Bula Vinaka Fiji.

Fiji’s 7-day rolling average of cases per million per day remains among the highest in the world. This means we have among the highest daily cases reported for our population size. What we are experiencing right now in Fiji we witnessed in other countries, including high income countries, since the start of this pandemic last year. We are not alone, countries that had similar successes to Fiji in the past when it came to containing and keeping out the original virus, are now suffering large outbreaks because of the delta variant.

In our daily statements we talk about the daily toll in terms of cases and lives lost. The toll in terms of mental and social suffering is high. Frontline health workers are integral to the global response to COVID-19. In hospitals, clinics and homes around the world, health workers are taking on significant personal risk. This is the same in Fiji.  This current crisis is demonstrating the essential, tireless, innovative and too-often undervalued role of health workers and our frontline colleagues in ensuring strong, resilient health systems for everyone, everywhere. They work long hours, sacrifice time with their families, and endure the stresses that this pandemic places upon them as individuals, professionals, and upon the entire health system. Delivering health services in an environment of constraint resources will often mean providing access to life saving care at the expense of comfort.  Maintaining sensitivity and empathy during the provision of service has never been more important.

It therefore is deeply saddening that I announce today the passing of a fellow health worker who many of us knew and loved. She was 44 years old and was going through a pregnancy when she turned positive for COVID-19. Unfortunately, she also had other pregnancy related complications. Delivery by Caesarean section was done to facilitate the baby’s survival and our colleague’s critical care. Unfortunately, our colleague passed away on Wednesday, the 21st of July from complications of COVID-19, despite the best efforts of the attending physicians. Her baby has recovered well and is in stable condition.

In the past weeks a fellow doctor also succumbed to COVID 19 and we may, unfortunately, see more of our fellow health workers and front liners get severe disease in the near future. Our sympathies are extended to all those who have lost loved ones and those who are living through anxiety and fear for loved ones during this difficult time. Please be assured that these suffering, have only served to strengthen our resolve to save lives. They also serve to strengthen the resolve of fellow civil servants from other Govt. ministries and agencies who are working with us in the frontline to facilitate the rapid deployment of vaccines and to promote a more COVID safe society through our Community Engagement program.

This virus has and will continue to affect our health care workers from community transmission and through the course of duty. We know that community transmission in Suva-Nausori is at such a high level, that it is more likely that a healthcare worker will pick up the virus in the community than in hospital when they are wearing full personal protective equipment. Over the 3 months of this outbreak, we have transitioned from having our health care teams working in work bubbles during the Containment phase, to our current Mitigation phase strategy of escalating the infection prevention and control measures and personal protection measures to ensure that all potential and known exposures to COVID 19 cases is as low risk as humanly possible.

We have reorganized our PPE distribution program to ensure that the large stocks we have are always readily available to all health care workers at the frontline, especially those who work in Critical Care Units and Emergency Departments. By ensuring that our Health Care workers are vaccinated, well trained in PPE use and are diligent in helping each other to maintain PPE discipline in the workplace, we will be able to maintain health worker numbers in all our health facilities. To date nobody who has been fully vaccinated against COVID-19 has died in Fiji, we know that this is the very best protection we can provide for our colleagues. The potential strength of PPE practice was clearly demonstrated in Lautoka Hospital when during the closure of the hospital, none of the staff manning the COVID wards were positive.

Two days ago we  did a press conference in the Vodafone Arena, which is the site of the FEMAT field hospital, to highlight some of the changes we have made to build up more extra capacity to save lives. We have increased clinical care spaces, and access to therapeutic interventions. We are scaling up our 165 and 158 COVID help line to be able to respond to requests for help. We have escalated our ability to monitor all positive cases through phone calls and home visits with a focus on an escalated monitoring protocol for high risk cases. We acknowledge other Govt ministries and agencies that assisted in creating the monitoring database and helping us with the monitoring process.  We have reorganized and reinvented our Case Retrieval Capability by working with donor agencies, CSOs and our military and naval partners.  We have refocused our swabbing screening effort to identify positive cases in the vulnerable groups in our community and in those with severe symptoms. Because we know that people within those vulnerable groups are more at risk of developing severe disease and needing lifesaving medical care.

At the FEMAT Hospital, we have seen 70% of patients with significant COVID disease go home after receiving care, 20% are referred on to CWM; unfortunately, 10% had arrived too late. In CWM more than 60% of cases with severe disease have recovered with most of the deaths occurring in persons with associated severe comorbidities. The Maternity Unit of CWM has seen close to 400 cases of COVID 19 admissions since June with 12 of the cases reaching the severe stages of disease. All but 3 have recovered. The underlying theme in all these recoveries from significant COVID-19 disease is that we were given the opportunity to deal with them early either by admitting the highly vulnerable positive case and monitoring them or supporting a home monitoring program that allowed timely retrieval.

Unfortunately, despite these efforts, we continue to see that the overwhelming majority of COVID-19 deaths have been in our most vulnerable community members who have arrived too late or succumbed at home. When our health teams first saw these patients, most of them were either in a critical condition or had already passed away. We believe that if our health teams were able to see these patients earlier, we may have been able to save them.

We know many families are valiantly trying to care for their loved ones at home, but for those who are most at risk of severe COVID-19, home care won’t be enough. These individuals need their oxygen levels closely monitored, likely need access to oxygen therapy, and have clinical teams on stand-by who can rapidly respond if their condition deteriorates.

So please, if you or someone you are caring for has COVID-19 symptoms and are at high risk of severe COVID-19, we need you to engage early with our 165 help line while your loved ones are still stable.

We all have seen how the cases are building up in the Western Division. We are glad that our first dose vaccination coverage in the west is 83% and the second dose coverage is escalating at a good rate. WWe have also distributed the doses to be used in the Yasawa and Mamanuca Maritime area. We know that if we can delay for as long as possible the expected surge in cases in the Western Division, we will be able to prevent a lot of severe disease and deaths that we are seeing in the Lami to Nausori Containment Zone. Therefore,  as of Monday the 26th of July, the following measures are to be implemented and strengthened:

- All unnecessary movements should stop. Please stay home as much as possible. Movement outside your home must only be for approved employment purposes, medical purposes or to get groceries. To facilitate this the curfew hours throughout the Western division will begin from 6pm and end at 4am.
- All movements from the Central Division to the Western Division will be assessed on a case by case basis and higher priority for approval will be given to those who have completed 14 days after the 2nd dose of the vaccine.
- All movements from the Viti Levu to the Northern Division and maritime islands will be assessed on a case by case basis and higher priority for approval will be given to those who have completed 14 days after the 2nd dose of the vaccine.
I will end by congratulating the efforts of the Vaccination teams. Today Ba Subdivision have achieved a first dose vaccination of 110% as they escalate to cover cane cutters and other individuals that have returned to Ba. Rewa Subdivision have achieved 104% first dose coverage. Nadroga Subdivision has 91% first dose coverage. Coverage in the Savusavu Town area is 91% first dose vaccination of their eligible population  and almost 30% for their second dose. The Macuata province leads the North with 74% first dose coverage while Cakaudrove and Bua sitting at close to 60%. I have closely followed the vaccination efforts on the many  viber groups and I am sure that many of us in the frontline take to heart the good efforts of the community in escalating our efforts to protect all who live in Fiji and help many of us go back to the comfort of our family. Together we can and together we will get back to a Safer Fiji. Have faith Fiji!