It’s hard to believe that this is the last day of July. The time seems to go slowly in one sense – when are we going to come out of the woods on COVID-19? – and at the same time seems to hurry along. Now, on the eve of the Emancipation/Independence national holidays (August 1 and 6, respectively) – which I expect will be toned down somewhat – I thought I would do a quick update based on last night’s press briefing by the Ministry of Health and Wellness. See the link here. It’s well worth a browse through, as it was very informative and helpful, answering many questions or concerns.
Here’s the latest as of July 31, 2020:
Jamaica now has 878 positive cases to date, including 14 new cases in the last 24 hours. Nine of these cases are “imported,” and five are under investigation. We have had 726 recoveries, and 47 positive cases have returned to their country of origin. We have had 10 deaths. We have one moderately ill patient, none critically ill. We have 95 active cases (this number is increasing gradually).
Imported cases: We have had 335 imported cases in total. We have had 43,264 arrivals since April 20 – the highest number was in the first half of July. Out of this number, 25,553 were swabbed and a total of 287 found positive. As we would have expected, the majority of COVID-positive cases under the Controlled Entry Programme have been on flights from the United States (213); 18 on flights from the UK (15 identified from a cruise ship); 47 from cruise ships; 8 on flights from Canada; and one on a flight from Dominican Republic. Since Jamaica opened its borders on June 15, the percentage of positive cases has varied between 0.6 and 1.2 percent of all those who have arrived, week by week. Currently it is 1.1 percent (up to July 19). The number of confirmed contacts for all the confirmed imported cases remains quite low (50 out of 321 as of July 29). “Everything since June 1 so far has been imported cases,” Chief Medical Officer (CMO) Dr. Jacqueline Bisasor-McKenzie told us. There are some, however, on the nice graph shown in red that are still under investigation and that may turn out to be locally transmitted.
And of course, more imported cases will be coming in, since there is no indication whatsoever that we will close our borders again (as the Bahamas has had to do).
Testing: The total number of samples tested is 38,733. In the last 24 hours, 627 samples were tested. The backlog of 10,000 has not yet been cleared as of July 31, which was the Ministry’s self-imposed deadline two weeks ago. “Well over half” of the backlog has been cleared but more than 3,000 samples remain to be tested. From July 25 current incoming samples have been tested within the “usual turnaround time of 24 to 48 hours” – along with the backlog. So older and more recent samples will be tested at the same time, for the next two weeks. The Ministry is talking to five private laboratories and more information is to come. Demand for tests is growing from people who need a test for employment, study, etc. One private laboratory is expected to start testing privately by the week of August 9, but not all labs have the capability to do the PCR testing.
Jamaica is using PCR tests (the “gold standard”), and there has been concern about reagent availability. Some more test kits have recently arrived, and Jamaica will receive more on Monday next week – for the COBAS machine, which tests more quickly. The Ministry will continue to test at the National Influenza Centre and the National Health Lab, while continuing to receive samples from hospitals and health centers (a total of 823 tested). 4,121 hospital check-ins with respiratory systems have been tested, with 49 positive cases detected (the last one two or three weeks ago).
Jamaica is not participating in any vaccine trials so far.
The “R Nought” (the infection rate from one positive person): Most countries do not want the R Nought to be above 1. Jamaica has been at 0.7 for quite a while now and is currently 0.6 between July 4 – 25. “We were last above 1 on April 25,” reported the CMO.
Demographics and Senior Citizens: There have been no significant changes, said the CMO, delving into her sheaf of papers. Most cases have been in the 20 -29 and 30 – 39 age group. On senior citizens, there have been 84 cases aged 50 – 59 years; 44 cases aged 60 – 69 years; 24 cases aged 70 -79 years; and three cases over 80 years. In general, there has been some increase in positive cases among senior citizens – around 70 patients over 60 years old. The early rule established for those age 65 and over to stay home has been effective, the Minister maintains. The rule applies now to those over 75 years. He emphasized that older populations, especially those with underlying health conditions, should be very careful, avoid crowds as best as possible; stay home as much as possible (but maintain a daily routine that will enhance health and wellbeing, including exercise); and wear masks. He gave some helpful advice, including restricting family gatherings. “You represent a vulnerable group,” he reminded those over 60.
Rules and Orders: Nothing much has changed in Disaster Risk Management Order #11, announced by the Prime Minister in Parliament this week but not yet posted online. The existing curfews (11:00 p.m. to 5:00 a.m. nightly) and all related rules remain until September 30. Gatherings are restricted to not more than 20 people, as before. Moreover, there will be no change in the arrangements for visitor arrivals – tourists, returning nationals and business visitors.
A major holiday starts tomorrow – but there will be no additional restrictions, the Prime Minister announced, as we had over the long Easter weekend. Minister Tufton said “we are encouraging” celebrations in a much smaller way than usual, preferably at home. “Resist the temptation to overindulge,” he said.
Quarantine: The most important rule of all, according to the Ministry, is the quarantine – home quarantine, that is, for two weeks. We now have 20,985 people in home quarantine and 92 in home isolation, and there are persistent reports of some not abiding by the rules, despite the best efforts of geo-fencing and community surveillance, etc. Last week the press briefing was canceled, because the Minister and a large team had to visit a community in Trelawny, western Jamaica, where there were problems caused by two people who arrived on the island, ignored home quarantine, and tested positive. The team of nearly fifty workers had to do a “mop up” there, testing etc. The app for geo-fencing is being uploaded at the airports and it is monitored by the Ministry of National Security but a nationwide app system is not yet available (will come soon). Monitoring is taking place with call outs and home visits, otherwise.
“In terms of containing the infection, as a country we are doing pretty well,” concluded the CMO. She added that the numbers show that they are able to monitor the quarantine process quite well. These cases came from outside, were confirmed positive – “but they have not been spreading,” she added. Business travelers must stay in their hotel until they get a negative test; returning Jamaicans must stay home for two weeks; and tourists must stay on property in their “COVID-resilient” zone. The CMO does not want to see locally transmitted cases “popping up” (one of her favorite expressions).
The Minister did register some concerns, however – apart from a slight anxiety over the pending Emancipation/Independence holiday celebrations (between August 1 and 6). He noted that we have more cases under investigation, which “could mean many things”; a few cases have arrived in hospital for surgery and tested positive – where did they pick up the infection?
Stigma: The Ministry is still on its anti-stigma campaign, partnering with UNICEF Jamaica. “It will only instill fear in persons and make them reluctant to seek help if they are experiencing symptoms,” they say. There are some parallels with the HIV/AIDS campaign back in the 1990s, and it was very tough going to break the back of that one. Stigma can actually make matters worse.
Personnel: The Ministry is trying to prepare for “living with COVID,” said Tufton. He stressed the importance of strategically deploying “at least 1,000” community-based health aides (who are being recruited and trained now in several parishes), doubling their numbers – the “COVID Army”; and it seems to me that the community approach is a good one. Moreover, the Ministry has acquired some funding to employ 120 medical officers – an issue that was problematic some weeks ago when there were no posts for graduating doctors. The CMO is also working on engaging more public health inspectors. These were needed before COVID. The Minister, who seemed in a more expansive mood than usual, was lavish in his praise of the primary health care team, which he credited with picking up cases early in the community.
The current phase that Jamaica is in seems to me rather tricky and quite complicated. There remains a hesitancy to lift restrictions, and that seems sensible. As the Minister said, from what we know things are going quite well; but what is out there that we don’t know? “What we report does not reflect the totality of the concerns or the spread of the virus,” the Minister insisted. So, we must obey the rules, first and foremost, stay the course, and…
Fingers crossed for the month of August.