Vice Chancellor Ambassador Richard Bernal and he spoke on the Post Covid-19 Pandemic Economic Outlook.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 j

Presentation begins at approx 2:40:00 in the video recording

Professor Wendel Abel, Professor of Mental Health and Head of the Department of Community Health & Psychiatry, was the final speaker at the teleconference. He spoke on Hope in Uncertain Times.

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 k

Presentation began at approx 3:05:00 in the video recording.

It was a good conference, covering a wide range of topics, providing a lot of information, some of which was fairly technical, but a lot of which was accessible to the layman and general public. Congratulations to the Faculty of Medical Sciences for the second of their Covid-19 conferences!

UWI Mona Faculty of Medical Sciences Covid-19 Approaching Code Red teleconference 19-4-2020 l

Context for the Conference

April 18, 2020 – Ministry of Health & Wellness press release

MOHW Covid-19 press release 18-4-2020 p 1MOHW Covid-19 press release 18-4-2020 p. 2

April 19, 2020 – Ministry of Health & Wellness press release

MOHW Covid-19 press release 19-4-2020

The Ministry of Health and Wellness website has a specific Covid-19 page on which information can be gained.

My blog post on March 11, 2020 focused on information available at the time, including the first Faculty of Medicine Covid-19 conference.

Information Sharing Events: #COVID19 #Jamaica

 

 

 

 

 


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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.