The World Bank – Fiji COVID-19 Emergency Response Project Virtual Implementation Support Mission kicks off today Monday, October 25th at 2.00 pm. It started with PS Health & Medical Services Opening Remarks before the Project Manager presented on the progress update of the project. This was followed by the presentation from General Manager IMT on the Government of Fiji’s COVID Response Unit. The meeting will finish on Thursday, October 28, 2021.
Transmission Update:
Since the last update, we have recorded a total of 51 new cases; of which 22 new cases were recorded on 23/10/2021, 15 new cases on 24/10/2021, and 14 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 for this 2nd wave, there have been 51,958 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 35 daily cases calculated for 20th October 2021. |
Deaths: We do not have any COVID-19 deaths to report.There has been 1 death of a COVID-19 positive patient. However, this death has been classified as a Non-COVID-19 death by the doctors, as patients died of serious pre-existing medical conditions. There have been 673 deaths due to COVID-19 in Fiji, with 671 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 20th, the national 7 days rolling average of COVID-19 deaths per day is 0.1. The 7 days rolling average for COVID-19 deaths per day in the Central Division is 0.1 and 0.0 in the Western Division. We have also recorded 560 COVID-19 positive patients who died from the 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 26 cases per day or 29 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 will transition to community surveillance testing as severe disease numbers and positivity rates approach the containment phase levels.
Public Advisory:
Preparation for Quarantine Free Travel to the Northern Division
Our current vaccine coverage data indicates a need for MOHMS to provide additional resources to Nabouwalu Hospital to prepare for the possible escalation of COVID 19 cases and adverse events. The second dose vaccination coverage for the Bua subdivision remains a concern based on the MOH vaccination coverage data. This will have to be a key strategy in remodelling the health service provision to ensure:
The Whole-of-Government Community Engagement initiative will be escalated in the North with particular attention made to the Bua Subdivision and this will include a reduction of the dose interval to 6 weeks. We look forward to the engagement of all community leaders to facilitate this exercise.
Exemption from Vaccination
We have received a number of requests for exemption from vaccination on medical grounds. The exemptions on medical grounds are provided for the following reasons:
The following conditions that are NOT considered for a medical exemption include:
International Travel
From 11th November through to 1st December 2021, Fiji will only accept fully vaccinated permit holders, Fijian passport holders, and returning residents who will be required to undertake a 3-day quarantine in a Fiji Managed Quarantine facility and will be subject to RT-PCR tests 72 hours pre-departure and in-country. Beginning 1st December 2021, Fiji will be open to fully vaccinated travelers from Travel Partner Countries for reduced quarantine arrangements on arrival.
The Ministry of Health and Medical services is also in the final phases of:
The public is reminded that there will always be people vulnerable to the virus despite our high vaccination coverage. We have one-third of the population under 18 years old, most of whom still need to be vaccinated. We will have older people with comorbidities whose ability to build up vaccine immunity is not as good as younger and healthier persons. Also of concern is that we will have unvaccinated people in our communities who are also not exposed to the virus, and hence do not have any protection against the disease, and among them are elderly persons and those with serious comorbidities. As such, future resurgence of infections and increased case numbers will again test our critical care capacities. We are constantly reviewing and updating our healthcare protocols so we can respond effectively to future outbreaks.
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. Whilst the easing of restrictions is needed to facilitate social and economic livelihood, the public must ensure that together with vaccination, we continue to observe our COVID safe measures and avoid contained spaces and crowds.
The potential for transmission in any community will be slower, and the ability to contain the outbreak better, when we achieve a high vaccination rate and also maintain strict adherence to COVID safe measures. When we do this, we not only protect ourselves but also protect all those around us, especially the vulnerable, those not eligible for vaccination, and those who are not yet vaccinated.
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. |
Deaths:
We have an additional 10 COVID-19 deaths to report for the period 2nd August 2021- 20th October 2021. Nine deaths were reported from the Western Division and one from the Central Division. An analysis of the 10 deaths highlighted that individuals were aged between 45 to 92 years, 56% (n=6) were males, all 10 individuals died at home or on their way to the hospital and 67 % (n=6 ) of these deaths were unvaccinated, the remaining 33% (n=4) received only one dose of the vaccine. This means that there were no deaths of individuals who were fully vaccinated. Nine of these deaths were reported from August today due to a delay in the issuance of the death certificates. We have also recorded 559 COVID-19 positive patients who died from the 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 40 cases per day or 45 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 will transition to community surveillance testing as severe disease numbers and positivity rates approach the containment phase levels.
Public Advisory:
International Travel
From 11th November through to 1st December 2021, Fiji will only accept fully vaccinated permit holders, Fijian passport holders, and returning residents who will be required to undertake a 3-day quarantine in a Fiji Managed Quarantine facility and will be subject to RT-PCR tests 72 hours pre-departure and in-country. Beginning 1st December 2021, Fiji will be open to fully vaccinated travelers from Travel Partner Countries for reduced quarantine arrangements on arrival.
The Ministry of Health and Medical services is also in the final phases of:
The public is reminded that there will always be people vulnerable to the virus despite our high vaccination coverage. We have one-third of the population under 18 years old, most of whom still need to be vaccinated. We will have older people with comorbidities whose ability to build up vaccine immunity is not as good as younger and healthier persons. Also of concern is that we will have unvaccinated people in our communities who are also not exposed to the virus, and hence do not have any protection against the disease, and among them are elderly persons and those with serious comorbidities. As such, future resurgence of infections and increased case numbers will again test our critical care capacities. We are constantly reviewing and updating our healthcare protocols so we can respond effectively to future outbreaks.
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. Whilst the easing of restrictions is needed to facilitate social and economic livelihood, the public must ensure that together with vaccination, we continue to observe our COVID safe measures and avoid contained spaces and crowds.
The potential for transmission in any community will be slower, and the ability to contain the outbreak better, when we achieve a high vaccination rate and also maintain strict adherence to COVID safe measures. When we do this, we not only protect ourselves but also protect all those around us, especially the vulnerable, those not eligible for vaccination, and those who are not yet vaccinated.
Vaccine Third Doses and Booster Doses
The Strategic Advisory Group of Experts on Immunization (SAGE) have recommended that moderately and severely immunocompromised persons should be offered an additional dose of all WHO EUL COVID-19 vaccines as part of an extended primary series since these individuals are less likely to respond adequately to vaccination following a standard primary vaccine series and are at high risk of severe COVID-19 disease. The Ministry of Health will be offering third doses to eligible persons.
Booster doses for those over 60 years old, those 18 years or older with medical conditions that put them at high risk of COVID-19 and those 18 years and older who work in locations that put them at high risk is currently being planned for.
Preparing COVID safe Workplaces
As we prepare for more industries and workplaces to open, the Ministry of Health and Medical Services reiterates our advice for all workplaces and business places to establish strategies to ensure personal COVID safe practices continue and are monitored, improved, and escalated. We remind all businesses and workplaces of the need to focus on improving ventilation and air quality to support their current COVID safe measures. There is increasing scientific evidence that improvement in ventilation and air quality in workplaces is necessary for a COVID safe working environment, whilst sanitization of all contact surfaces provides secondary support in reducing the transmission of the SARS-CoV-2 virus.
Maximizing natural ventilation by opening windows, doors, and vents when conditions allow (not posing a safety risk), or mechanical ventilation using fans and ducts, or a combination of both is important. Any poorly ventilated spaces in the workplace must be identified and steps are taken to improve fresh air flow in these areas. The use of portable air cleaners with High-Efficiency Particulate Air (HEPA) filters in spaces with high occupancy or limited ventilation is strongly recommended. In buildings with heating, ventilation, and air conditioning (HVAC) systems, it is important to ensure that:
 Transmission Update:
In the past 7 days, 181 cases were recorded in the central division, 82 new cases in the western division, 16 new cases in the eastern division, and 6 new cases in the northern division. The central division cases constitute 71% of the cumulative total cases nationally, with the western division making up 27% and 2% in the northern and eastern divisions. Since the last update, we have recorded 64 new cases of which 39 new cases were recorded on 19/10/2021 and 25 new cases in the last 24 hours ending at 8 am this morning. The weekly incidence rate graph by division indicates a continually declining trend. Furthermore, the peak weekly incidence in the western division was approximately a third of that in the central division, and the cumulative case numbers are also reflecting a similar difference. |
 Deaths:
This curve depicts the weekly death rate per 1000 population by divisions since the 2nd wave of this outbreak began in April 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 weekly cases and are likely a reflection of vaccination levels, COVID mitigation measures, and differences in population density. 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 15th, the national 7 days rolling average of COVID-19 deaths per day is 0.1. The 7 days rolling average for COVID-19 deaths per day in the Central Division is 0.1 and 0.0 in the Western Division, with a case fatality rate of 1.28%. |
 Hospitalisation: The downward trend in both the new hospital admissions and total admissions in all hospitals admitting COVID-19 patients across the country is consistent with the cases and death trends. The hospital admissions continue on a downward trend indicating a sustained positive response to COVID mitigation measures, Population density differences, and differential Vaccination rates. |
 Testing:
834 tests have been reported for October 19th, 2021. The 7-day daily test average is 982 tests per day or 1.1 tests per 1,000 population. The national 7-day average daily test positivity is 3.9%, which is on a downward trend, and below the WHO recommendation of 5%, and this is illustrated by the lab testing graph; also noting the reduction in the daily number of cases. Though we continue testing in high-risk areas, our case numbers and test positivity rate continue to decrease, indicating a better control of the community transmission in Fiji through the combined efforts of containment and mitigation measures with ongoing community surveillance. |
Epidemic Outlook:
The 7-day average of new cases per day is 37 cases per day or 42 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 will transition to community surveillance testing as severe disease numbers and positivity rates approach the 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:
We are continuing the process of normalizing movement between Viti Levu and Vanua Levu. Precautions are being taken, including requiring a negative COVID-19 test before departure and a 7 day home quarantine. However, COVID-19 has reached communities in almost all countries in the world. As such, community transmission of COVID-19 in the North is to be expected. However, we anticipate that the number of cases, and cases with severe disease, will be less than that seen with the outbreak in Viti Levu, because of higher vaccination coverage.
Within Viti Levu, the outbreak was contained in the Lami to Nausori containment area long enough to allow for escalation of vaccination coverage and clinical response capacity outside the containment area. This contributed to the lower peak and the total number of cases, hospitalizations, and deaths outside the containment area within Viti Levu. We expect to see the same trend in the Northern division, especially if covid safe measures are consistently adhered to.
The best protection from COVID-19 is to get vaccinated, as it reduces your risk of being infected, and spreading the virus. But if you do get infected, it is highly protective in preventing severe disease and death. If you are eligible for vaccination (aged 15 and over) and have not been vaccinated, please get vaccinated now, and continue to practice other protective measures: avoid poorly ventilated, crowded, and confined places, wear a mask when indoors (except in your own home) and in public transport.
The people of the North are reminded to continue to get vaccinated. And with vaccination, we must continue to closely observe our COVID safe measures and avoid contained spaces and crowds to minimize the risk of the 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 now enjoy.
The Ministry of Health and Medical Services in preparation for easing of restrictions in the North has remodeled the health service provision to ensure:
Our 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. As such:
Travel to the maritime islands will undergo similar changes once their 2nd dose vaccination coverage reaches 80% with a 72-hour pre-departure test and on island 7-day quarantine for fully vaccinated travelers. Also for all maritime resorts, travel restrictions will be eased for fully vaccinated workers originating from Viti Levu and maritime islands that have 80% or more 2nd dose coverage.
As mentioned by our Prime Minister on the 10th of October, we plan to drop any quarantine requirement for inter-island travel once more Fijians in Vanua Levu and other islands are fully vaccinated. From 11th November we will open regular inter-island travel but only if vaccination rates in the north and maritime islands maintain a steady rise.
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. |
 Deaths:
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 the present time, 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:
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.