Transmission Update
We have 303 new cases of COVID-19 to report for the 24 hour period that ended at 8am today. 185 cases are from the Western Division, 33 cases are from the Central Division and 85 cases from the Eastern Division (Kadavu). A full breakdown of areas of interest will be published online tonight on the Ministry’s COVID-19 dashboard. You will also be able to view the approximate locations of new cases, active cases, and recovered cases on the dashboard at the following link:

There have been 1,468 new recoveries reported since the last update, which means that there are now 19,097 active cases. 10,252 active cases are in the Central Division, 8,713 active cases in the Western Division, 1 active case in the Northern Division (Nabouwalu) and 131 active cases in the Eastern Division (all in Kadavu). We are currently reviewing and reconciling our active case database with recoveries and as a result we expect the recovery numbers to increase in the coming weeks.

There have been 43,527 cases during the outbreak that started in April 2021. We have recorded a total of 43,597 cases in Fiji since the first case was reported in March 2020, with 23,809 recoveries.

We have 5 new COVID-19 deaths to report for the period of 19th – 22nd August. 1 death was reported from the Central Division and 4 deaths were reported from the Western Division.

The first COVID-19 death to report is an 84 year old man from Nakasi who died at home on the 19/08/2021.  He was not vaccinated.

The second COVID-19 death to report is a 61 year old woman from Tavua. She presented to the Tavua Hospital in severe respiratory distress. She reported to have shortness of breath two days prior to her presentation. She died 5 days after admission on the 21/08/2021. She received the dose of the vaccine in mid-July. She did not receive the second dose of the vaccine. This means that she was not fully vaccinated.

The third COVID-19 death to report is a 56 year old woman from Lautoka. She presented to the Lautoka Hospital in severe respiratory distress. She reportedly had a cough and shortness of breath for two days prior to her presentation. She died 7 days after admission on the 21/08/2021. She was not vaccinated. 

The fourth COVID-19 death to report is a 56 year old man from Ba. He presented to the Ba Mission Hospital in severe respiratory distress. He was reported to have a fever, cough and shortness of breath two days prior to his presentation. He died 1 day after admission on the 22/08/2021. He was not vaccinated. 
The fifth COVID-19 death to report is a 50 year old man from Nadi. He presented to the Nadi Hospital in severe respiratory distress. He was transferred by a medical team from the Nadi Hospital to the Lautoka Hospital. Sadly, he died 3 days after admission (22/08/2021). His family reported that he had a cough, shortness of breath and generalized weakness one week prior to his presentation. He received the first dose of the vaccine in late-May. He did not receive the second dose of the vaccine. This means that he was not fully vaccinated. 
There have been 4 more deaths of COVID-19 positive patients. However, these deaths have been classified as non-COVID deaths by their doctors. Doctors have determined that their deaths were caused by serious pre-existing medical conditions and not COVID-19. 

With today’s newly reported deaths, there have now been 438 deaths due to COVID-19 in Fiji, with 436 of these deaths during the outbreak that started in April this year. Please note that due to the time required by clinical teams to investigate, classify and report deaths, a 4-day interval is required to calculate the 7 day rolling average of deaths, based on date of death, in order to help ensure the data collected is complete before the average is reported.

Therefore, as of August 18th, the national 7 day rolling average of COVID-19 deaths per day is 8. The 7 day rolling average for COVID-19 deaths per day in the Central Division is 2 and in the Western Division is 6.

We also have recorded 253 COVID-19 positive patients who died from the serious medical conditions that they had before they contracted COVID-19; these are not classified as COVID-19 deaths. 

There are currently 296 COVID-19 patients admitted to hospital. 114 patients are admitted at the Lautoka Hospital, 38 patients are admitted at the FEMAT field hospital, and 144 admitted at CWM hospital, St Giles, and Makoi. 20 patients are considered to be in severe condition, and 20 are in critical condition. 
Screening Update
A total of 1,083 individuals were screened and 253 swabbed at our stationary screening clinics in the last 24 hours, bringing our cumulative total to 482,540 individuals screened and 84,918 swabbed to date. As of the 21st August our mobile screening teams screened a total of 2082 individuals and swabbed 73. This brings our cumulative total to 800,267 individuals screened and 70,834 swabbed by our mobile teams. 

Testing update
A total of 318,146 samples have been tested since this outbreak started in April 2021, with 361,007 tested since testing began in March 2020. 1,613 tests have been reported for August 21st. The testing data from some labs are still being received. Therefore, testing data numbers are expected to increase. The 7-day daily test average is 1489 tests per day or 1.7 tests per 1,000 population. The national 7-day average daily test positivity is 32.8%.  

Vaccination Update
As of the 21st August, 543,254 adults in Fiji have received their first dose of the vaccine and 234,905 have received their second doses. This means that 92.6% of the target population have received at least one dose and 40% are now fully vaccinated nationwide. We are currently doing a mop up exercise of our first dose campaign, which will allow us to specifically target communities with low coverage, and subsequently also correct and update the total eligible population for our current vaccination program.  

Fijians can check the Ministry’s vaccine dashboard to find real-time data on first-dose and second-dose numbers at the national, divisional and sub-divisional levels. You can access the live dashboard at 
Epidemic Outlook

The 7-day average of new cases per day is 480 cases per day or 542 cases per million population per day. We have noted a drop in cases reported per day recently. However, our daily testing numbers have also been dropping around the same time, due to the change in testing policy in Suva-Nausori. As announced on July 21st by the Permanent Secretary, only persons that have a higher risk of developing severe COVID-19 are being targeted for testing in Suva-Nausori. This was done so that resources could be targeted to early detection, monitoring and care of persons with COVID-19 who are at higher risk of severe disease, to prevent more people succumbing to severe disease and death. 

We are likely seeing the effect of this testing policy change now in Suva-Nausori with the drop in daily reported cases. This does not mean that the outbreak is on a downward trend in the Suva-Nausori community. As previously announced by the Permanent Secretary, daily case numbers in Suva-Nausori are currently not being used as an indicator to monitor progress of the outbreak in Suva-Nausori. The Ministry is closely monitoring other indicators such as test positivity, hospitalisations and deaths to track the progress of the outbreak in Suva-Nausori. 

We are seeing increasing cases reported in the Western Division with evidence of widespread community transmission in that division.  Deaths per day at a 7 day average in the Western Division now surpass the Central Division. 

Advice to the public
People with severe COVID-19 are still dying at home, or are coming to a medical facility in the late stages of severe illness. 
Severe COVID-19 is a medical emergency, and a delay in receiving appropriate medical treatment reduces your chance of recovering from the disease. You are at higher risk of developing severe COVID-19 if you are over the age of 50 or have a non-communicable disease or chronic disease like diabetes, hypertension, heart disease, kidney disease, or if you are obese or pregnant. 
If you are at high risk of severe disease and have any symptoms of COVID-19 such as a cough, runny nose, fever, sore throat, body ache, headache, loss of taste/smell - please come to your nearest screening clinic to be checked and tested by our medical teams. 
We need also need all Fijians to know the severe symptoms of COVID-19, which include the following: 
•             Difficulty breathing
•             Persistent pain or pressure in the chest
•             Severe headache for a few days
•             New confusion, inability to wake or stay awake
•             Pale, gray, or blue-coloured skin, lips or nail beds
In Suva-Nausori we have identified health facilities specifically designated to receive people with symptoms of severe COVID-19. If you or a loved one live in Suva-Nausori and have any of these severe symptoms please go immediately to the designated health facilities listed below. 
- Colonial War Memorial Hospital (CWMH)
- FEMAT Hospital, Vodafone Arena
Individuals in Nausori with severe symptoms should go to:
- Nausori Health Centre
-Wainibokasi Hospital
In the Western Division, please go to your nearest healthcare facility if you have any symptoms of COVID-19. 
Call 165 if you are unable to travel to a medical facility. 

The public in the North are being reminded that with one active case identified in Nabouwalu, it is important that people throughout Vanua Levu listen to advice and continue to practice COVID-19 safety measures.

The public is requested to practice COVID-19 safety measures of wearing a mask when leaving your home, wash your hands regularly with soap and water or use a hand sanitiser, practice safe physical distancing of 2m, ensure that the careFIJI app is downloaded on your phone and enabled and remember to get vaccinated. 

The situation in Kadavu Island remains a major concern. The clinical scoping team in Kadavu have begun to put together a clinical response plan that will help to efficiently escalate our response to the expected wave of severe disease and deaths in Kadavu however we do anticipate this to be a challenging exercise. The public health team is continuing with screening and isolation protocols. A key part of the response will be to identify persons vulnerable to severe COVID and to pre-emptively engage them in a care plan that allows early identification of danger symptoms and signs and access to clinical care in a timely manner. Another important part of the response to mitigate severe disease will be community wide engagement to establish specific plans that help maintain oversight over vulnerable persons, and facilitate their timely transfer to a health care facility when required.

The Ministry of Health and Medical Services reiterates its call for maritime islanders not to engage in unauthorized travel to and from Viti Levu. All our current protocols to regulate domestic movements must be adhered to in order to prevent spread of the virus beyond Viti Levu. Furthermore, we repeat our call to all village leaders and elders to support our current efforts to protect our maritime islands and to immediately report any suspicious movements into your community.