Bula Vinaka.
This evening I wish to discuss with you how we are now seeing important shifts in the COVID-19 situation in Fiji.
Today we have 205 new cases of COVID-19 to confirm. It is not the total number of cases, but the location of these cases that is of greatest concern. We are now managing outbreaks in multiple locations across Fiji, including in some remote areas with limited healthcare infrastructure.
Outer Islands Response
As you are no doubt aware, the virus has now spread out of Viti Levu to Kadavu, Malolo island, and Naviti island in the Yasawa group. We have confirmed 29 new cases on Kadavu adding to a total of 164 active cases reported on the island. There remain 23 active cases reported in Malolo Island with investigations and further testing of contacts continuing.
We have dispatched a 55-member response team to Kadavu this week to assist with containment efforts on the island and offer treatment for those who develop severe disease.
In response to the situation in Malolo Island, we have deployed a public health team to rapidly map out a plan to contain the virus and also identify community members who are most at risk of severe disease. To ensure we are allocating our health resources best, all operations in Vunibaka are to stop immediately.
For Somosomo Village in Naviti, we expect the impact to be more severe. Over the weekend we will be deploying a team to Naviti to develop a plan to increase our capacity to provide critical care to patients, as well as put in place protective measures for those most vulnerable.
Unfortunately, our investigations and deployment to Kadavu, Malolo and Naviti have been delayed due to bad weather conditions, however over the coming days we hope to see quick measures being placed in these new areas of concern.

Northern Division Response
In response to the cases reported today in the Northern Division, the Namara Tiri Settlement has been placed into lockdown. Check points will be set up at the 2 road entry points into the settlement.

The Nabouwalu index case –– the first Labasa case we confirmed –– is in stable condition and the members of their family have continued to test negative for the virus. All primary contacts’ exit swabs have also returned negative.

As regards to the three positive cases in Namara Tiri Labasa, so far, we have established 60 primary contacts. All have been swabbed and have returned negative results. There are ongoing investigations to verify the final number of contacts.

Screening teams are sweeping the containment zone today and have collected 84 total swabs. Screening and swabbing is also being conducted at vaccination sites and all health stations in the Labasa area.

Most families in the Namara Tiri lockdown area are low income earners and we know they will be heavily impacted by this lockdown. This is why we will be providing essential food and supplies to households in the lockdown area, with our teams making sure that COVID-19 safe measures are put in place when delivering these items.

Our contact tracing teams have identified the places where the second COVID-19 case went, and because of this we will be placing a restricted movement for the greater Labasa Town Area. The reason for this is to reduce the risk of the virus spreading out of this area, as well as allowing time for our health teams to undertake screening of the local population. Under this restricted movement, the following measures will apply  to the greater Labasa Town area from tomorrow: 
●     Curfew will be from 8pm to 4am. If more cases are detected, these hours may change.
●     Until further notice, all persons in a public place in the Provinces of Bua and Macuata, must wear a face covering, except with reasonable excuse. Children under 5 years are exempt from this requirement.
●     The following essential businesses can remain open, but must apply strict COVID-19 protocols:
○     Supermarkets and shops selling food
○     Banks
○     Pharmacies; and  
○     FNPF
●     Restaurants can only open for delivery and takeaway services, no in-person dining.
●     Other businesses, such as factories and shops, can open but must apply the following measures:
○     Vendors and businesses must ensure strict physical distancing. Customers in ques must be spaced two metres apart and no crowding.
○     Customer-facing businesses should limit customer capacity to 50%.
○     Businesses that do not manage these risks with COVID-safe plans will be shut down.
●     Within the Labasa Town Area, higher-risk businesses, such as gyms, movie theatres, video gaming shops, cyber cafes, taverns, bars, billiard shops and amusement arcades cannot open for at least the next 14 days.
We know that when applied and followed by the public, these strict containment measures are successful in reducing the spread and allow our health teams to identify and isolate people who may have been infected with the virus. In the North, this will buy us precious time needed to allow our vaccination teams to reach all eligible adults for vaccination, in particular those most at risk of severe disease.

We are also strengthening our network of Northern screening clinics and encourage anyone who has COVID-18 symptoms to visit one immediately. We request that if people have these symptoms they do not go to their normal health centre as this puts other individuals at risk of the virus.
COVID-19 Deaths
We have eleven COVID deaths to report today. Three were fully vaccinated individuals who had existing medical conditions that placed them at higher risk of severe disease. I know that some of you have heard the recent claims made by certain members of the community that vaccines don’t work, but I want to start by reminding you that COVID-19 vaccines provide a person the best protection from becoming seriously ill, hospitalised or dying from COVID-19.
Global studies and what we learn from other countries like the UK, show us how effective these vaccines are at reducing the number of persons who become seriously ill, hospitalised or dying from COVID-19 by providing a person up to 92% protection. However, like any other vaccine, there is a small chance that people who have been partially or fully vaccinated can still get infected with COVID-19. And sadly fully vaccinated people can still get severe COVID-19 and die. 92% is not 100%. No vaccine offers 100% protection. Because the effectiveness of vaccines depends on an individual’s immune response, the risk of death in fully vaccinated individuals increases if someone has a medical condition that weakens their immune system (e.g. diabetes, heart disease, chronic kidney disease, obesity) or they are in an older age group. These deaths in fully vaccinated individuals are rare, however we can expect to see these as we continue to see widespread transmission in our community. 
However, the evidence is very clear that vaccines lower your risk of severe disease and death if you get infected with COVID-19. Of the 477 deaths recorded in Fiji during this outbreak: 371(77.8%) were not vaccinated, 103 were partially vaccinated (21.6%), and 3 (0.6%) were fully vaccinated. Therefore, 99.4% of people who have died due to COVID-19 in Fiji were not fully vaccinated.
Also, of the 11 deaths reported today, 2 were children. These losses show us a new picture of how the virus is impacting our community. The death of a child is always terrible and sadly COVID-19 does not discriminate. Whilst we know children are at significantly lower risk of suffering severe COVID-19, unfortunately as we continue to see the virus spread in our community, we will see children being infected and some tragically dying from COVID-19.
This is why I cannot reinforce enough, whilst COVID-19 vaccines are critically important, we must all continue to practice other COVID-19 safety measures if we want to see a drop in COVID-19 cases in our community. This means wearing a mask properly, keeping physical distance from others outside our household, washing our hands regularly and avoiding crowds. Without these measures, plus high levels of vaccination coverage, we can expect to see COVID-19 continue to spread in our communities and find those who are most vulnerable.
Due to a combination of steady vaccine administration and the adoption of COVID-safe measures, in the Central Division we are happy to report we are seeing a reduction in the number of individuals being treated in hospitals and dying. Unfortunately, the situation in Western Division is getting worse, as we are seeing an intensifying outbreak. The containment area protocol in the Central division has prevented a concurrent rise in hospitalizations and deaths in both Divisions which would have complicated our medical response. 
Reminder: Early treatment provides the best chance of recovery
I have said this before but I again want to remind people of how vital early treatment is to saving lives from COVID-19. We are still seeing a worrying trend of very severe cases showing up late at hospitals and, sadly, passing away before we can provide life-saving treatment. 78% of COVID-19 deaths during this outbreak occurred at home, or on the way to hospital, or within 2 days of admission to hospital - giving no or little opportunity for our clinical teams to provide potentially lifesaving treatment.
And we know that many of these people had been trying to treat themselves at home with herbal medicines and steam baths. Whilst these treatments might be helping to alleviate some of their symptoms, they should not be a replacement for treatment at the hospital. COVID-19 is not like the common cold, it is a virus that our bodies have no immunity to protect ourselves against - unless you are vaccinated. For people who have severe COVID-19, for the majority the key to their recovery will be placing them on oxygen therapy and a ventilator, as well as giving them specific medications.
For many of the individuals who died, there was a real chance that we may have been able to save them if only our health teams were able to see them earlier.
If you have severe flu-like symptoms, like difficulty breathing or chest pain, you need to call 165 now. If someone in your home has severe flu-like symptoms, you need to call 165 now. Do not wait. Those symptoms may not go away on their own, and by the time you call, it could be too late.
An internal audit of deaths during this crisis indicates that much of the adverse health seeking behavior that predated this crisis has been potentiated by the misinformation and falsehoods promoted on social and mainstream media. It is even more unfortunate that people from the medical community have promoted this deadly misinformation –– doing so is an utter violation of the duty of care we owe the people of Fiji. 
When we see instances of misinformation, we gather the facts and respond as quickly as possible. But the unfortunate reality about inflammatory misinformation is that it can spread far faster than the truth. To help us combat falsehoods and save lives, we are seeking communal support to help to identify persons vulnerable to severe COVID and pre-emptively engage them to have a plan that allows early identification of danger symptoms and signs so they can access clinical care.

Vaccination Update
As of the 26th August, 555,230 adults in Fiji have received their first dose of the vaccine and 255,864 have received their second doses. This means that 94.6% of the target population have received at least one dose and 43.6% are now fully vaccinated nationwide.

Over the coming weeks we will be going out into communities, especially those with low vaccination coverage, and reaching those who are unvaccinated.

We are also tracking any reports of side-effects experienced after vaccination, otherwise known as adverse events. To date we have recorded 56 reports and of these 51 were not serious and the usual side-effects experienced after a person is vaccinated.

In addition, we have conducted thorough investigations into 5 potential adverse events and following these investigations have determined none of these were as a result of the vaccine. These investigations were carried out by our specialist medical teams, in consultation with specialists from Australia and the World Health Organization. 

Quarantine Facilities
I want to speak on some recent concerns raised about our quarantine facilities.

Lapses in quarantine protocols present a risk globally during the pandemic. I have a specific team led by Dr Sam Fullman who together with a smaller military and police team will provide the leadership needed to strengthen our quarantine operations. A border health protection facility has been established in the CAAF compound in Namaka, Nadi, and this facility will be responsible for coordinating and overseeing quarantine operations.

We are also setting up a container laboratory in Namaka which has the capacity to process around 500 tests per day.

As part of the additional measures to strengthen our quarantine operations, we will also be enforcing the following measures: 
    1.         Establishing a slot management system with Fiji Airways so we can put a cap on our quarantine capacity to more manageable levels;
   2.         Restricting international traveler entry to only fully vaccinated individuals (except in some emergency situations);
   3.         Requirement that all quarantine personnel engaged in quarantine operations are fully vaccinated;
   4.         CCTV support and oversight increased.

As part of these measures we also want to create a no-blame environment where our quarantine teams feel safe from discrimination for reporting any breaches or if feeling unwell.  At the end of the day we can only work with lessons learnt and improve. History has taught us many lessons, but the scale up required by this crisis has been phenomenal and we need to continue to adapt and learn as we respond.

careFIJI Reminder
We’ve also received some queries on the usefulness of the careFIJI app. On Viti Levu, we are employing a mitigation strategy that does not rely heavily on contact tracing, it is still vital. We need to develop the habit of keeping the application turned on whenever we leave our homes because COVID containment and contact tracing are going to be part of our lives for the foreseeable future.

From lessons learnt by other countries around the world who have high vaccination rates, we cannot relax our game even if we have high vaccination rates in Fiji. The protection offered by the vaccines is most effective when paired with other containment protocols, including strong contact tracing regimes. So keep using careFIJI. Particularly in the North and the outer islands where we are still aggressively contact tracing. It could save your life or the life of someone you love.

Thank you.