Statement by Permanent Secretary for the Ministry of Health and Medical Services, Dr James Fong.
As we announced earlier today, the individual admitted to the Lautoka Hospital Intensive Care Unit yesterday from a severe illness due to COVID-19 has sadly passed away.
As I covered in last night’s press conference, the patient was transferred to the ICU yesterday afternoon after his condition began deteriorating, and it was at this time that he was swabbed and tested positive for the virus. Unfortunately, despite the best efforts of the ICU team, he passed away just a few hours later with time of death at 6.35pm.
We are devastated by this loss. For the teams of doctors and nurses I lead, one fatality is far too many. We actually learned of this gentleman’s passing just before our announcement last night, but we chose to delay making the official announcement until after we could properly inform his family members. No family should learn about the death of a loved one on the news or one social media if that can be avoided. We stand by the decision to allow them a window of privacy before the passing of their loved one was announced to the nation.
This may technically be Fiji’s third fatality due to COVID-19 –– but it is our first death from a locally-transmitted case of the virus. So our sorrow –– this time –– is matched by an extreme sense of urgency to stop the spread of COVID-19 in our communities, and to prevent more vulnerable Fijians from succumbing to this deadly virus.
We suspect this patient was the source point of transmission to the two doctors at Lautoka Hospital who were previously announced as COVID-positive, but we still do not know how he contracted the virus.
I read some comments last night and today –– some confused and some angry –– about why this gentleman did not consent to be tested for COVID-19 until, quite sadly, it was too late. I can’t speak to his decision, but I know I speak for the staff of the Lautoka Hospital when I say –– this is not the time for blame. As we have seen, this virus can attack anyone. Pointing fingers is pointless. We urge the public to show concern and sympathy for all people who become infected. We also urge the public once again to agree to be tested if there is even a small chance you may have been exposed to the virus, to cooperate fully with the contact tracing teams, and to observe the practices that will keep us all safe. It could easily be a matter of life-or-death. This is a devastating virus, and as we have said, it is very unforgiving of even the smallest lapse or mistake.
After another 1723 tests, we have confirmed four new cases of COVID-19. The first is another border quarantine case who had travelled with a border quarantine case announced earlier. Dr Sahukhan will share the details of that case later. Three are local cases.
One is a 47-year-old nurse at the Raiwaqa Health Centre. She was swabbed after she reported a slight cough. After her positive result registered today, we immediately closed the Raiwaqa Health Centre to the public. A contact tracing investigation has been launched, all relevant personnel and patients are being quarantined. Her household contacts have also been swabbed. Her 51-year-old husband has also tested positive for COVID-19. He is also a focus of a contact tracing investigation.
We only identified these two cases late today, and we do not yet have a clear link of transmission for either case.
Our other local case is a 25-year-old nurse working within Lautoka Hospital. This nurse was sequestered within the hospital last night along with the rest of the hospital’s personnel and patients. Since her positive test results she has since been entered into isolation. Investigations are ongoing into how she might have caught the virus.
Our testing has ruled out a breach of the Lautoka Hospital Isolation Ward after all staff have returned negative COVID-19 test results. This is a reassuring affirmation of the operational protocols for our COVID isolation ward –– which must be maintained as the most secure facilities in the country. But that’s where the good news ends, because this indicates that the community is the most likely source of the Lautoka Hospital outbreak.
In the early phase of our containment strategy, we hoped to break the early chains of transmission quickly by tracing and testing primary and secondary contacts of existing cases. We have always screened carefully for symptomatic cases among the community as well, however, this surge in cases of unknown origin demands that we develop much stronger mechanisms of community surveillance. As our testing capacity steadily increases, we are going to become even more judicious in our testing of all Fijians with COVID-like symptoms, regardless of their connection to existing patients. But the thing about “community” surveillance is that it requires the community. It requires that all of us are fully invested in the containment of the virus. Screening clinics can be opened, but it takes the initiative of an ill patient to come forward for us to find them. Mobile screening teams can be dispatched, but my teams work far better and quicker when people are honest with them and the public is cooperative. So please, let’s make community surveillance more than a Ministry priority –– it has to be prioritised society-wide.
Following this worrying spate of cases among our healthcare workers, we are also taking urgent steps to prevent more of our health facilities from becoming source points of new outbreaks. Our longstanding protocol has been to screen all incoming patients for COVID-19 symptoms and test if necessary at admission – this will be strengthened. We’ll also be heavily restricting visiting hours at all hospitals and health centres in Fiji to limit mixing between patients, medical personnel, and the general public.
This was not an easy decision for the Ministry. We’ve only considered it given the serious threat this virus poses to our people and to our ability offer other forms of live-saving care. With Lautoka Hospital now serving as a full-time COVID care facility, we need every hospital and health centre in the country open and accessible for other critical medical treatments.
I’ve just finished a video conference with the team who are securely contained within the Lautoka Hospital Command Centre. We will be activating FEMAT –– the Fiji Emergency Medical Assistance Team –– and, as our Hon Prime Minister announced today, we have dispatched the government medical carrier vessel, the MV Veivueti, to support our healthcare management strategy within the Lautoka Containment Area.
• To cater for non-COVID patients, we are setting up a 150-bed Non-COVID Field Hospital in Lautoka. We plan to have this open in 48 hours to handle patients with illnesses that can be treated on a 21-day timeline.
• Extending from that field hospital will be clear patient care flow pathways that allow for patients to be securely moved to other hospitals and healthcare facilities if necessary. We’ll also manage staffing within the field hospital in response to patient demand.
• The Field hospital will enforce strict COVID screening and security to ensure it is a COVID-free facility, while the Lautoka Hospital remains exclusively a COVID care facility.
• To ensure there are no lapses in healthcare services for those looking to visit public hospitals, I have been talking to a number of private general practitioners in the Nadi-Lautoka-Ba area to open the doors of their clinics to those Fijians who normally cannot afford to visit a private practitioner. Under these soon-to-be finalised arrangements, patients who normally go to public hospitals and health centres can access non-COVID treatment or consultations at private clinics in Nadi, Lautoka, and Ba. Government will directly pay the private practitioners for the treatment and consultations provided for such people. Tomorrow, we will be announcing the names of the private doctors who have stepped up in solidarity with the Ministry to ensure our people can access the non-COVID care they require. I urge others I haven’t spoken with to call me. This is an opportunity for us to bring the public and private sector together at a time of urgent need for our people. Again, government will be footing the bill for the services that you provide these Fijians in-need. Most of you have my mobile number, call me and let’s get you on board.
Contingency plans have also been developed for a range of scenarios, including the need to expand capacity in the event of additional community cases in and outside of Lautoka, a severe weather event, or a COVID-leak in the field hospital. This is the first major operation for FEMAT in response to a national disaster –– our teams are ready to show the nation what they can do.
Lautoka and Suva are not the only areas of the country that require vigilance. We now have too many cases of possible community transmission to say ––with confidence –– that the virus is limited to our containment areas. Earlier, we announced that non-essential businesses outside of the containment areas may open. That’s simply no longer worth the risk. These non-essential businesses should close. Nationwide, supermarkets, shops, banks, pharmacies, and other essential industries –– as previously announced – are the only businesses that should open.
The costs of this outbreak are already unacceptably high, and I cannot stress enough how important early, preventive action is to stopping those costs from rising further. Early diagnosis of the virus can increase survivability. Early society-wide prevention measures can decrease widespread transmission. Wash your hands often, wear a mask in public, install careFIJI and keep it running every time you leave the home, and maintain physical distance at all times. The police have announced today they will be enforcing physical distance in public places and businesses. If you see a crowd, don’t add to the problem. Stay away. Better yet, don’t leave home at all. Stay home. My staff in Lautoka Hospital don’t have that privilege at the moment, so let’s honour their sacrifice by staying within the safety of our homes as much as possible.
COVID-19 has never posed a graver risk to Fijian lives than it does today. If our ICUs become stressed with high numbers of COVID-positive patients, we will be hard-pressed, like other countries with high rates of infection, to fully treat people who need critical care, and it will be too late to prevent a great deal of human suffering. We still have the chance to stop that from happening. I’ve detailed the steps the Ministry is taking to make our services as COVID-safe as possible. I ask that households, communities, organisations, and businesses all think just as seriously about the steps they can take as well. The health guidance we publish is the baseline for the actions and behaviour we expect from businesses and the public. If you see an opportunity to go above and beyond our guidance to keep yourself, your workplace, or your household members safe –– take it. You could save a life. And together, as that commitment carries across the country, all of us can spare Fiji from the further heartbreak of losing more patients to this virus.