COVID-19 Update 16-03-2022

Last Updated on 1 year by Publishing Team

COVID-19 Update

Wednesday 16th March

Transmission Update: Since the last update, we have recorded 13 new cases of which 8 new cases were recorded on 15/03/2022 and 5 new cases in the last 24 hours ending at 8 am this morning. Of the 13 cases recorded, 7 cases were recorded in the Central Division; 5 cases were recorded in the Western Division, 1 case was recorded in the Northern Division, and nil case was recorded in the Eastern Division. The national 7-day rolling average of cases as of 12th March is 6 daily cases. In the 7 days until 15/03/2022, 18 new cases were recorded in the Central division, 4 new cases in the Western division, 5 new cases in the Northern Division, and 1 new case in the Eastern Division. The Central Division cases constitute 68% of the cumulative total cases nationally, with the Western division making up 27%, 3% in the Northern Division, and 2% in the Eastern Division.

Deaths: The curves depict weekly COVID-19 deaths by division since May 2021. It indicates a surge from December-end 2021, which peaks by mid-January 2022. The 3rd COVID 19 wave is considered to have started around mid to late December 2021. (Note: Death notifications from within the last two weeks are still being received, therefore the graphs may alter slightly upon reporting).Analysis of Deaths in the Third Wave  Table 1: Death rates by Division Division Total COVID Deaths Deaths per 100,000 Central 61 15.4 Western 44 12.3 Northern 28 20.0 Eastern 5 13.0 An analysis of the 138 deaths recorded in the third wave shows that, while the Central Division has the highest absolute number of deaths, the Northern Division has the highest rate of death when adjusted for population.  Table 2: Deaths by Age Group Age Group Total Deaths Deaths per 100,000 population 0 – 9 6 3.3 10-19 2 1.3 20-29 3 2.1 30-39 4 2.9 40-49 6 5.4 50-59 18 19.8 60-69 27 51.9 70-79 42 187.5 80-89 23 408.8 90-99 5 961.5 For the 138 deaths in the third wave, the death rate adjusted per 100,000 population, has been highest in age groups 50 and onwards. There were 8 deaths below the age of 19 years, 7 out of the 8 children had significant pre-existing medical conditions, and one child had no known underlying medical condition. Table 3: Deaths by Vaccination Status Age Cohort Total COVID deaths Total Vaccinated/ Unvaccinated Deaths per 100,000 Vaccinated Population Deaths per 100,000 Unvaccinated Population >18 129 55/75 9.4 175.4 15-17 1 0/1 0 6.6 12-14 1 0/1 0 2.5 Out of 138 COVID -19 deaths reported in the third wave, six (6) deaths were in the population not eligible for vaccination (under age 12). An analysis of the 133 deaths in the vaccine-eligible population reflected, that when adjusted per 100,000 population, for fully vaccinated (received 2 doses) and unvaccinated/not fully vaccinated (received 0 doses or only 1 dose) adults in Fiji, a death rate of 9.6 per 100,000 population for fully vaccinated adults and 190.5 for unvaccinated adults was exhibited. This means that unvaccinated adults in Fiji have been dying at a rate 18.5 times higher than fully vaccinated adults during the current COVID-19 wave. Individuals of the 12-17 age group who died were not vaccinated. There have been no COVID-19 deaths in individuals who received a booster (3rd dose) of the vaccine. New deaths to report There is no new COVID-19 death to report. There have been a total of 834 deaths due to COVID-19 in Fiji. 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 March 12th, 2022, the national 7 days rolling average for COVID-19 deaths per day is now 0.0, with a case fatality rate of 1.29%. We have recorded 912 COVID-19 positive patients who died from other serious medical conditions unrelated to COVID-19; their doctors determined that COVID-19 did not contribute to their deaths, therefore these are not classified as COVID-19 deaths.

Hospitalization: There is a sustained downward trend in daily hospitalizations. Using the WHO clinical severity classification, a greater percentage, 75% (n=3) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild, 25% (n=1) are categorized as moderate with nil cases in the severe and critical category. Anyone admitted to the hospital is tested before admission, therefore, a significant number of people are admitted to the hospital for non-covid health conditions, but incidentally, test positive due to the high amount of transmission in the community. The number of people being admitted because of COVID-19 remains low.

Testing: 116 tests have been reported for March 15th, 2022. Total cumulative tests since 2020 are 502,686 tests. The 7-day daily test average is 121 tests per day or 0.1 tests per 1,000 population. The national 7-day average daily test positivity is 4.0%, which is within the WHO recommendation of 5%.

Public Advisory:

COVID-19 Vaccination

As of 16th March, a total of 112,295 individuals have so far received booster doses. Members of the public are advised to obtain their booster dose after at least 5 months from their second COVID-19 vaccine dose. Moderna vaccine and Pfizer vaccines are both available for adult booster doses.

Our vaccination efforts in children are currently progressing well. We have reported that the estimated numbers of adults (i.e. people aged 18 and over) that we wanted to vaccinate have been achieved, however as these were estimates, we expect that there will be pockets of unvaccinated adult individuals. We’re extremely proud to have achieved such high coverage but our operational focus is on the larger target population of people aged 12 years and above. Our 2 dose vaccination coverage of our entire vaccine eligible population (all persons 12 years old and beyond) is 87%. The impact of our vaccination program has been clearly demonstrated by the fact that case numbers and severe disease outcomes were significantly mitigated in the West during the second wave (Delta), and the higher vaccination rates contributed significantly to this. Furthermore, the health impact of the last wave (Omicron) was mitigated by our collective engagement in Vaccineplus measures. Our borders were opened safely because of the high level of protection we built up together.

Our current booster program has been slowed down by slower uptake and deployment difficulties related to competing priorities in dealing with the surge of leptospirosis, typhoid, dengue fever, and influenza. The public is reminded of the need to get booster vaccine doses, and the list of vaccination sites is provided daily on the MOH webpage. The current situation is that we expect decreasing immunity from the 2 doses of vaccines and possibly decreasing post-infection acquired immunity. COVID is endemic in Fiji, as it is in most of the world, which basically means it is always present. We are also open to international travel while Europe, China, New Zealand, and Australia are experiencing surges in COVID cases. We need people to get a booster dose so we can reduce the risk of future surges in COVID 19 in terms of severe disease and hospitalisation, and severe public health measures.

We will continue to monitor the evidence on post-infection immunity based on quality data that is being generated globally.  However, until we have a better sense of the role of post-infection immunity, the Ministry of Health will continue to define our level of protection based on vaccination numbers

Given the current stocks of Pfizer vaccine we have, we will be using Pfizer for the ongoing primary 2 dose schedule of children and adults and as the booster dose.

Influenza

The surge in influenza cases has caused a severe strain on outpatient care capacity. We are still seeing a high number of LTDD cases while also continuing our efforts to support COVID-19 vaccination needs. These factors together only increase the pressure on all healthcare services, especially our outpatient facilities.

Before the pandemic, Fiji’s influenza season typically began in January and ended by May/June. However, in 2020 and 2021 there was a marked decrease in cases of influenza detected, a trend that was also seen in other countries. It is likely that public health and social measures deployed for COVID-19 worked to decrease other respiratory viruses, including influenza. The current increase in cases suggests a return to pre-pandemic levels of seasonal influenza, however, it is also possible that decreased incidence of influenza in recent years will have led to decreased immunity in the community, and subsequently more people becoming ill than in a usual flu season.

Children under the age of 5 (especially babies) and the elderly are most at risk of severe influenza.

We have published advisories on how to care for oneself and children with flu, and what symptoms to be on the watch out for especially as related to seeking extra care (https://www.health.gov.fj/influenza/).

The Ministry has been working on measures to open more facilities with extended service hours and streamline outpatient services to help reduce waiting times. We have recently seen the return of many of our staff from annual leave that had been deferred during the second and third waves of COVID-19, as well as sick leave during this increase in flu. We have also made adjustments in our outreach programs to deal with LTDD,  and vaccination needs, in order to free up staff for outpatients services in health centres to help improve services.

Leptospirosis, typhoid, and dengue fever

As previously mentioned, the recent weather has resulted in conditions conducive to outbreaks of leptospirosis, typhoid, and dengue fever, which are climate-sensitive diseases endemic to Fiji. Though we have noted a decrease in hospital admissions, we are also aware of continued heavy rain in parts of the country, particularly the Western Division, and our experience has been that leptospirosis cases, hospitalizations, and deaths increase following similar weather events. As such the medical advice we provide needs to be followed, while we continue to mount our public health and clinical response. Please heed our advice to protect yourselves and your loved ones

Prevention

The leptospirosis bacteria is spread to humans through the urine of infected animals, such as cows, pigs, rats, and dogs. To reduce your individual risk, it is important to understand that exposure to animals, soil, mud, and floodwaters during work or recreational activities increases your risk of infection.

Important prevention measures include wearing full covered footwear at all times when going outdoors, avoiding wading or swimming in flooded waters, using clean fresh water to wash up after exposure to muddy waters, and keeping all food and drinks covered and away from rats. For workplaces, practice good personal hygiene at all times, cover cuts and wounds well, and use protective equipment, especially footwear when in flooded and/or muddy areas.

We are also urging all parents and guardians to prevent children from playing in the mud or swimming in flooded rivers or creeks, and ensure that they wear shoes when outside.

Symptoms and treatment

Early treatment can decrease the severity and duration of the disease. Please seek medical care if you have recently had contact with floodwaters, mud, or animals, and develop the following symptoms: fever, muscle pain, headache. You may also have red eyes, loss of appetite, nausea/vomiting, dizziness, or feel weak.

Leptospirosis can be treated with appropriate antibiotic medications prescribed by a doctor if treatment is sought early. Danger signs for severe leptospirosis include shortness of breath, coughing blood, chest pain, yellow eyes/skin (jaundice), signs of bleeding (including unexplained bruising), decreased or increased urination, difficulty staying awake. Severe leptospirosis is life-threatening, and anyone with these symptoms must be taken to the hospital immediately.

Typhoid fever

Typhoid fever is typically found in areas that do not have access to proper toilet facilities and/or clean drinking water. We strongly encourage people who live in rural areas, informal urban areas, and any other areas where access to clean drinking water is limited, to boil all drinking water. We must all also continue to practice basic hygiene measures such as frequently washing hands with soap and water, especially after visiting the toilet and before eating or preparing food.

Dengue fever

We continue to urge everyone to get rid of potential mosquito breeding places, such as empty containers inside and outside your homes that may collect water, including discarded tires, flower vases, and pot plant bases. Protect yourself from being bitten by mosquitoes by using mosquito screens in your homes, and mosquito repellents.