Statement by Permanent Secretary for the Ministry of Health and Medical Services, Dr James Fong.
After another 2065 tests, we have confirmed four new cases of COVID-19 since yesterday. Two are border quarantine cases –– these are both soldiers returning from their tours of duty as peacekeepers in the Golan Heights.
Our two other cases are local. One is extremely serious –– I want to talk through exactly how this case came about.
The patient (case 125) is a 53-year-old gentleman who was admitted to the Lautoka Hospital on the 19th of April 2021 for a surgical procedure. The procedure was performed successfully. However, on the 28th of April, he developed some respiratory symptoms.
On the 29th of April, he was seen by case 120, the 25-year-old doctor. He was asked to be swabbed for COVID-19. However, he refused on two occasions. The doctor developed symptoms on May 1st, and tested positive yesterday.
On the 2nd of May, the same patient was assessed by case 121, the 30-year-old, doctor. We know that this doctor, case 121, had tested negative for the virus on April 26th, he tested positive yesterday as part of contact tracing for case 120, and his results indicate he very recently caught the virus.
Early today, the patient’s condition began deteriorating. He was moved into an intensive care unit and swabbed for the virus. Barely four hours ago he tested positive for COVID-19. His condition will be discussed more with his family before any public announcement. His described timeline and the recent deterioration in his condition indicate he is likely a late-stage carrier of the virus. So, we suspect that this patient, who is case number 125, transmitted the virus to the doctors, not the other way around.
We do not know when or where this patient contracted the virus. It could have been from outside or within the hospital. Our response must consider both possibilities.
From a statistical standpoint, ICU cases –– like the one we now have –– may be a red flag for widespread transmission. Essentially, it tells us that there are likely many more cases of the virus out there. We have dreaded a worst-case scenario such as this since the day of our first case in March of last year. Through that time, we have also gone to great lengths to prepare for it. Those months of planning have informed an immediate whole-of-government course of action.
Our first priority is to contain the cases we know about within Lautoka Hospital. To prevent the hospital from becoming ground-zero for a wider outbreak, the members of our disciplined forces have locked down Lautoka Hospital in a matter of hours –– it is now a tightly-contained, full-time COVID care facility.
• More than 400 patients, doctors, nurses, and other staff have been sequestered and will be effectively quarantined within the hospital until we can determine who else may or may not have had contact with this patient. Some staff who have left the hospital have been called back in. RFMF personnel and members of the Police have ring-fenced the entire hospital and will strictly manage who is allowed onto the premises.
• Lautoka Hospital will be closed to the public, all medical services will be re-routed to a network of back-up hospitals in Nadi, Ba, and Sigatoka, as well as the Punjas and Kamikami health centres in Lautoka. We’ve activated the entire government machinery to ensure these critical services remain accessible to our people. As we’ve announced before, the borders of the containment areas are open to those travelling for medical emergencies, so this can already be facilitated.
• Given we expect more cases, and more severe cases. Sections within the Lautoka Hospital are being converted into intensive care units which will house additional beds and ventilators.
• The staff of Lautoka Hospital will be accomodated and work within the hospital while contact tracing continues. Remember, our staffing capacity was already stretched due to quarantine of the close contacts of our two doctors. Those who are working will operate on high-alert, fully-equipped in the proper personal protective equipment. They will be screened regularly and tested often. We are going to provide them with any and all support that they need. Food, supplies, bedding, whatever they require, we will provide.
• Finally, not only in the hospital, but around Lautoka, there is going to be a lot more swabbing.
The protocols for COVID management across our healthcare network are strengthening further so that these facilities can continue offering their normal services to bear the out-patient load from Lautoka Hospital.
Our other local case is a 27-year-old who resides in Narere. She entered quarantine on 28th April 2021 as a contact of one of the cases from Makoi. Further investigations revealed that, during a family gathering on April 17th, she also had close contact with another case from Makoi. She was confirmed as positive for COVID-19 this morning. That gathering is now potentially the source point of three cases. It was only a small family gathering with members from a few different households, but that was more than enough to have national ramifications. It is why one of our first and most important health measures we introduced was to limit gatherings, of all sizes, everywhere in Fiji.
The members of this patient’s household have also been in quarantine from 29th April –– all have tested negative for COVID-19 at this time.
Contact tracing is ongoing into her movements before being quarantined, unfortunately, she did not have the careFIJI app installed, so we are relying entirely on our traditional contact tracing methods. If she had the careFIJI app and had kept it on –– this could all happen much faster. With more than 250,000 downloads, careFIJI is rapidly being widely adopted across Fiji, thank you to everyone who has taken this simple, life-saving step. But on behalf of our contact tracers, I won’t stay quiet about the need for more downloads of the app until that number surpasses 600,000 –– which is the number of smartphones in Fiji.
We have received the genomic sequencing result from the Microbiological Diagnostic Unit (MDU) at the Peter Doherty Institute in Melbourne with regards to the first COVID-19 case of unknown origin in Ra. We can confirm that the virus this patient has is genetically identical to other local cases, and it is the same B1.617 variant that was first detected in India. So, while we have not established a direct person-to-person link to other local cases, we know that this case is linked to the others, and is within the same cluster that links back to the border quarantine facility. While this genetic link is positive news, not yet having a person-person link indicates that other chains of transmission have happened, and are possibly ongoing in the community. There are likely more cases out there linked to this cluster that we have not yet found.
We still have three cases of unknown origin in Fiji, case 116 –– the second gentleman from Ra, whose sample is being genetically sequenced in Melbourne, case 120, the 25-year-old doctor at Lautoka Hospital, and the most recent patient at Lautoka hospital. Though, as I mentioned, we suspect the doctor contracted the virus from this patient.
In light of the severity of the situation at Lautoka Hospital, the Ministry’s recommendation is to maintain the current borders of the existing containment areas. Food, fuel, freight, and medical evacuations, are moving across these containment area borders.
Fiji, I do not use the word “war” lightly. But, right now, we are in a war with this virus and the frontline has just extended to Lautoka Hospital. This will be the greatest test our healthcare system has ever faced –– it will be a test for all of us. Lives are at stake, sacrifices must be made, and every Fijian’s commitment is needed. The virus is insidious, it is unrelenting. All it takes is one unknown case in our community to spark an explosion of cases across the country. If that COVID-positive person remains unidentified, they are at-risk and so in the nation. But if that person comes forward, we can care for them, we can keep them safe, and we can keep the country safe. Every day of early diagnosis adds effectiveness to the treatment we can offer and stops the spread of the virus before it rages beyond our control.
I know our hearts are breaking for this patient and his family and we all have a great deal of empathy for our healthcare staff who are now working and living within Lautoka Hospital. My teams will go to every imaginable length to prevent this virus from spreading further. As our Hon Prime Minister has said, our frontliners deserve more than our empathy, they deserve more than our gratitude –– they deserve our respect for the science that informs their every action. Your adherence to our health measures is the highest form of appreciation you can show. Let’s show it together.