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DIARRHEA OUTBREAK IN BALEVUTO, BA

MINISTRY OF HEALTH AND MEDICAL SERVICES ADDRESSES DIARRHEA OUTBREAK IN BALEVUTO, BA

12 September 2023

The Ministry of Health and Medical Services wishes to inform the public that investigations into the increase of cases of diarrhoeal disease reported in the Balevuto Medical Area remain ongoing. From August 20th to 11 September 2023, 72 cases of diarrhoeal illness presenting with loose bowel motions, with or without blood in stool, with fever, abdominal pain or vomiting were reported in the Balevuto medical area,  including in Nukuloa, Balevuto, Nacaci, Toge, Vatusui, Tabataba, Naruku, Talaiya, and Moto. Currently we are seeing 4 to 5 new cases per day as opposed to 0 to 2 cases per day prior to this outbreak.

The Ba team are, working on ensuring there is community wide close follow up of patients with chronic underlying disease, and the elderly, to ensure ongoing wellbeing, as these are the groups of people more at risk of falling ill and also developing severe disease during this outbreak.

As of 11 September 2023, seven (7) out of 18 people admitted to the hospital, have been discharged. Furthermore, all the cases admitted have responded well to antibiotics and other support treatment provided.  One suspected case has tested positive for Shigella sonnei, a type of bacteria that is spread through the faeces of infected persons, and that is known to cause outbreaks of acute diarrhoeal illness. Further specialized testing of patient samples will be done at a reference laboratory in Melbourne.

The Ministry Health and Medical Services has four teams on the ground actively monitoring the situation, and contingency plans are in place to expedite or escalate our response if necessary. Chemical analysis of tap water from the water supply scheme providing tap water to over 6,000 residents conducted by Koronivia Research Station shows all chemicals are within the normal range for drinking water standards (USAEPA Drinking Water Standards, 2018; WHO Drinking Water Standards 2019 Guidelines).

In addition to the already conducted analysis of the tap water, the Ba Medical team, , are collecting samples from alternative sources of water i.e., tanks and borehole for analysis at Fiji CDC. The teams are also doing house visits, supplying WASH kits, purification tablets and conducting public health awareness.

Ministry of Health and Medical Services continues to work in close collaboration with partners including the Water Authority of Fiji, the Ministry of Rural and Maritime Development and Disaster Management, and Ministry of Education and wishes to assure the Nacaci residents that we are committed to addressing this issue promptly and transparently to ensure the health and well-being of our communities.

We implore all residents of Nacaci Settlement, as well as those in Balevuto and nearby areas, to prioritize good hygiene practices, including boiling all drinking water and proper handwashing with soap and water before and after meals, as well as after visiting the toilet.

We urge the public to promptly seek medical attention at their nearest health facility if they experience loose and watery stools, along with any of the following symptoms:

– Nausea (feeling sick)

– Vomiting

– Fever

– Headaches

– Bloating and Flatulence (excess gas)

– Abdominal pain

– Loss of appetite

The Government remains committed to ensuring the safety and health of our communities, and we will continue to provide updates as the situation evolves.

The rumored strike/protest by the nurses is not happening

PRESS RELEASE

23 AUGUST 2023

 

The rumored strike/ protest tomorrow by the nurses is not happening. This has been welcomed by the Acting Minister for Health & Medical Services Filimoni Wainiqolo Vosarogo. All Fijians can continue to rely on undisrupted medical services Fiji wide.

“We have had a great meeting today between the Executives of the Fiji Nurses Association (“FNA”) and executives of the Ministry of Health and Medical Services. Today, we had a hard talk. Everything was laid on the table, historical, systemic and legacy issues of the past that needed consideration, urgent or otherwise” said Acting Minister for Health & Medical Services Filimoni Wainiqolo Vosarogo.

Staff of the Ministry and the Ministry of Finance are working through to ensure that pays for nurses reflecting their new pay backdated to 1 August is accurately reflected in their pay slips and in what they get.

“Any anomalies will be addressed by the Ministry in the subsequent pay and nurses are urged to report any anomaly that they find in their pay tomorrow. This has been assured to the FNA Executives by the Deputy Prime Minister and Minister for Finance, Prof Biman Prasad” Acting Minister said.

The parties were reminded that consultation and continued dialogue on the most important things concerning nurses should be done periodically and consistently.

“We invite dissonance when we forget the importance of continued dialogue and officials of

government need to understand that we must work with stakeholders who serve as a  support mechanism for the common good of the nation. When we choose to discard genuine arms length dialogues, systemic strains result and before we know it, a crisis is inevitable. The key is fixing it when you have the time and opportunity to do so. We were able to do part of that today.”

“We thank the FNA Executives for coming to the meeting today and for laying on the table these legacy issues that should have been addressed years ago. I can identify systemic issues that have caused these dissonance and mistrust, apprehension and creation of an unhealthy work environment that is not good for our medical services.”

The Ministry and the FNA have agreed to meet again in the next 14 days to reflect on today’s meeting outcomes and to then map a way of a periodic scheduled meeting to continuously monitor the issues that will be discussed 14 days from now.

“Today, I have urged the parties, continue to talk. If you have not talked periodically in the past, do that now. It is for the well-being and welfare of nurses. They are the frontline personnel who receive the sick and ills of our nation and care for them. Government may not be able to do it all at once, but we can map a future plan of action for them, one that they know and understand that would allow them to enjoy working in the conditions they are exposed to” Vosarogo said.

COVID-19 Update 29-06-2023

COVID-19 Update

Thursday 29th June

Transmission Update:

Since the last update on 22/06/23, we have recorded 17 new cases.

Of the 17 new cases recorded, 11 cases were recorded in the Central Division; 6 cases in the Western Division; with nil cases in the Northern and Eastern Divisions.

The national 7-day rolling average of cases as of 25th June is 3 daily cases.

The Central Division cases constitute 66% of the cumulative total cases nationally, with the Western division making up 28%, 4% in the Northern Division, and 2% in the Eastern Division.

Deaths:

This graph depicts weekly COVID-19 deaths by division from November 2022 to the current full Epi week.

COVID Death Reports

There is no (0) COVID-19 death to report.

Analysis of COVID-19 Deaths 

Table 1: Death rates by Division

Division Total COVID Deaths Deaths per 100,000
Central 78 19.44
Western 70 19.7
Northern 31 22.1
Eastern 5 13.0

An analysis of the 182 deaths recorded since December 2021, shows that 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 8 4.4
10-19 2 1.3
20-29 3 2.1
30-39 5 3.6
40-49 8 7.7
50-59 24 26.4
60-69 38 73.1
70-79 55 245.5
80-89 35 607.1
90-99 6 1153.8

The death rate adjusted per 100,000 population, has been highest in the age group 50 years and over for the 182 deaths since December 2021. There were ten (10) deaths below the age of 19 years, 7 out of the 9 children had significant pre-existing medical conditions, and three (3) children 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
>18 172 73/99 12.4 344.4
15-17 1 0/1 0 6.6
12-14 1 0/1 0 2.5

Of the 182 COVID-19 deaths reported since December 2021, eight (8) deaths were in the population not eligible for vaccination (under the age of 12). An analysis of the 174 deaths in the vaccine-eligible population revealed that Fiji has a death rate of 12.4 per 100,000 population for fully vaccinated adults and 344.4 per 100,000 population for unvaccinated adults. This means that unvaccinated adults in Fiji have been dying at a rate 27.8 times higher than fully vaccinated adults. Individuals in the 12-17 age group who died were not vaccinated.

There has been a total of 885 deaths due to COVID-19 in Fiji. As of December 25th, 2022, the national 7 days rolling average for COVID-19 deaths per day is 0.0 with a case fatality rate of 1.28%. 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.

We have also recorded 1,007 COVID-19-positive patients who died from other serious medical conditions unrelated to COVID-19; their doctors have determined that COVID-19 did not contribute to their deaths, and therefore these are not classified as COVID-19 deaths.

Hospitalisation:

Currently, we do not have any (0) admissions as a direct cause of COVID-19. However, four (4) admissions have tested as covid positive but are admitted for other diseases. Patients presented to the hospital are tested before admission therefore, a high number of people who are admitted for non-covid health conditions, test positive for COVID-19 due to the current level of transmission in the community.

Using the WHO clinical severity classification, there are 50% (n=2) cases in the asymptomatic and mild categories; 25% (n=1) cases in the moderate category; 25% (n=1) in the severe category, with nil cases in the critical category.

Testing:

12 tests had been reported for 28th June 2023. The total cumulative tests since 2020 are 672,883 tests. And the 7-day daily test average is 19 tests per day or 0.0 tests per 1,000 population.

The national 7-day average daily test positivity is 5.3%, which is just above the WHO recommendation of 5%, indicating some community transmission of the COVID-19 virus.

Public Advisory

COVID-19;

There is a continuing report of new COVID-19 cases however the number of cases we report together with declining absenteeism rates in schools and hotels suggest declining trends in COVID-19 transmission.

Even with this current wave, hospital data suggests that Recent mutations of COVID-19 have led to less severe disease. This indicates that we still currently enjoy a high level of protection from severe disease.  We continue to focus on implementing COVID safe measures around those vulnerable to the severe effects of COVID-19. This includes escalating measures in hospitals, old people’s homes, and facilities catering to disabled persons. As such we expect to escalate screening protocols and masking for staff, patients, and visitors. Furthermore, visitor restrictions will be in place.

However, we must remain vigilant. There is expected to be some immune escape capability that makes the variant more transmissible. The elderly, those with chronic diseases, pregnant mothers, and children with disabilities must be closely watched. That said, the booster would still be important for people at the highest risk of getting severe disease. This includes those ages 65 and older and those who are immunocompromised. Even small, additional increases in antibody production are critically important for them.

We emphasize the point that strengthening our ability to live with COVID means we remain vigilant, maintain community-wide adoption of COVID safe measures where appropriate, and keep the impetus for immunisation. This is the only means to reduce the disease spread and protect those in the community who are less able to fend for themselves.

There are several reasons it’s important to avoid getting COVID-19. Getting infected puts you at risk of severe illness, potential hospitalization, and death, especially if you are high-risk and unvaccinated.

The risk of long COVID remains a concern. There are currently too many unknowns regarding who is more likely to get long COVID, but the risk of developing this chronic condition after infection is very real. Millions of people have developed this and suffered for many months, including time and money lost by the inability to work.

COVID-19 is unlikely to go away completely. There are still many unknown variables. Virologists wonder whether it will behave like other coronaviruses – many of which cause the common cold. It may end up reappearing seasonally, as most of our viruses do.

In prior epidemics, viruses eventually reach a saturation threshold, meaning most of the population will be or has already been infected. At this point, when the virus has fewer people to infect, the epidemic will decrease naturally.

Hopefully, this will equate to an endemic instead of a pandemic. Endemic is a disease that is still around but at a more manageable level, without causing spikes in deaths, for example. Instead, the disease is more manageable in terms of not overwhelming the system. The hope is that if COVID-19 is not eliminated, it would become more like the common cold.

Also, anyone who falls sick should not be attending work or school, especially if they have COVID-19-like symptoms. You must get tested for COVID-19; 5-day isolation is recommended if you have tested positive.

Influenza and Acute Respiratory Illness

Our surveillance data shows that the current and ongoing influenza-like and acute respiratory illnesses continue.

Earlier this year, we had an outbreak of a type of Influenza type A virus scientifically labeled as FluA/H1 Pdm. This outbreak had receded however, we now have indications of another outbreak of Flu-like illness. Essentially, we are observing a “double peak trend” (bi-phasic) of Influenza-like illness (ILI) case reports over the last several months since December 2022. As observed from past years’ trends, Fiji’s annual influenza season runs from January to May – June.

The predominant influenza strain Influenza B/Victoria has been in circulation and is likely the cause of this surge of ILI cases being reported and observed locally. It must be noted that this increased presence of influenza B in circulation is similarly being observed in other countries of the region and the world.

We do have Tamiflu (antiviral medications) stock which has been distributed and we are getting more Flu vaccines which will be offered to those vulnerable to the severe effects of Influenza (individuals with chronic illness, pregnant women, and to frontline staff. Surveillance has also been escalated and we await more recent reports to determine ongoing trends. Whilst we still have stocks of flu testing reagents and consumables, we are also working with WHO to increase our stocks.

The Ministry of Health and Medical Services advises public members to stay at home when feeling unwell or wear face coverings (masks) when going outside to minimize the spread of infection.

We also advise that people living with chronic disease and children, especially babies, need to be protected from the severe effects of influenza. This entails preventing infection by proper masking in crowded and/or poorly ventilated spaces, early recognition of the symptoms, and seeing a doctor early. It is essential that these vulnerable persons are carefully monitored to ensure early access to intervention if severe symptoms develop.

Preventative measures will be familiar as they are similar to COVID-19. Wear a mask that covers your mouth and nose when in a public place, wash your hands frequently with soap and water or use an alcohol-based hand sanitizer, avoid crowds, stay home if you are sick, and cover your mouth and nose if you cough or sneeze.

Seek medical care: For adults, see a Doctor if the following dangerous symptoms develop; difficulty breathing or shortness of breath, pain or heaviness in the chest, persistent fever ( more than 3 days, despite home treatment), very high temperature (over 40°C), feeling sicker as time goes by, confusion and persistent drowsiness, severe headache that doesn’t respond to painkillers and unusual symptoms such as hallucinations, severe vomiting, neck stiffness, skin rash, rapid heart rate, chills, uncontrollable shivering, or muscle spasms.

For children, seek medical care right away if your child:

  • has a fever greater than 38°C for more than two days, or a fever of 40°C or higher for any amount of time
  • has a fever of 38°C or higher and is under 3 months old
  • has a fever that doesn’t get better after taking Panadol
  • seems unusually drowsy or lethargic
  • won’t eat or drink
  • is wheezing or is short of breath

COVID-19 Vaccination

While we are expecting new supplies of COVID vaccines at the end of next month (July), the Pediatric supplies of vaccines are available for children aged 5 to 11 years and are accessible at the nearest Health Center.

We have been reporting that 100% of our estimated adult population have received one dose and 95% have received the second dose. The vaccination of our target population has been progressing well with the 12 years and above coverage rate for Fiji being 99% for Dose 1 and 89% for Dose 2.

Additionally, as of the 22nd of June, 172,078 (55%) booster-eligible individuals have so far received their 3rd dose while 29,929 individuals have been administered the 4th dose.

We urge the unvaccinated adults and children to get their vaccine status updated. Those who are residing in the Central and Western Division and are yet to receive their 1st and 2nd doses and especially the children in the Rewa and Nasinu schools. All travelers are also encouraged to get themselves vaccinated.

To register online for the first dose, please visit vra.digitalfiji.gov.fj

COVID-19 Update 15-06-2023

COVID-19 Update

Thursday 15th June

 

Transmission Update:

 

Since 08/06/23, we have recorded 49 new cases, inclusive of  6 reinfections.

Of the 43 new cases recorded, 26 cases were recorded in the Central Division; 16 cases in the Western Division; 1 case in the Northern Division with nil cases in the Eastern Division.

The national 7-day rolling average of cases as of 11th June is 8 daily cases.

The Central Division cases constitute 66% of the cumulative total cases nationally, with the Western division making up 28%, 4% in the Northern Division, and 2% in the Eastern Division.

Deaths:

 

This graph depicts weekly COVID-19 deaths by division since November 2022 to current full Epi week.

COVID Death Reports

There is 1 COVID-19 death to report.

This is a 90-year-old male from Labasa who developed respiratory symptoms on the morning of 09/06/2023. He had no pre-existing medical conditions. Sadly, he died before arrival to Labasa Hospital on 09/06/2023 from a suspected heart attack. He also tested positive for COVID-19 on 09/06/2023. He was vaccinated with 2 doses of the COVID-19 vaccine.

Analysis of COVID-19 Deaths 

Table 1: Death rates by Division

Division Total COVID Deaths Deaths per 100,000
Central 78 19.44
Western 70 19.7
Northern 31 22.1
Eastern 5 13.0

An analysis of the 182 deaths recorded since December 2021, shows that 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 8 4.4
10-19 2 1.3
20-29 3 2.1
30-39 5 3.6
40-49 8 7.7
50-59 24 26.4
60-69 38 73.1
70-79 55 245.5
80-89 35 607.1
90-99 6 1153.8

The death rate adjusted per 100,000 population, has been highest in the age group 50 years and over for the 182 deaths since December 2021. There were ten (10) deaths below the age of 19 years, 7 out of the 9 children had significant pre-existing medical conditions, and three (3) children 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
>18 172 73/99 12.4 344.4
15-17 1 0/1 0 6.6
12-14 1 0/1 0 2.5

Of the 182 COVID-19 deaths reported since December 2021, eight (8) deaths were in the population not eligible for vaccination (under the age of 12). An analysis of the 174 deaths in the vaccine-eligible population revealed that Fiji has a death rate of 12.4 per 100,000 population for fully vaccinated adults and 344.4 per 100,000 population for unvaccinated adults. This means that unvaccinated adults in Fiji have been dying at a rate 27.8 times higher than fully vaccinated adults. Individuals in the 12-17 age group who died were not vaccinated.

There has been a total of 885 deaths due to COVID-19 in Fiji. As of December 25th, 2022, the national 7 days rolling average for COVID-19 deaths per day is 0.0 with a case fatality rate of 1.28%. 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. 

We have also recorded 1,007 COVID-19-positive patients who died from other serious medical conditions unrelated to COVID-19; their doctors have determined that COVID-19 did not contribute to their deaths, and therefore these are not classified as COVID-19 deaths.

Hospitalisation:

Currently, we do not have any (0) admissions as a direct cause of COVID-19. However, five (5) admissions have tested as covid positive but are admitted for other diseases. Patients presented to the hospital are tested before admission therefore, a high number of people who are admitted for non-covid health conditions, test positive for COVID-19 due to the current level of transmission in the community.

Using the WHO clinical severity classification, there are 80% (n=4) cases in the asymptomatic and mild categories; 20% (n=1) cases in the critical category with nil cases in the moderate and severe categories.

Testing:

18 tests had been reported for 14th June 2023. The total cumulative tests since 2020 are 672,519 tests. And the 7-day daily test average is 32 tests per day or 0.0 tests per 1,000 population.

The national 7-day average daily test positivity is 30%, which is above the  WHO recommendation of 5%, indicating community transmission of the COVID-19 virus.

Public Advisory

COVID-19;

There is a continuing report of new COVID-19 cases. With currently available data, the symptoms are similar to the prior strains with no evidence of more severe infection. Recent mutations of COVID-19 have led to less severe disease. This is because the virus must give up something, in this case, its ability to harm, to survive. We continue to focus on implementing COVID safe measures around those vulnerable to the severe effects of COVID-19. This includes escalating measures in hospitals, old people’s homes, and facilities catering to disabled persons. As such we expect to escalate screening protocols and masking for staff, patients, and visitors. Furthermore, visitor restrictions will be in place.

We currently enjoy a high level of protection from severe disease and as such we have supported the rescinding of all vaccine mandates. So far despite the surge in cases, the impact on hospital admission has remained manageable. There is expected to be some immune escape capability that makes the variant more transmissible. The elderly, those with chronic diseases, pregnant mothers, and children with disabilities must be closely watched. That said, the booster would still be important for people at the highest risk of getting severe disease. This includes those ages 65 and older and those who are immunocompromised. Even small, additional increases in antibody production are critically important for them.

We emphasize the point that strengthening our ability to live with COVID means we remain vigilant, maintain community-wide adoption of COVID safe measures where appropriate, and keep the impetus for immunization. This is the only means to reduce the disease spread and protect those in the community who are less able to fend for themselves.

There are several reasons it’s important to avoid getting COVID-19. Getting infected puts you at risk of severe illness, potential hospitalization, and death, especially if you are high-risk and unvaccinated.

In addition, if more people get seriously ill, it could place an unnecessary strain on an already overwhelmed hospital system. Current strains are also better at evading our immune defenses as compared to prior strains. Therefore, your risk of reinfection is higher. Getting infected also puts vulnerable populations at unnecessary risk of infection including severe illness, hospitalization, and death.

Last, you could end up with long COVID. There are currently too many unknowns regarding who is more likely to get long COVID, but the risk of developing this chronic condition after infection is very real. Millions of people have developed this and suffered for many months, including time and money lost by the inability to work. 

COVID-19 is unlikely to go away completely. There are still many unknown variables. Virologists wonder whether it will behave like other coronaviruses – many of which cause the common cold. It may end up reappearing seasonally, as most of our viruses do.

In prior epidemics, viruses eventually reach a saturation threshold, meaning most of the population will be or has already been infected. At this point, when the virus has fewer people to infect, the epidemic will decrease naturally.

Hopefully, this will equate to an endemic instead of a pandemic. Endemic is a disease that is still around but at a more manageable level, without causing spikes in deaths, for example. Instead, the disease is more manageable in terms of not overwhelming the system. The hope is that if COVID-19 is not eliminated, it would become more like the common cold.

Also, anyone who falls sick should not be attending work or school, especially if they have COVID-19-like symptoms. You must get tested for COVID-19; 5-day isolation is recommended if you have tested positive.

Influenza and Acute Respiratory Illness

Our surveillance systems show that the resurgence of influenza-like and acute respiratory illnesses continues. Reports are suggesting an increase in absenteeism rates in schools and workplaces.  

Earlier this year, we had an outbreak of a type of Influenza type A virus scientifically labeled as FluA/H1 Pdm. This outbreak had receded however, we now have indications of another outbreak of Flu-like illness. Essentially, we are observing a “double peak trend” (bi-phasic) of Influenza-like illness (ILI) case reports over the last several months since December 2022. As observed from past years’ trends, Fiji’s annual influenza season runs from January to May – June.

The Fiji CDC has confirmed that Influenza B/Victoria is now the predominant influenza strain in circulation, and likely the cause of this surge of ILI cases being reported and observed locally. It must be noted that this increased presence of influenza B in circulation is similarly being observed in other countries of the region and the world.

We have Tamiflu (antiviral medications) stock which is being distributed and we are getting more Flu vaccines which will be offered to those vulnerable to the severe effects of Influenza (individuals with chronic illness, pregnant women, and to frontline staff. Surveillance has also been escalated and we await more recent reports to determine ongoing trends. Whilst we still have stocks of flu testing reagents and consumables, we are also working with WHO to increase our stocks.

The Ministry of Health and Medical Services advises public members to stay at home when feeling unwell or wear face coverings (masks) when going outside to minimize the spread of infection.

We also advise that people living with chronic disease and children, especially babies, need to be protected from the severe effects of influenza. This entails preventing infection by proper masking in crowded and/or poorly ventilated spaces, early recognition of the symptoms, and seeing a doctor early. It is essential that these vulnerable persons are carefully monitored to ensure early access to intervention if severe symptoms develop.

Preventative measures will be familiar as they are similar to COVID-19. Wear a mask that covers your mouth and nose when in a public place, wash your hands frequently with soap and water or use an alcohol-based hand sanitizer, avoid crowds, stay home if you are sick, and cover your mouth and nose if you cough or sneeze.

Seek medical care: For adults, see a Doctor if the following danger symptoms develop; difficulty breathing or shortness of breath, pain or heaviness in the chest, persistent fever ( more than 3 days, despite home treatment), very high temperature (over 40°C), feeling sicker as time goes by, confusion and persistent drowsiness, severe headache that doesn’t respond to painkillers and unusual symptoms such as hallucinations, severe vomiting, neck stiffness, skin rash, rapid heart rate, chills, uncontrollable shivering, or muscle spasms.

For children, seek medical care right away if your child:

  • has a fever greater than 38°C for more than two days, or a fever of 40°C or higher for any amount of time
  • has a fever of 38°C or higher and is under 3 months old
  • has a fever that doesn’t get better after taking Panadol
  • seems unusually drowsy or lethargic
  • won’t eat or drink
  • is wheezing or is short of breath

COVID-19 Vaccination

While we are expecting new supplies of COVID vaccines at the end of next month (July), the Pediatric supplies of vaccines are available for children aged 5 to 11 years which is accessible at the nearest Health Center.

We have been reporting that 100% of our estimated adult population have received one dose and 95% have received the second dose. The vaccination of our target population has been progressing well with the 12 years and above coverage rate for Fiji being 99% for Dose 1 and 89% for Dose 2.

Additionally, as of the 15th of June, 172,078 (55%) booster-eligible individuals have so far received their 3rd dose while 29,929 individuals have been administered the 4th dose.

We urge the unvaccinated adults and children to get their vaccine status updated. Those who are residing in the Central and Western Division and are yet to receive their 1st and 2nd doses and especially the children in the Rewa and Nasinu schools. All travelers are also encouraged to get themselves vaccinated.

To register online for the first dose, please visit vra.digitalfiji.gov.fj

The public is reminded that vaccination sites are strictly closed at 3 pm. Therefore, any person going to the site in the afternoon is requested to be present at least by 1.30 pm.

Sites for vaccination will be operational from 9 am – 3 pm each day (Monday – Friday) while Suva Health Center will also operate on Saturdays (9 am – 3 pm).

The list of sites is available at: bit.ly/35Fozux

COVID-19 Update 09-06-2023

COVID-19 Update

Friday 09th June

 

Transmission Update:

There has been a notable increase in cases over the past 2 weeks, as illustrated by the graph above.

Since 02/06/23, we have recorded 52 new cases, including 7 reinfections.

Of the 45 new cases recorded, 38 cases were recorded in the Central Division; 7 cases in the Western Division; with nil cases in the Northern Division and Eastern Division.

The national 7-day rolling average of cases as of 4th June is 4 daily cases.

The Central Division cases constitute 66% of the cumulative total cases nationally, with the Western Division making up 28%, 4% in the Northern Division, and 2% in the Eastern Division.

Deaths:

The curve depicts weekly COVID-19 deaths by division since May 2021. It indicates a surge from last December, with peaks in mid-January 2022 followed by a downward trend. 

COVID Death Reports

There is a COVID-19 death to report.

This is a 57-year-old female from Nausori who was admitted on Friday (02/06/2023) with evidence of severe lower limb vascular disease. She tested positive for COVID-19 on 03/06/2023. She was also admitted in 2021 in CWMH with Severe COVID-19 with similar complications. Sadly, she developed further complications during this admission and passed away on 04/06/2023. She was vaccinated with 1 dose of the COVID-19 vaccine.

Analysis of COVID-19 Deaths 

Table 1: Death rates by Division

Division Total COVID Deaths Deaths per 100,000
Central 78 19.44
Western 70 19.7
Northern 30 21.4
Eastern 5 13.0

An analysis of the 182 deaths recorded since December 2021, shows that 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 8 4.4
10-19 2 1.3
20-29 3 2.1
30-39 5 3.6
40-49 8 7.7
50-59 24 26.4
60-69 38 73.1
70-79 55 245.5
80-89 34 604.3
90-99 6 1153.8

The death rate adjusted per 100,000 population, has been highest in the age group 50 years and over for the 182 deaths since December 2021. There were ten (10) deaths below the age of 19 years, 7 out of the 9 children had significant pre-existing medical conditions, and three (3) children 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
>18 172 73/99 12.4 344.4
15-17 1 0/1 0 6.6
12-14 1 0/1 0 2.5

Of the 182 COVID-19 deaths reported since December 2021, eight (8) deaths were in the population not eligible for vaccination (under the age of 12). An analysis of the 174 deaths in the vaccine-eligible population revealed that Fiji has a death rate of 12.4 per 100,000 population for fully vaccinated adults and 344.4 per 100,000 population for unvaccinated adults. This means that unvaccinated adults in Fiji have been dying at a rate 27.8 times higher than fully vaccinated adults. Individuals in the 12-17 age group who died were not vaccinated.

There has been a total of 884 deaths due to COVID-19 in Fiji. As of December 25th, 2022, the national 7 days rolling average for COVID-19 deaths per day is 0.0 with a case fatality rate of 1.28%. 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. 

We have also recorded 1,006 COVID-19-positive patients who died from other serious medical conditions unrelated to COVID-19; their doctors have determined that COVID-19 did not contribute to their deaths, and therefore these are not classified as COVID-19 deaths.

Hospitalisation:

Currently, we do not have any (0) admissions as a direct cause of COVID-19. However, ten (10) admissions have tested as covid positive but are admitted for other diseases. Patients presented to the hospital are tested before admission therefore, a high number of people who are admitted for non-covid health conditions, test positive for COVID-19 due to the current level of transmission in the community.

Using the WHO clinical severity classification, there are 100% (n=10) cases in the asymptomatic and mild categories; with nil cases in the moderate, severe and critical categories.

Testing:

98 tests had been reported for 8th June 2023. The total cumulative tests since 2020 are 672,279 tests. And the 7-day daily test average is 37 tests per day or 0.0 tests per 1,000 population.

The national 7-day average daily test positivity is 22.3%, which is above the WHO recommendation of 5%, indicating community transmission of the COVID-19 virus.

Public Advisory

COVID-19;

There is a continuing report of new COVID-19 cases. With currently available data, the symptoms are similar to the prior strains with no evidence of more severe infection. Recent mutations of COVID-19 have led to less severe disease. This is because the virus must give up something, in this case, its ability to harm, to survive. We continue to focus on implementing COVID safe measures around those vulnerable to the severe effects of COVID-19. This includes escalating measures in hospitals, old people’s homes, and facilities catering to disabled persons. As such we expect to escalate screening protocols and masking for staff, patients, and visitors. Furthermore, visitor restrictions will be in place.

We currently enjoy a high level of protection from severe disease and as such we have supported the rescinding of all vaccine mandates. So far despite the surge in cases, the impact on hospital admission has remained manageable. There is expected to be some immune escape capability that makes the variant more transmissible. The elderly, those with chronic diseases, pregnant mothers, and children with disabilities must be closely watched. That said, the booster would still be important for people at the highest risk of getting severe disease. This includes those ages 65 and older and those who are immunocompromised. Even small, additional increases in antibody production are critically important for them.

We emphasize the point that strengthening our ability to live with COVID means we remain vigilant, maintain community-wide adoption of COVID safe measures where appropriate, and keep the impetus for immunization. This is the only means to reduce the disease spread and protect those in the community who are less able to fend for themselves.

There are several reasons it’s important to avoid getting COVID-19. Getting infected puts you at risk of severe illness, potential hospitalization, and death, especially if you are high-risk and unvaccinated.

In addition, if more people get seriously ill, it could place an unnecessary strain on an already overwhelmed hospital system. Current strains are also better at evading our immune defenses as compared to prior strains. Therefore, your risk of reinfection is higher. Getting infected also puts vulnerable populations at unnecessary risk of infection including severe illness, hospitalization, and death.

Last, you could end up with long COVID. There are currently too many unknowns regarding who is more likely to get long COVID, but the risk of developing this chronic condition after infection is very real. Millions of people have developed this and suffered for many months, including time and money lost by the inability to work. 

COVID-19 is unlikely to go away completely. There are still many unknown variables. Virologists wonder whether it will behave like other coronaviruses – many of which cause the common cold. It may end up reappearing seasonally, as most of our viruses do.

In prior epidemics, viruses eventually reach a saturation threshold, meaning most of the population will be or has already been infected. At this point, when the virus has fewer people to infect, the epidemic will decrease naturally.

Hopefully, this will equate to an endemic instead of a pandemic. Endemic is a disease that is still around but at a more manageable level, without causing spikes in deaths, for example. Instead, the disease is more manageable in terms of not overwhelming the system. The hope is that if COVID-19 is not eliminated, it would become more like the common cold.

Also, anyone who falls sick should not be attending work or school, especially if they have COVID-19-like symptoms. You must get tested for COVID-19; 5-day isolation is recommended if you have tested positive.

Influenza and Acute Respiratory Illness

Our surveillance systems show that the resurgence of influenza-like and acute respiratory illnesses continues. Reports are suggesting an increase in absenteeism rates in schools and workplaces.  

Earlier this year, we had an outbreak of a type of Influenza type A virus scientifically labeled as FluA/H1 Pdm. This outbreak had receded however, we now have indications of another outbreak of Flu-like illness. Essentially, we are observing a “double peak trend” (bi-phasic) of Influenza-like illness (ILI) case reports over the last several months since December 2022. As observed from past years’ trends, Fiji’s annual influenza season runs from January to May – June.

The Fiji CDC has confirmed that Influenza B/Victoria is now the predominant influenza strain in circulation, and likely the cause of this surge of ILI cases being reported and observed locally. It must be noted that this increased presence of influenza B in circulation is similarly being observed in other countries of the region and the world.

We have Tamiflu (antiviral medications) stock which is being distributed and we are getting more Flu vaccines which will be offered to those vulnerable to the severe effects of Influenza (individuals with chronic illness, pregnant women, and to frontline staff. Surveillance has also been escalated and we await more recent reports to determine ongoing trends. Whilst we still have stocks of flu testing reagents and consumables, we are also working with WHO to increase our stocks.

The Ministry of Health and Medical Services advises public members to stay at home when feeling unwell or wear face coverings (masks) when going outside to minimize the spread of infection.

We also advise that people living with chronic disease and children, especially babies, need to be protected from the severe effects of influenza. This entails preventing infection by proper masking in crowded and/or poorly ventilated spaces, early recognition of the symptoms, and seeing a doctor early. It is essential that these vulnerable persons are carefully monitored to ensure early access to intervention if severe symptoms develop.

Preventative measures will be familiar as they are similar to COVID-19. Wear a mask that covers your mouth and nose when in a public place, wash your hands frequently with soap and water or use an alcohol-based hand sanitizer, avoid crowds, stay home if you are sick, and cover your mouth and nose if you cough or sneeze.

Seek medical care: For adults, see a Doctor if the following danger symptoms develop; difficulty breathing or shortness of breath, pain or heaviness in the chest, persistent fever ( more than 3 days, despite home treatment), very high temperature (over 40°C), feeling sicker as time goes by, confusion and persistent drowsiness, severe headache that doesn’t respond to painkillers and unusual symptoms such as hallucinations, severe vomiting, neck stiffness, skin rash, rapid heart rate, chills, uncontrollable shivering, or muscle spasms.

For children, seek medical care right away if your child:

  • has a fever greater than 38°C for more than two days, or a fever of 40°C or higher for any amount of time
  • has a fever of 38°C or higher and is under 3 months old
  • has a fever that doesn’t get better after taking Panadol
  • seems unusually drowsy or lethargic
  • won’t eat or drink
  • is wheezing or is short of breath

COVID-19 Vaccination

We have been reporting that 100% of our estimated adult population have received one dose and 95% have received the second dose. The vaccination of our target population has been progressing well with the 12 years and above coverage rate for Fiji being 99% for Dose 1 and 89% for Dose 2.

Additionally, as of the 7th of June, 172,078 (55%) booster-eligible individuals have so far received their 3rd dose while 29,929 individuals have been administered the 4th dose.

We urge the unvaccinated adults and children to get their vaccine status updated. Those who are residing in the Central and Western Division and are yet to receive their 1st and 2nd doses and especially the children in the Rewa and Nasinu schools. All travelers are also encouraged to get themselves vaccinated.

Increasing Vaccine Booster Coverage Program

The following COVID-19 vaccination services are currently offered at the sites:

  • 1st and 2nd dose of COVID-19 vaccines for 12 years and above
  • 1st and 2nd dose of COVID-19 boosters for 18 years and above

An individual is eligible for the first booster dose 3 months after receiving the 2nd dose of the COVID-19 vaccine and the 2nd booster dose 4 months after receiving the 1st booster dose.

The public is advised that the COVID-19 vaccination program for children aged 5-11 years old is currently unavailable and the Ministry will advise once the program resumes.

To register online for the first dose, please visit vra.digitalfiji.gov.fj

The public is reminded that vaccination sites are strictly closed at 3 pm. Therefore, any person going to the site in the afternoon is requested to be present at least by 1.30 pm.

Sites for vaccination will be operational from 9 am – 3 pm each day (Monday – Friday) while Suva Health Center will also operate on Saturdays (9 am – 3 pm).

The list of sites is available at: bit.ly/35Fozux