STATEMENT BY THE PERMANENT SECRETARY FOR HEALTH & MEDICAL SERVICES DR JAMES FONG - 18.10.21

Vaccination 
As previously mentioned, given that dose one is beyond 95%, a verification exercise for dose one is ongoing which may result in minor changes. The dose one coverage rate has been adjusted recently to reflect our verification process.
 
Transmission Update:
Since the last update, we have recorded a total of 146 new cases, of which 85 new cases were recorded on 16/10/2021; 39 new cases on 17/10/2021, and 22 new cases in the last 24 hours ending at 8 am this morning.

This epidemic curve depicts the daily positive cases since the 2nd wave of this outbreak began in April 2021. Overall, there have been 51,777 cases recorded, with 71% of the cases from the Central Division, 27% of the cases from the Western Division, and 2% of the cases from the Eastern and Northern Division. Our National 7- day rolling average is 43 daily cases calculated for 14th October 2021.
 

Overall the death rate graphs for the Central and Western Divisions indicate a declining trend. The differences between the Central and Western are similar to the incidence of the daily cases and are likely a reflection of vaccination levels, COVID mitigation measures, and differences in population density.  

We have no COVID-19 deaths to report for today.

There have been 663 deaths due to COVID-19 in Fiji, with 661 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 days rolling average of deaths, based on the date of death, to help ensure the data collected is complete before the average is reported. Therefore, as of October 14th, the national 7 days rolling average of COVID-19 deaths per day is 0.1. We have also recorded 547 COVID-19 positive patients who died from serious medical conditions they had before they contracted COVID-19; these are not classified as COVID-19 deaths.

Epidemic Outlook:
The 7-day average of new cases per day is 45 cases per day or 50 cases per million population per day. As previously announced by the Permanent Secretary, the daily case numbers are currently not being used as the sole indicator to monitor the progress of the outbreak. The Ministry continues monitoring other indicators such as test positivity, hospitalisations, and deaths to track the progress of the outbreak, and it is noted that there is a downward trend across all indicators of the COVID-19 epidemic in Fiji.

With the reduction in testing numbers, which is above the WHO recommended rate of 4 tests per 1,000 population per week (or approx. 3,500 tests per week), we are transitioning community surveillance testing to containment phase levels.

The overall indications of the cases, hospitalization, and deaths data indicate a positive response to our overall COVID response with the epidemic in the west having a lower and delayed disease peak with lower cumulative numbers compared to the Central Division.

Public Advisory:  
North Travel Update
We are continuing the process of normalizing movement between Viti Levu and Vanua Levu. At present, the movement is mediated by registration for a repatriation number and the issuance of a MOHMS travel pass. The current COVID-19 vaccine coverage rates for the North are 91.8% for dose one and 75.1% for dose 2. The team managing the travel to and from the North will continue to increase the number of travelers we can support to travel as the vaccination rates improve. From tomorrow, Tuesday, the 19th of October all travel from Vanua Levu to the central division will not need a registration number nor a MOHMS pass. The Registration and MOHMS pass process will be maintained with regards to travel from Viti Levu to Vanua Levu to ensure that the travel is documented for contact tracing, a negative pre-departure test, and vaccination status is verified, and the travel caseload to the North team is kept manageable. All these factors are important to both preventing and being able to contain Sars-CoV 2 transmission in the North. The public is strongly advised to only do a pre-departure test only after your registration number is obtained. Also note that given the increasing vaccination rates, daily traveling quotas to the North are being increased and we will be transitioning to self-monitored home quarantine. 

The Ministry of Health and Medical Services in preparation for easing of restrictions in the North has remodeled the health service provision to ensure:

-Strengthened quarantine capacity. We have a registration and pass issuance process that will facilitate our ability to maintain oversight over both home and facility-based quarantine.  Each traveler will be provided with the rules relating to quarantine and punitive measures will be applied if there is a verified breach in any of the quarantine conditions.

-Community surveillance through test trace and track protocols is being escalated to help us identify and contain any outbreak early.
-Registration and line listing of vulnerable persons especially in poorly vaccinated areas has been done;
-Preparations for the monitoring of positive cases and vulnerable persons to ensure better access to appropriate care plans has been made;
-Clinical care protocols for the severe disease has been reviewed and strengthened;

The Ministry of Health and Medical Services Communication team together with our multi-agency community engagement team are working with community leaders to identify and strengthen mechanisms that will facilitate the monitoring of vulnerable persons and persons with COVID like symptoms and help encourage them toward timely engagement of health care services so that medical teams have a greater opportunity to provide timely treatment.

The easing of travel restrictions is needed to facilitate social and economic livelihood especially given that too many people have been stuck away from their homes since April this year. However, even with the precautions that have been put in place with this relaxation of the re-entry protocols, we do expect cases to occur in the community of the Northern Division with the movement of people from Viti Levu. The key is for this movement to be into a highly vaccinated population in the North as the vaccines are very good at preventing severe disease and death. The expectation is that the North will report cases in the community, but large numbers of people with severe disease will be prevented because of high vaccination coverage.

The people of the North are reminded that, together with vaccination, we must continue to closely observe our COVID safe measures and avoid contained spaces and crowds to avoid the risk of increased spread of the virus. The key to avoiding future restrictions and lockdowns is for the public to remain cautious about how they engage in the greater freedom they will enjoy.

COVID-19 Endemic:
A disease becomes endemic when it is expected to remain persistently present in the community. Some diseases endemic to Fiji are dengue fever and the common cold. These diseases persist at some level in the community and become epidemic when levels go beyond what is determined to be expected and acceptable. Determining what that acceptable level of disease is for COVID-19, is a work in progress but in general, it will be at the level which triggers additional control measures, Because COVID-19 is a vaccine-preventable disease, and the vaccines are very good at preventing severe disease and death, in a highly vaccinated population determining and monitoring acceptable levels, or thresholds, goes beyond case numbers. A disease that causes frequent cases in the community (like the common cold) but has a small impact on the numbers of people needing hospitalization or death, and minimal impact on the health system, will require less intervention.  This is why we will be closely monitoring the following indicators: cases, test positivity, hospitalisations, and deaths.