Transmission Update
We have 302 new cases of COVID-19 to report for the 24 hour period that ended at 8am today. 148 cases are from the Western Division and 154 cases are from the Central Division. 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 are two individuals who have tested positive for COVID-19 in Cubi Settlement, Malolo Island. Early investigations reveal that these two individuals travelled to Malolo Island from Viti Levu without proper authorization. They are currently isolated. Further details will be provided once investigations are complete.

The Ministry of Health and Medical Services is again urging all Fijians not to engage in unauthorized travel to and from Viti Levu. All our current protocols to regulate domestic movements must be followed to prevent spread of the virus beyond Viti Levu. The remoteness of the maritime islands, and their  limited resources, mean that any outbreak with severe cases will be very challenging to manage. We need the people in our maritime islands fully vaccinated against COVID-19  to help protect them from severe disease and death  before any movement occurs beyond the current controlled repatriation.

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.

There have been 430 new recoveries reported since the last update, which means that there are now 18,916 active cases. 9,653 active cases are in the Central Division, 9,127 active cases in the Western Division, 1 active case in the Northern Division (Nabouwalu) and 135 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 44,420 cases during the outbreak that started in April 2021. We have recorded a total of 44,490 cases in Fiji since the first case was reported in March 2020, with 24,855 recoveries.

We have 9 new COVID-19 deaths to report for the period of 18th – 23rd August. Four deaths were reported from the Central Division and five deaths were reported from the Western Division.  

The first COVID-19 death to report is a 60 year old woman from Lautoka. She presented to the Lautoka Hospital in respiratory distress. She reported to have a fever, cough and shortness of breath for one week prior to presentation. She died 11 days after admission on the 21/08/2021. She was not vaccinated.
The second COVID-19 death to report is a 67 year old woman from Lautoka. She presented to the Lautoka Hospital Emergency Department in severe respiratory distress. She died on the same day (20/08/2021). She was not vaccinated.
The third COVID-19 death to report is a 66 year old woman from Navua who died at home on the 18/08/2021. She was not vaccinated.
The fourth COVID-19 death to report is a 66 year old man from Naitasiri. He presented to the CWM Hospital in severe respiratory distress. He died 10 days after admission on the 23/08/2021. He was not vaccinated.
The fifth COVID-19 death to report is an 84 year old woman from Navua who died at home on the 21/08/2021. She was not vaccinated.
The sixth COVID-19 death to report is a 57 year old man from Nadi. He presented to the Nadi Hospital in severe respiratory distress. He died on the same day 23/08/2021. He was not vaccinated.
The seventh COVID-19 death to report is an 80 year old man from Nadi. He presented to the Nadi Hospital in severe respiratory distress. His family reported that he had shortness of breath for one week prior to presentation. He died on the same day 23/08/2021. He was not vaccinated.
The eighth COVID-19 death to report is a 72 year old woman from Suva. She presented to the CWM Hospital in severe respiratory distress. She died 16 days after admission on the 23/08/2021. She received the 1st dose of the vaccine in late July. She did not receive the second dose of the vaccine. This means that she was not fully vaccinated.
The ninth COVID-19 death to report is a 49 year old man from Ba who died at home on the 20/08/2021. He was not vaccinated.
There have been 9 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 453 deaths due to COVID-19 in Fiji, with 451 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 19th, the national 7 day rolling average of COVID-19 deaths per day is 10. The 7 day rolling average for COVID-19 deaths per day in the Central Division is 4 and in the Western Division is 6.

We also have recorded 266 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 264 COVID-19 patients admitted to hospital. 111 patients are admitted at the Lautoka Hospital, 38 patients are admitted at the FEMAT field hospital, and 115 admitted at CWM hospital, St Giles, and Makoi. 24 patients are considered to be in severe condition, and 10 are in critical condition. 
Screening Update
A total of 5,415 individuals were screened and 712 swabbed at our stationary screening clinics in the last 24 hours, bringing our cumulative total to 488,763 individuals screened and 85,776 swabbed to date. As of the 23rd August our mobile screening teams screened a total of 1524 individuals and swabbed 73. This brings our cumulative total to 801,862 individuals screened and 70,941 swabbed by our mobile teams. 

Testing update
A total of 322,144 samples have been tested since this outbreak started in April 2021, with 365,005 tested since testing began in March 2020. 1,533 tests have been reported for August 23rd. The testing data from one lab is still being received. Therefore, testing data numbers are expected to increase. The 7-day daily test average is 1724 tests per day or 1.9 tests per 1,000 population. The national 7-day average daily test positivity is 27.9%.  

Vaccination Update
As of the 23rd August, 545,459 adults in Fiji have received their first dose of the vaccine and 241,027 have received their second doses. This means that 93% of the target population have received at least one dose and 41.1% 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 473 cases per day or 535 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. Since July 21st, 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 will be transitioning to community surveillance testing as severe disease numbers and positivity rates approach the containment phase levels. 

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. 

The Northern Division remains with one active case, with all contacts in quarantine so far testing negative, and swabbing results from within the containment area, and nearby communities also returning negative. The situation in Kadavu in the Eastern Division continues to remain a concern.

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. 

Kadavu Response Update
The situation in Kadavu Island remains a major concern. The clinical scoping team have 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 team is expected to depart for Kadavu over the next 2 days. FEMAT response to Kadavu will involve both public health and clinical teams. The clinical team will include doctors and nurses from the clinical specialized fields of medicine.

Upon arrival in Kadavu the clinical team will boost up the public health response on, case identification through rapid diagnostic tests, risk assessment and stratification, COVID awareness, Vaccination coverage and clinical case management based on the clinical care flow pathway. The aim will be to identify the extent of transmission, instituting containment strategies, early detection and retrieval of sick cases and minimizing deaths. They will also work very closely with the teams from other ministries under Provincial Administrator Kadavu on community engagement. The main goal is also to minimize severe and critical cases given the expected challenges in medical evacuation. While they commit towards community response and engagement the logistic teams will be setting up the COVID wards and the intermediate care facilities in readiness for patients with severe COVID-19 disease.