COVID-19 UPDATE - 27.08.21

27/08/2021


Transmission Update
We have 205 new cases of COVID-19 to report for the 24 hour period that ended at 8am today. 95 cases are from the Western Division, 80 cases are from the Central Division, 29 cases from the Eastern Division and 1 case from the Northern 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: http://bit.ly/3vE2ZBb

There are 29 more individuals who tested positive for COVID-19 in Kadavu. There are now 164 active cases in Kadavu. All these individuals have been isolated.

One individual repatriating from Suva to the North has tested positive for COVID-19 while undergoing 14 days of quarantine at the Malau Quarantine Facility in Labasa. There are now 5 active cases in the Northern Division, one in Nabouwalu, three in Labasa, and one at the Malau Quarantine Facility. All these individuals have been isolated. The primary contacts of the Nabouwalu index case (wharf worker) continue to return negative test results in quarantine. 62 primary contacts of the 3 cases in Labasa (Namara Tiri Settlement) have tested negative. 

There remain 23 active cases on Malolo Island with investigations and further contact tracing and testing continuing.

There have been 151 new recoveries reported since the last update, which means that there are now 19,311 active cases. 9,505 active cases are in the Central Division, 9,637  active cases in the Western Division, 5 active cases in the Northern Division (Nabouwalu and Macuata) and 164 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 45,303 cases during the outbreak that started in April 2021.

We have recorded a total of 45,373 cases in Fiji since the first case was reported in March 2020, with 25,289 recoveries.

Deaths
We have 11 new COVID-19 deaths to report for the period of 18th – 26th August. Three deaths were  reported from the Central Division and eight deaths were reported from the Western Division.  
 
The first COVID-19 death to report is an 11 year child from Naboutini Village, Navua. She was pronounced dead on arrival by the attending medical officer at the Navua Hospital on the (19/08/2021). As per protocol she was swabbed and tested positive for COVID-19 on 19/08/2021. Her family reported that she had a fever and cough two days prior to her presentation (17/08/2021).  She was not vaccinated; she was not in the target population of 18 years and over that are eligible to receive the vaccine. 

The second COVID-19 death to report is a 6 month old infant from Nausori Highlands. He was brought to the Bukuya Health Center by his parents on 03/08/2021 with a one day history of fever and irritability (02/08/2021). He was noted to be in severe respiratory distress by the attending medical officer at the Bukuya Health Center. The infant was medically stabilized and a medical team from the Nadi Hospital was arranged to retrieve the infant from Bukuya Health Center and transfer him to the Lautoka Divisional Hospital (04/08/2021). Sadly, he died 20 days after admission (24/08/2021). He was not vaccinated; he was not in the target population of 18 years and over that are eligible to receive the vaccine.    
 
The third COVID-19 death to report is a 49 year old man from Nadi. He presented to the Lautoka Hospital Emergency Department in respiratory distress (08/08/2021). He reported that he had a cough and shortness of breath that began two days prior to his presentation (06/08/2021). As per protocol he was swabbed and he tested positive for COVID-19 on the 08/08/2021. Sadly, he died ten days after admission on the 18/08/2021. He received the first dose of the vaccine in early-May. He received his second dose of the vaccine on the 09/07/2021. He was fully vaccinated.
The fourth COVID-19 death to report is a 54 year old man from Ba. He had a history of generalized weakness, a reduced appetite and fever for three days (17/08/2021). He was admitted to the Lautoka Hospital in respiratory distress on the 20/08/2021. He was swabbed as per protocol and tested positive for COVID-19 on the 20/08/2021.  Sadly, he died one day after admission on the 21/08/2021. He received the first dose of the vaccine in late-May. He received his second dose of the vaccine on the 27/07/2021. He was fully vaccinated.
The fifth COVID-19 death to report is a 50 year old woman from Rakiraki. She presented to the Rakiraki Hospital in severe respiratory distress (21/08/2021). Her family reported that she had generalized weakness, a cough and shortness of breath that began three days prior to her presentation (18/08/2021). As per protocol she was swabbed and she tested positive for COVID-19 on the 21/08/2021. Sadly, she died on the same day of presentation 21/08/2021. She received the first dose of the vaccine in mid-April. She received the second dose of the vaccine on the 24/06/2021. She was fully vaccinated.

The sixth COVID-19 death to report is 43 year old woman from Tailevu who died at home on the 26/08/2021.She received the first dose of the vaccine in early-July.She did not receive the second dose of the vaccine. This means that she was not fully vaccinated.
 
The seventh COVID-19 death to report is 68 year old man from Lautoka who died at home on the 26/08/2021. He was not vaccinated.
 
The eighth COVID-19 death to report is a 78 year old man from Tavua who died at home on the 24/08/2021.He was not vaccinated.
 
The ninth COVID-19 death to report is an 85 year old woman from Tavua who died at home on the 22/08/2021. She was not vaccinated.
 
The tenth COVID-19 death to report is an 82 year old woman from Tavua who died at home on the 23/08/2021. She was not vaccinated.
 
The eleventh COVID-19 death to report is an 87 year old woman from Tavua who died at home on the 24/08/2021. She was not vaccinated.
 
There have been 12 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 479 deaths due to COVID-19 in Fiji, with 477 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 given 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 22nd, the national 7 day rolling average of COVID-19 deaths per day is 7. The 7 day rolling average for COVID-19 deaths per day in the Central Division is 2 and in the Western Division is 5.

Of the 477 deaths recorded 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.

We also have recorded 294 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. 

Hospitalisations
There are currently 245 COVID-19 patients admitted to hospital. 108 patients are admitted at the Lautoka Hospital, 26 patients are admitted at the FEMAT field hospital, and 111 admitted at CWM hospital, St Giles, and Makoi. 21 patients are considered to be in severe condition, and 10 are in critical condition. 
 
Screening Update
A total of 5,027 individuals were screened and 589 swabbed at our stationary screening clinics in the last 24 hours, bringing our cumulative total to 502,742 individuals screened and 87,484 swabbed to date. As of the 26th August our mobile screening teams screened a total of 1,244 individuals and swabbed 109. This brings our cumulative total to 807,287 individuals screened and 71,247 swabbed by our mobile teams. 

Testing update
A total of 326,851 samples have been tested since this outbreak started in April 2021, with 369,712 tested since testing began in March 2020. 1,504 tests have been reported for August 26th. The 7-day daily test average is 1692 tests per day or 1.9 tests per 1,000 population. Testing data from one lab is still being received. So testing data is expected to increase. Weekly testing is at 12.9 tests per 1000 population, which remains above the WHO recommended level of 4 per 1000 population per week. The national 7-day average daily test positivity is 19.1%, which is on a downward trend, but still indicating a high level of community transmission. 
 
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. 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 http://bit.ly/3h2JfCZ 

Epidemic Outlook
The 7-day average of new cases per day is 325 cases per day or 368 cases per million population per day. As previously announced by the Permanent Secretary, daily case numbers in Suva-Nausori are currently not being used as the sole indicator to monitor progress of the outbreak. The Ministry is closely monitoring other indicators such as test positivity, hospitalisations and deaths to track the progress of the outbreak. 
With the decrease in testing numbers, testing remains above the WHO recommended rate of 4 tests per 1000 population per week (or approx. 3500 tests per week). We will be transitioning to community surveillance testing as severe disease numbers and positivity rates approach the containment phase levels. 
We are still seeing a high number of cases and high test positivity of 33.5% in the Western Division indicating a very high level of community transmission. Test positivity in the Central Division is on a downward trend but still indicating a very high level of community transmission at 20.5%. Deaths have also been decreasing in Suva-Nausori over the last 4 weeks. While deaths in Western are still at a high level, with deaths per day at a 7 day average in the Western Division now surpassing the Central Division. 

The outlook for the cases found in the North indicate a persistent risk of a community outbreak. Further tracing and testing results are needed to clearly understand the level of community transmission. All contacts of the first case identified are in quarantine and so far testing negative. The swabbing results from within the Nabouwalu containment area, and nearby communities are  also returning negative. The Nabouwalu index case (wharf worker) 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 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.

The situation in Kadavu and Malolo Island is extremely concerning as there is clear evidence of community transmission on both islands. We expect the case numbers to escalate together with the risk of severe disease and death. The death reported from Naviti Island in the Yasawas is also of concern as it also suggests there is  transmission occurring on the island. 
 
Advice to the public
Severe COVID-19

People with severe COVID-19 are still dying at home, or are coming to a medical facility in the late stages of severe illness. As mentioned by the Permanent Secretary today: 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 life saving treatment.
 
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 it is important that people throughout Vanua Levu listen to advice and continue to practice COVID-19 safety measures. While all cases are related to operations on the Nabouwalu jetty, the first resided in Nabouwalu and the last 3 resided in the Namara Tiri Settlement which is near the township of Labasa.

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.