MHMS FIJI
MHMS FIJI

Press Release

COVID-19 Update 04-02-2022

COVID-19 Situation Update

Friday 04th February

Transmission Update:

Since the last update, we have recorded 123 new cases of which 55 new cases were recorded on 03/02/2022 and 68 new cases in the last 24 hours ending at 8 am this morning.

Of the 123 cases recorded, 50 cases were recorded in the Central Division; 53 cases were recorded in the Western Division, 20 cases were recorded in the Northern Division, and nil case was recorded in the Eastern Division.

Overall, there have been 63,204 cases of COVID-19  recorded in Fiji, with 68% of the cases from the Central Division, 28% of the cases from the Western Division, 1% of the cases from the Eastern Division, and 3% from the Northern Division.

The national 7-day rolling average of cases as of 31st January is 130 daily cases.
Deaths:

This curve depicts daily deaths by division since May 2021. (Please note: Death notifications from the week of 24/01/22 are still being received and we are currently on week 31/01/22 which is yet to be completed,  therefore the appearance of a downward trend on the graph from week 24/01/22 may not be accurate. There are deaths from the Western Division currently under investigation for the same time period hence, the death rate for the division may increase).

Analysis of Deaths in the Third Wave 

Table 1: Death rates by Division

Division Total COVID Deaths Deaths per 100,000
Central 52 12.9
Western 32 9
Northern 28 20.0
Eastern 3 7.8

An analysis of the 115 deaths recorded in the third wave show 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.(Note: There are deaths currently being investigated from the Western Division for the same time period, therefore the rate for the division may increase).

Table 2: Deaths by Age Group

Age Group Total Deaths Deaths per 100,000 population
0 – 9 5 2.7
10-19 2 1.3
20-29 3 2.1
30-39 3 2.2
40-49 5 4.8
50-59 16 17.7
60-69 22 42.3
70-79 35 156.2
80-89 20 355.4
90-99 4 769.2

For the 115 deaths in the third wave, the rates of death when adjusted for population, have been highest in the age groups 50 and upwards. There were 7 deaths below the age of 19 years, 6 out of the 7 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
>18 108 47/61 8.1 137.8
15-17 1 0/1 0 6.6
12-14 1 0/1 0 2.5

Out of  115 COVID -19 deaths reported in the third wave, five (5) deaths were from the population not eligible for vaccination (under age 12). An analysis of the 110 deaths from the vaccine-eligible population reflected that when adjusted with per 100,000 population in fully vaccinated (received 2 doses) and unvaccinated/not fully vaccinated (received 0 doses or only 1 dose) adults in Fiji, a death rate of 8.1 per 100,000 population for fully vaccinated adults and 137.8 per 100,000 for unvaccinated adults was exhibited. This means that unvaccinated adults in Fiji have been dying from COVID-19 at a rate 17 times higher than fully vaccinated adults during this current 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 are 2  new COVID-19 deaths to report from 26th January and 1st February 2022.

The first COVID-19 death to report is of a 2 month-old male infant from the Northern Division, who died at home on 26/01/2022. A thorough investigation was carried out by the Ministry of Health and the Police Forensics Unit, as a result, the infant’s death was classified as COVID-19 related. He did not belong to the population age group for vaccination hence, he was unvaccinated.

The second COVID-19 death to report is of a 70-year old male from the Central Division, who died at home on 01/02/2022. He was fully vaccinated.

There has been a total of 811 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 January 31st, 2022,  the national 7 days rolling average for COVID-19 deaths per day is 2.2, with a case fatality rate of 1.32%.

We have recorded 849 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 downward trend in daily hospitalisations. Using the WHO clinical severity classification, a greater percentage, 42% (n=260) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild,27% (n=17) are categorized as moderate and 26% (n=16) as severe with 3 cases in the 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:

226  tests have been reported for February 3rd, 2022. Total cumulative tests since 2020 are 492,980 tests. The 7-day daily test average is 281 tests per day or 0.3 tests per 1,000 population.

The national 7-day average daily test positivity is 30.4%. The high positivity rate is an indication of widespread community transmission.

Public Advisory:

The death of the 2-month-old child at home continues to remind us that severe rare outcomes become visible every time we allow the transmission to run rife among us. As such we cannot afford complacency in our Vaccine Plus endeavour.  We must do our best to protect the vulnerable by following COVID safe measures, getting fully vaccinated, and getting the booster dose when eligible (at least 5 months after the second dose). The evidence internationally, including from the United Kingdom, is that a booster dose (3rd dose) improves protection against symptomatic disease, which is reduced with infection with the Omicron Variant among the fully vaccinated and those previously infected with other variants. Studies are also showing that increased protection against symptomatic disease also decreases the risk of transmission to others, therefore, protecting the vulnerable.

As we see a reducing trend in transmission, we anticipate the trends in deaths also to follow suit. We will also, therefore, expect the reduction in COVID restrictions to help improve further our social and economic recovery. The public of Fiji is reminded, however, that we should expect the virus to be endemic, and for as long as the virus remains in our midst, there is always the risk of resurgence. As such, the vulnerable and relatively immobile minority population will still depend on the more immunocompetent and mobile majority for protection, both in maintaining the drive towards 100% vaccination of eligible adults and in adhering to their personal COVID safe behaviour measures. The tragedy of the deaths from COVID-19 is a sad reminder of the impact of this pandemic, however, the bigger tragedy is if all the very obvious lessons we have repeatedly published, announced, and posted on social media are too quickly forgotten. The Vaccine Plus approach must become a personal daily objective and the COVID safe measures become a community-wide habit, for us to safely navigate to a more secure socioeconomic future. 

While we have reported that fully vaccinated people have died during this third wave, deaths in unvaccinated people (in the vaccine eligible population) are occuring at a massive 17 times the rate of the vaccinated. This confirms what we already know from other countries, which is that vaccination reduces the risk of severe disease, hospitalization, and death from COVID-19. The fact that we still have people not fully vaccinated, especially people who are at high risk of severe disease and death (the elderly and people with chronic diseases including NCDs) remains a serious concern. And we would strongly urge everyone, especially medical professionals, to encourage vaccination.

We have noted how difficult it is to increase our vaccination coverage for the last 10% of our adult population despite the increased risk of severe outcomes in this group. While we will continue to do our part to promote and deploy vaccines, we need community support to sustain the impact of our efforts especially to the vulnerable within this 10%. It is a grave concern that we continue to receive requests for vaccine exemption from persons with medical comorbidities, especially NCDs; their medical condition is an indication for vaccination, and granting the exemption is not an option for any qualified medical person.

The booster dose program began at the end of November 2021. As of January 31st, 78,806 individuals have so far received booster doses of the Moderna COVID-19 vaccine. For the month of February, a further 175,558 have become eligible for booster doses.

Health Services Transition

The implications of COVID-19 to health service provision are clear. The required change in the health service delivery model implies a change to infrastructure, human resource structure, working conditions, equipment, and the supply chain of drugs and consumables.

One important change that will require community-wide support is in developing the capability to ensure that available health care services get to those who need the service. Working with key partners such as WHO, UNDP, UNICEF,  the World Bank, and other organizations such as Diabetes Fiji Inc, Fiji Cancer Society, Medical Services Pacific, Empower Pacific, Lifeline Fiji, National Committee On Preventing Suicide, and the Substance Abuse Advisory Council, we have evolved a network of avenues to help to provide prevention and care services for NCDs. We will continue to collaborate with other ministries and work with faith-based civil society organisations to enable our reach into communities.

With the pandemic into its second year, the Ministry has maintained emergency mode operations for much of this time.  And as highlighted by WHO, there is data to show that more than 1 in 4 health workers globally has experienced mental health issues during the pandemic and several countries have reported that many health workers have considered leaving or have left their jobs because of difficult working conditions, staffing constraints, and the distress of making life and death decisions every day under intense pressure. There is an urgent need to safeguard the welfare of our medical staff by ensuring that they get some rest and attend to family needs. As such we will embark on initiatives to ensure that our staff move back to working normal working hours, take official leave entitlements accrued over the past year, and receive payment of meal and other allowances they are entitled to. We will continue to look at sustainable options to support our medical staff in working within the scope of our remodeling of health service delivery. However, we do anticipate that this will need to be part of a medium to long-term plan for the Ministry.

We have also highlighted how severe comorbidities and poor health-seeking behaviour have vastly contributed to severe outcomes in the COVID outbreak. We need to build resilience in the face of an endemic problem. Based on the lessons learned from the deaths, we need to:

  1. Prevent all preventable chronic diseases of which NCDs are the most prominent
  2. Promote the better control of controllable chronic diseases of which NCDs are the most prominent, and
  3. Build stronger support for better health-seeking behaviour especially among the vulnerable amongst us

We are urgently reviewing and strengthening our public health measures to find, stop and prevent health threats wherever they arise. Much of this will depend on a coordinated effort to detect these health threats early, investigate and put in control measures early. The Medical Sub-divisional Teams have been reminded to review and strengthen their community surveillance program and line list management of vulnerable persons.

However, the impact of these efforts cannot be sustained unless we get a broad level of support from the community in implementing the above 3 strategies, and at the same time reducing the transmission of COVID-19 to protect our vulnerable populations. Maintaining the Vaccine Plus approach remains critical.

COVID-19 Update 02-02-2022

COVID-19 Situation Update

Wednesday 02nd February 2022

Transmission Update:

Since the last update, we have recorded 95 new cases of which 83 new cases were recorded on 01/02/2022 and 12 new cases in the last 24 hours ending at 8 am this morning.

Of the 95 cases recorded, 88 cases were recorded in the Central Division; 4 cases were recorded in the Western Division, 3 cases were recorded in the Northern Division, and nil case was recorded in the Eastern Division.

The national 7-day rolling average of cases as of 29th January is 107 daily cases.

In the 7 days until 01/02/2022, 436 new cases were recorded in the Central division, 127 new cases in the Western division, 2 new cases in the Eastern Division, and 54 new cases in the Northern Division.

The Central Division cases constitute 68% of the cumulative total cases nationally, with the Western division making up 28%, 3% in the Northern Division, and 1% in the Eastern Division.
Deaths:

This curve depicts the weekly death rate by division since October 2021. Overall, as of the week of 17/01/2022, the death rate graph indicates an upward trend in the number of COVID-19 deaths in the Central, Western, Eastern, and Northern divisions. Please note that notifications of deaths in the week of 24/01/22 are still being received and the week of 31/01/22 (this week) is not yet complete,  therefore the appearance of a downward trend on the graph from the week of 24/01/22 may not be accurate. There are deaths from the Western Division currently under investigation for the same time period, therefore the rate for that division may increase.

Analysis of Deaths in the Third Wave 

Table 1: Death rates by Division

Division Total COVID Deaths Deaths per 100,000
Central 51 12.7
Western 32 9
Northern 27 19.3
Eastern 3 7.8

An analysis of the 113 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. (Note: There are deaths currently being investigated from the Western Division for the same time period, therefore the rate for that division may increase).

Table 2: Deaths by Age Group

Age Group Total Deaths Deaths per 100,000 population
0 – 9 4 2.2
10-19 2 1.3
20-29 3 2.1
30-39 3 2.2
40-49 5 4.8
50-59 16 17.7
60-69 22 42.3
70-79 34 151.8
80-89 20 355.4
90-99 4 769.2

For the 113 deaths in the third wave, the rates of death when adjusted for population, have been highest in the age groups 50 and upwards. The 6 deaths from the under 19 age group were in children with significant underlying medical conditions.

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
>18 107 46/61 8.0 137.0
15-17 1 0/1 0 6.6
12-14 1 0/1 0 2.5

Out of  113 COVID -19 deaths reported in the third wave, four deaths were in the population not eligible for vaccination (under age 12). An analysis was done for the 109 deaths in the vaccine-eligible population. When adjusted for population in the fully vaccinated (received 2 doses) and unvaccinated/not fully vaccinated (received 0 doses or only 1 dose) adults in Fiji, we can see that death rates per 100,000 population are 8.0 deaths per 100,000 for fully vaccinated adults and 137.0  deaths per 100,000 for unvaccinated adults. This means that unvaccinated adults in Fiji have been dying from COVID-19 at a rate 17.1 times higher than fully vaccinated adults during this current wave. Individuals in the 12-17 age group who died were not vaccinated. There have been no deaths in individuals who received a booster (3rd dose) of the vaccine.

New deaths to report

There are 8 new COVID-19 deaths to report from 27th January -1st February 2022.

All 8 deaths reported today were from the Central Division with one being below the age of 12 years, an age group not eligible for vaccination.

The first COVID-19 death to report is of a 72-year old female from the Central Division, who was admitted at the CWM hospital on 14/01/2022. Sadly, she succumbed to death on 20/01/2022. She was fully vaccinated.

The second COVID-19 death to report is of a 39-year old female from the Central Division, who died at home on 23/01/2022. She was fully vaccinated.

The third COVID -19 death to report is of a 41-year old female from the Central Division, who was admitted at the CWM hospital on 10/01/2022. She had significant pre-existing medical conditions which contributed to the severity of her illness. Sadly she succumbed to death on 27/01/2022.  She was fully vaccinated.

The fourth COVID-19 death to report is of a 71-year old male from the Central Division, who was admitted at the CWM hospital on 13/01/2022. He had pre-existing medical conditions and sadly, succumbed to death on 27/01/2022. He was not vaccinated.

The fifth COVID-19 death to report is of a 75-year old female from the Central Division, who was admitted at the CWM hospital on 27/01/2022. She sadly succumbed to death on 29/01/2022. She was fully vaccinated.

The sixth COVID-19 death to report is of a 64-year old male from the Central Division, who died at home on 30/01/2022. He was fully vaccinated.

The seventh COVID-19 death to report is of a 6 month – old female infant from the Central Division, who was admitted at the CWM Hospital on 14/01/2022.  Her medical records reflected that she had a congenital medical condition that contributed to the severity of her illness and death on 31/01/2022. She was not vaccinated as she did not belong to the eligible population for vaccination.

The eighth COVID-19 death to report is of a 66-year old male from the Central Division, who died at home on 01/02/2022. He was not vaccinated.

There has been a total of 809 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 January 29th, 2022,  the national 7 days rolling average for COVID-19 deaths per day is 2.4, with a case fatality rate of 1.32%.

We have recorded 848 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 downward trend in daily hospitalisations. Using the WHO clinical severity classification, a greater percentage, 47% (n=40) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild,19% (n=16) are categorized as moderate and 31% (n=27) as severe with 3 cases in the 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:

106  tests have been reported for February 1st, 2022. Total cumulative tests since 2020 are 492,527 tests. The 7-day daily test average is 291 tests per day or 0.3 tests per 1,000 population.

The national 7-day average daily test positivity is 30.4%. The high positivity rate is an indication of widespread community transmission.

Public Advisory:

COVID-19 Trends

The deaths announced tonight remain a sad reminder of the fact that, while transmission indicators are on a decline, and the majority of people infected are able to recover with no significant long-term effects, the vulnerable and more dependent members of our population will carry the weight of severe outcomes. We protect ourselves to protect the vulnerable and while COVID-19  is and will be endemic it is not mild to vulnerable groups and they will continue to need our protection.

Since my press statement of Friday, 28th January 2022, the case, hospital admissions data, and informal employment data continue to indicate a downward trend in transmission. These are clear indications that we have past the peak of this outbreak.  The death reports generated reflect delays not only in reporting but also in transmission as many of the deaths have occurred in a population that was not mobile.

The initial and subsequent analysis of the deaths in the vaccine-eligible population during this third wave has revealed that fully vaccinated adults have a 17.1 times lower rate of death from COVID-19 than unvaccinated adults. This is comparable to rates seen overseas, which is an indication of the quality of our COVID-19 vaccination program, even with the urgency of ensuring rapid deployment of vaccines in a very short time period. A testament to the work put in by our dedicated health teams and partner agencies to ensure that protocols are followed, and vaccines are administered properly to the people of Fiji. The huge difference in death rates between vaccinated and unvaccinated adults is even further evidence that vaccination lowers the risk of severe disease outcomes from COVID-19.

We have also highlighted how severe comorbidities and poor health-seeking behaviour have vastly contributed to severe outcomes. There has also been comprehensive global data to indicate that COVID 19 will remain endemic and as such will persist as a danger to the unvaccinated, those with severe comorbidities, and those in need of support to engage in better health-seeking behaviour.

All this indicates a need for a national reset for our national discourse on the health of our people. We need a new focus, from the media and members of the public, on chronic disease (especially  NCDs) and health-seeking behaviour.

This speaks to 3 distinct strategies to facilitate resilience:

  1. Prevention of preventable chronic diseases of which NCDs are the most prominent
  2. Better control of controllable chronic diseases of which NCDs are the most prominent
  3. The promotion of better health-seeking behaviour

We will also need to urgently review and strengthen our public health measures to find, stop and prevent health threats wherever they arise. Much of this will depend on a coordinated effort to detect these health threats early, investigate and put in control measures early. The Medical Subdivisional Teams have been reminded to review and strengthen their community surveillance program and line list management of vulnerable persons.

However, the impact of these efforts cannot be sustained unless we get a broad level of support from the community in implementing the 3 strategies alluded to above and at the same time reduce the transmission of COVID-19 to protect our vulnerable populations. Maintaining the  Vaccine Plus approach remains critical.

Health Services Transition

The implications of COVID 19 to health service provision are clear. The required change in the health service delivery model implies a change to infrastructure, human resource structure, working conditions, equipment, and the supply chain of drugs and consumables.

One important change that will require community-wide support is developing the capability to ensure that whatever services are available gets to those that need the service. Working with key partners WHO, UNDP, UNICEF, World Bank, and other organizations such as Diabetes Fiji Inc, Fiji Cancer Society, Medical Services Pacific, Empower, Lifeline Fiji, National Committee On Preventing Suicide, Substance Abuse Advisory Council, we have evolved a network of avenues to help to provide prevention and care services for NCDs. We will need to collaborate with other ministries and work with faith-based civil society organizations to enable our reach into communities.

With the pandemic into its second year, the Ministry of Health and Medical Services has had to maintain emergency mode operations for much of this time.  As highlighted by WHO, there is data to show that more than 1 in 4 health workers globally has experienced mental health issues during the pandemic and several countries have reported that many health workers have considered leaving or have left their jobs because of difficult working conditions, staffing constraints, and the distress of making life and death decisions every day under intense pressure. There is an urgent need to safeguard the welfare of our medical staff by ensuring that they get some rest and attend to family needs. As such we will be embarking on initiatives to ensure that our staff moves back to working normal working hours, take official leave entitlements accrued over the past year, and ensure payment of meal and other allowances. We will continue to look at sustainable options to support our medical staff in working with and within the scope of our remodeling of health service delivery, however, we do anticipate that this will need to be part of a medium to long term plan rather than an immediate change.

Vaccination

The booster dose program began at the end of November 2021. As of January 31st, 76,410 individuals have so far received booster doses of the Moderna COVID-19 vaccine. For the month of February, a further 175,558 have become eligible for booster doses.

We received the first batch of Pfizer vaccines last night which will be handed over to MOH formally tomorrow. This will be used for booster doses and as a vaccine for children.

The booster vaccine and vaccination for children are not considered mandatory, however, we encourage all eligible individuals to be vaccinated or get a booster dose, and help navigate Fiji into a safer covid zone that supports the socio-economic revival and safer reopening of schools.

Vaccination of children under 12 years remains part of ongoing discussions as sourcing them remains difficult.

COVID-19 Update 31-01-2022

COVID-19 Situation Update

Monday 31st January 2022

Transmission Update:

Since the last update, we have recorded 460 new cases of which 71 new cases were recorded on 29/01/2022; 54 new cases were recorded on 30/01/2022 and 335 new cases in the last 24 hours ending at 8 am this morning.

Of the 460 cases recorded, 345 cases were in the Central Division; 71 cases in the Western Division, 43 cases in the Northern Division, and 1 case in the Eastern Division.

Overall, there have been 62,785 cases recorded, with 68% of the cases from the Central Division, 28% of the cases from the Western Division, 1% of the cases from the Eastern Division, and 3% from the Northern Division.

The national 7-day rolling average of cases as of 27th January is 194 daily cases.
Deaths:

This curve depicts the weekly death rate by division since May 2021. Overall, as of the week of 17/01/2022, the death rate graph indicates an upward trend in the number of COVID-19 deaths in the Central, Western, Eastern, and Northern divisions. Please note there is likely a delay in deaths reported in the last week therefore the appearance of a downward trend on the graph may not be representative of the actual trend.

Analysis of Deaths in the Third Wave 

Table 1: Death rates by Division

Division Total COVID Deaths Deaths per 100,000
Central 43 10.7
Western 32 9
Northern 27 19.3
Eastern 3 7.8

An analysis of the 105 deaths recorded in the third wave show 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.(Note: There are deaths currently being investigated from the Western Division for the same time period, therefore the rate for that division may increase).

Table 2: Deaths by Age Group

Age Group Total Deaths Deaths per 100,000 population
0 – 9 3 1.7
10-19 2 1.3
20-29 3 2.1
30-39 2 1.5
40-49 4 3.8
50-59 16 17.7
60-69 20 38.5
70-79 31 138.4
80-89 20 355.4
90-99 4 769.2

For the 105 deaths in the third wave, the rates of death when adjusted for population, have been highest in the age groups 50 and upwards. The 5 deaths from the under 19 age group were in children with significant underlying medical conditions.

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
>18 100 41/59 7.1 130.9
15-17 1 0/1 0 6.6
12-14 1 0/1 0 2.5

Out of  105 COVID -19 deaths reported in the third wave, three deaths were in the population not eligible for vaccination (under age 12). An analysis was done for the 102 deaths in the vaccine-eligible population. When adjusted for population in the fully vaccinated (received 2 doses) and unvaccinated/not fully vaccinated (received 0 doses or only 1 dose) adults in Fiji, we can see that death rates per 100,000 population are 7.1 deaths per 100,000 for fully vaccinated adults and 130.9 deaths per 100,000 for unvaccinated adults. This means that unvaccinated adults in Fiji have been dying from COVID-19 at a rate 18.4  times higher than fully vaccinated adults during this current wave. Individuals in the 12-17 age group who died were not vaccinated. There have been no deaths in individuals who received a booster (3rd dose) of the vaccine.

New deaths to report

There are 3 new COVID-19 deaths to report from 27th to 28th January 2022.

The first COVID-19 death to report is of a 92-year old female from the Central Division, who died at home on 27/01/2022. She was not vaccinated.

The second COVID-19 death to report is of a 46-year old female from the Western Division, who died at home on 27/01/2022. She had significant pre-existing comorbidities and was not vaccinated.

The third COVID-19 death to report is of a 79-year old female from the Central Division, who died at home on 28/01/2022. She had congenital comorbidity and was not vaccinated.

There has been a total of 801 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 January 20th, 2022,  the national 7 days rolling average for COVID-19 deaths per day is 2.9, with a case fatality rate of 1.32%.

We have recorded 839 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 downward trend in daily hospitalisations. Using the WHO clinical severity classification, a greater percentage, 58% (n=58) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild,18% (n=18) are categorized as moderate and 22% (n=22) as severe with 2 cases in the 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:

749  tests have been reported for January 30th, 2022. Total cumulative tests since 2020 is 492,136 tests. The 7-day daily test average is 302 tests per day or 0.3 tests per 1,000 population.

The national 7-day average daily test positivity is 37.6%. The high positivity rate is an indication of widespread community transmission.

Public Advisory:

Since my press statement of Friday, 28th January 2022, the hospital admissions data and informal employment data continue to indicate a downward trend in transmission. The death reports generated reflect delays not only in reporting but also in transmission as many of the deaths have occurred in a population that was not mobile.

The initial and subsequent analysis of the deaths in the vaccine-eligible population during this third wave has revealed that fully vaccinated adults have a 16.2 times lower rate of death from COVID-19 than unvaccinated adults. This is comparable to rates seen overseas, which is an indication of the quality of our COVID-19 vaccination program, even with the urgency of ensuring rapid deployment of vaccines in a very short time period. A testament to the work put in by our dedicated health teams and partner agencies to ensure that protocols are followed, and vaccines are administered properly to the people of Fiji. The huge difference in death rates between vaccinated and unvaccinated adults is even further evidence that vaccination lowers the risk of severe disease outcomes from COVID-19.

We have also highlighted how severe comorbidities and poor health-seeking behaviour have vastly contributed to severe outcomes. There has also been comprehensive global data to indicate that COVID 19 will remain endemic and as such will persist as a danger to the unvaccinated, those with severe comorbidities, and those in need of support to engage in better health-seeking behaviour.

All this indicates a need for a national reset for our national discourse on the health of our people. We need a new focus, from the media and members of the public, on chronic disease (especially  NCDs) and health-seeking behaviour.

This speaks to 3 distinct strategies to facilitate resilience:

  1. Prevention of preventable chronic diseases of which NCDs are the most prominent
  2. Better control of controllable chronic diseases of which NCDs are the most prominent
  3. The promotion of better health-seeking behaviour

We will also need to urgently review and strengthen our public health measures to find, stop and prevent health threats wherever they arise. Much of this will depend on a coordinated effort to detect these health threats early, investigate and put in control measures early. The Medical Subdivisional Teams have been reminded to review and strengthen their community surveillance program and line list management of vulnerable persons.

However, the impact of these efforts cannot be sustained unless we get a broad level of support from the community in implementing the 3 strategies alluded to above and at the same time reduce the transmission of COVID-19 to protect our vulnerable populations. Maintaining the  Vaccine Plus approach remains critical.

Vaccination

The booster dose program began at the end of November 2021. As of January 31st, 73,630 individuals have so far received booster doses of the Moderna COVID-19 vaccine from the 142, 240 persons considered eligible. This represents a 52% coverage rate for booster-eligible persons. We are also expecting to receive more Pfizer vaccines this week to be used for booster doses and as a vaccine for children. The booster vaccine and vaccination for children are not considered mandatory, however, we encourage all eligible individuals to be vaccinated or get a booster dose, and help navigate Fiji into a safer covid zone that supports the socio-economic revival and safer reopening of schools.

Vaccination of children under 12 years remains part of ongoing discussions as sourcing them remains difficult.

 

COVID-19 Update 28-01-2022

COVID-19 Situation Update

Friday 28th January 2022

Transmission Update:

Since the last update, we have recorded 146 new cases of which 102 new cases were recorded on 27/01/2022 and 44 new cases in the last 24 hours ending at 8 am this morning.

Of the 146 cases recorded, 86 cases were in the Central Division; 54 cases in the Western Division, 6 cases in the Northern Division, and nil cases in the Eastern Division.

Overall, there have been 62,303 cases recorded, with 68% of the cases from the Central Division, 28% of the cases from the Western Division, 1% of the cases from the Eastern Division, and 3% from the Northern Division.

The national 7-day rolling average of cases as of 24th January is 245 daily cases.
Deaths:

This curve depicts the weekly death rate by division since May 2021. Overall, as of the week of 17/01/2022, the death rate graph indicates an upward trend in the number of COVID-19 deaths in the Central, Western, Eastern, and Northern divisions. Please note there is likely a delay in deaths reported in the last week therefore the appearance of a downward trend on the graph may not be representative of the actual trend.

Analysis of Deaths in the Third Wave 

Table 1: Death rates by Division

Division Total COVID Deaths Deaths per 100,000
Central 40 9.9
Western 31 8.7
Northern 24 17.7
Eastern 3 7.8

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An analysis of the first 98 deaths recorded in the third wave show 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.(Note: There are deaths currently being investigated from the Western Division for the same time period, therefore the rate for that division may increase).

Table 2: Deaths by Age Group

Age Group Total Deaths Deaths per 100,000 population
0 – 9 3 1.7
10-19 2 1.3
20-29 3 2.1
30-39 2 1.5
40-49 3 2.9
50-59 16 17.7
60-69 19 36.6
70-79 29 129.5
80-89 18 319.9
90-99 3 576.9

 

For the first 98 deaths in the third wave, the rates of death when adjusted for population, have been highest in the age groups 50 and upwards. The 5 deaths from the under 19 age group were in children with significant underlying medical conditions.

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 93 41/52 7.1 115
15-17 1 0/1 0 6.6
12-14 1 0/1 0 2.5

Out of  98 COVID -19 deaths reported in the third wave, three deaths were in the population not eligible for vaccination (under age 12). An analysis was done for the 95 deaths in the vaccine-eligible population.. When adjusted for population in the fully vaccinated (received 2 doses) and unvaccinated/not fully vaccinated (received 0 doses or only 1 dose) adults in Fiji, we can see that death rates per 100,000 population are 7.1 deaths per 100,000 for fully vaccinated adults and 115 deaths per 100,000 for unvaccinated adults. This means that unvaccinated adults in Fiji have been dying from COVID-19 at a rate 16.2 times higher than fully vaccinated adults during this current wave. Individuals in the 12-17 age group who died were not vaccinated. There have been no deaths in individuals who received a booster (3rd dose) of the vaccine.

New deaths to report

There are 7 new COVID-19 deaths to report from the period 22nd January 2022 to 26th January 2022.

One death was from the Central Division, two from the Western and four from the Northern. Two were fully vaccinated, the remaining five were unvaccinated. Medical records reflected that, out of the seven, one individual had a significant congenital medical condition, while six had significant pre-existing comorbidities,  which contributed to the severity of their illness and demise.

The first COVID -19 death to report is of a 64-year-old male from the Northern Division, who died on arrival at Labasa Hospital on 22/01/2022. He had pre-existing medical conditions and was not vaccinated.

The second COVID-19 death to report is of a 71-year-old male from the Western Division, who died at home on 24/01/2022. He had pre-existing medical conditions and was fully vaccinated.

The third COVID-19 death to report is of an 86-year-old female from the Northern Division, who was admitted at Labasa Hospital on 23/01/2022 and died 2 days later in hospital on 25/01/2022. She was not vaccinated.

The fourth COVID-19 death to report is of an 83-year-old female from the Western Division, who died at home on 25/01/2022. She was not vaccinated.

The fifth COVID-19 death to report is of a 31-year-old male from the Northern Division, who died at home on 26/01/2022. He had a significant congenital medical condition that likely contributed to his death. He was fully vaccinated.

The sixth COVID-19 death to report is of a 75-year-old male from the Central Division, who died at home. He was not vaccinated.

The seventh COVID-19 death to report is of an 83-year-old female of the Northern Division, who was admitted at Labasa Hospital on 23/01/2022. She had pre-existing medical conditions which contributed to the severity of her illness. She died 2 days later in hospital on 25/01/2022. She was not vaccinated.

There has been a total of 798 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 January 20th, 2022,  the national 7 days rolling average for COVID-19 deaths per day is 3.0, with a case fatality rate of 1.32%.

We have recorded 785 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 downward trend in daily hospitalisations. Using the WHO clinical severity classification, a greater percentage, 49% (n=63) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild, 27% (n=36) are categorized as moderate and 19% (n=24) as severe with 6 cases in the 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:

236  tests have been reported for January 27th, 2022. The 7-day daily test average is 374 tests per day or 0.4 tests per 1,000 population.

The national 7-day average daily test positivity is 44.6%. The high positivity rate is an indication of widespread community transmission.

Public Advisory:

The analysis of the first 95  deaths in the vaccine eligible population during this third wave has revealed that fully vaccinated adults have a 16.2 times lower rate of death from COVID-19 than unvaccinated adults. This is comparable to rates seen overseas, which is an indication of the quality of our COVID-19 vaccination program, even with the urgency of ensuring rapid deployment of vaccines in a very short time period. A testament to the work put in by our dedicated health teams and partner agencies to ensure that protocols are followed, and vaccines are administered properly to the people of Fiji. The huge difference in death rates between vaccinated and unvaccinated adults is even further evidence that vaccination lowers the risk of severe disease outcomes from COVID-19.

We must all do our best to reduce the transmission of COVID-19 to protect our vulnerable populations. This means keeping up with the Vaccine Plus approach.

1) getting fully vaccinated (which includes getting a booster shot when due), plus

2) strictly adhering to the COVID transmission suppression protocols.

The COVID transmission suppression protocols are:

  1. Individual COVID safe measures (masking, physical distancing, avoiding crowds, hand hygiene), and
  2. Settings-based measures (social gathering restrictions, indoor capacity restrictions, ventilation, and curfews).

By vaccinating and maintaining our COVID safe measures, we protect the vulnerable among us. Looking after the vulnerable needs to be a community-wide effort. Everyone also needs to be aware of the symptoms of severe COVID-19 disease, and present early to a health facility when severe symptoms are present. The severe symptoms to look out for are: having trouble breathing (shortness of breath or difficulty breathing), ongoing chest pain, severe headache, confusion, inability to stay awake or wake up, pale, grey or blue-colored skin, lips or fingernails, worsening weakness, coughing blood.

Vaccination

The booster dose program began at the end of November 2021. As of January 26th, 72,399 individuals have so far received booster doses of the Moderna COVID-19 vaccine from the 142, 240 persons considered eligible. This represents a 51% coverage rate for booster-eligible persons. We are also expecting to receive more Pfizer vaccines soon which will be used for booster doses and as a vaccine for children. The booster vaccine and vaccination for children are not considered mandatory, however, we encourage all eligible individuals to be vaccinated or get a booster dose, and help navigate Fiji into a safer covid zone that supports the socio-economic revival and safer reopening of schools.

Vaccination of children under 12 years remains part of ongoing discussions as sourcing them remains difficult.

 

PS Health – Statement on NCDs

Friday, 28th January 2022

Bula Vinaka and good afternoon.

Our data show that we are through the worst of this third wave. Our employers can also vouch for this given the decreasing of COVID-related absences from work. All that said, our COVID-safe measures must continue in the near term to protect those most vulnerable.

We have seen relatively low rates of hospitalisations and deaths in this wave due to our high rate of vaccination and have not had to create any extra space in our treatment facilities or mortuaries. But among the fatalities we have recorded, there is a clear trend: Most are unvaccinated, suffer from serious comorbidity, and die while at home.

This trend tells us that the next stage of our response involves a more holistic view of the medical realities the nation faces. I know that we’ve all grown accustomed to my updating the nation on the latest COVID-19 case numbers and response measures, but the focus of my brief today is on a group of diseases that not only can worsen COVID-19, but that inflict a far higher toll on our society than the virus ever could. I’m speaking of the prevalence of non-communicable diseases in Fiji — what we call, NCDs.

After nearly two years of non-stop COVID-19 coverage, I fear that this issue — which is by far and away from the number one killer of our people — has become secondary in our national discourse. But the suffering it creates is not second to any threat our people face to their wellbeing. The doctors and nurses I lead see the brutal face of this epidemic every day. We know it is a burden that has persisted long before COVID, in fact long before I became a doctor, and it demands our urgent attention as part of our resilience-building in a COVID-endemic world.

So, today, I am calling for a national reset for our national discourse on the health of our people. We need a new focus, from the media and members of the public, on what is most deadly and that is the epidemic of NCDs in this country.

Last week, our Ministry of Health and Medical Services Wellness Unit and Diabetes Fiji published NCD-related statistics from 2020. In a year dominated by almost nothing but COVID-19 headlines, we lost an estimated 5,700 Fijians due to NCD-related causes. These lives were ended too soon by quiet killers like diabetes, stroke, heart disease, and others.

I was glad to see some coverage this week of that staggering statistic. But we can’t settle for a handful of headlines on such an important issue. We have to keep talking about these diseases, the burden they place on our society, and about what we can do –– together –– to address them. Because this is a societal problem that affects every community in Fiji, and saving lives depends on actions from all of us.

NCDs are deadly on their own –– but COVID-19 can turn them into more efficient killers. NCDs and other comorbidities also complicate our ability to precisely determine the causes of death. It may be that someone died with COVID, but not from it – but because most deaths have been at home that can be very difficult to determine. Our policy has been to categorize these as COVID-19 deaths, but what is indisputable is that the comorbidity is what contributed to the fatality –– so we know that the urgency of identifying, treating, and preventing NCDs is paramount.

We know that COVID-19 will be endemic in Fiji –– which means the virus will never go away, like the common flu. It is our duty to engage in health-seeking behavior that builds our resilience to the virus. That means taking steps to keep ourselves healthy, like eating more nutritious foods, exercising regularly, and getting vaccinated and boosted when we are eligible.

Because the NCD epidemic is such an underreported crisis, I worry that not enough of us know about the resources we have available at the Ministry to save lives from these diseases. So, I’d like to go over the basics for everyone.

The NCD burden has built up on our society over the course of many decades. These diseases are not viruses like COVID-19. You cannot catch them from other people. These diseases take root through bad habits, developing over an extended timeline of months to years, due primarily to the overconsumption of sugar, salt, oils, and highly-processed foods and a chronic lack of physical activity.

The burden these diseases place on our society and health system is enormous –– amounting to over $400 million annually. I want to clarify what that means for the media. It does not mean that the government spent over $400 million failing to combat NCDs, as one reporter wrote. A disease burden is a measure of lost potential. Basically, if you add up every lost hour of productivity due to medical procedures, loss of mobility due to injury or amputation, and loss of life due to NCDs, the estimated cost to the country amounts to more than $400 million each year.

This all goes to show how and why our perception of health priorities needs to change.

For example, the recommended daily intake of sugar is six teaspoons for women and nine teaspoons for men. I am sure that we’ve all seen someone spoon more sugar than that into a single cup of tea. The same goes for processed foods. They may be tasty and sometimes easy to get, but they are far worse for your health than raw fruits and vegetables (our mangoes, bananas, pineapples, cabbage, chauraiya, bhindi, and bele, to name a few), nuts, and lean meats, like fish. And I don’t mean fried Fish and Chips.

In much the same way we needed a whole of society response to deal with COVID 19, we need an effective whole of society response to deal with NCDs. However, this response needs to be sustained and improved over the years and decades. The hope is that we save lives now and create a flywheel of good habits that saves lives for generations to come.

Working with key partners WHO, UNDP, UNICEF, World Bank, and other organizations such as Diabetes Fiji Inc, Fiji Cancer Society, Medical Services Pacific, Empower, Lifeline Fiji, National Committee On Preventing Suicide, Substance Abuse Advisory Council, we have evolved a network of avenues to help to provide prevention and care services for NCDs.

We have clear and evolving guidelines on Diabetic Care, especially on diabetic foot care. A Training package called the PEN (Package of Essential NCDS) has been deployed to health personnel as an ongoing program to help equip them with the knowledge to be able to counsel patients and provide interventions appropriately. Together with NCDS, we have included programs to screen for and provide care for Rheumatic Heart Disease.

The Ministry had committed to facilitating regular outreach services and undertaking community-wide health awareness and promotion activities well before this pandemic. We recognize that decentralizing public health and clinical care remains the one means to ensure we reach all who need to be reached.

The pandemic has actually created an opportunity to identify and treat NCDs with greater accuracy. We needed to rapidly identify as many vulnerable Fijians as possible –– including those who were undiagnosed with NCDs –– in order to prioritize them for vaccination.

We now have accurate and consistently maintained registries of patients with a chronic disease that will allow us to reach out to them with advice and medications. Apart from face-to-face services access, we worked with strategic partners –– including DFAT and NGOs in Fiji –– to enable virtual care access through Telehealth number 165 for services such as COVID care, cardiac care, surgery, cancer treatment. eye treatment, and mobile medication support in cooperation with partners like Diabetes Fiji, Medical Services Pacific, and Fiji Cancer Society.

The line is currently being reviewed to engage in service provision to supplement the face-to-face clinics The three divisional hospitals team also has a roving team that provides mobile support for patients.

The Wellness team has engaged institutions and organizations through the virtual modes and has run sessions on Wellness and NCDs for the Ministry of Youth and Sports and Fiji Sports Commission, youth leaders, and ambassadors to empower them as champions in their communities. The Wellness unit has worked with the Fiji Sports Commission, Ministry of Youth and Sports, and WHO to develop videos for keeping physically active in pandemics and lockdowns

The Wellness unit has run an all-out awareness-raising campaign through social marketing programs, articles in the dailies; Visual media coverage, including the My Kana app and nutrition; radio messages; the Wellness Fiji and National Food and Nutrition Center Facebook pages; interviews on Fiji One and Fiji Two Breakfast show; and NCD workshops.

And to ensure our own staff are catered for as well, we’re working with WHO to provide support for Mental Health and Psychosocial Support (MHPSS) for front-liners with plans to expand this program and integrate it into the NCD prevention and Care network.

Through the My Kana App and social media platforms, we’re also encouraging uptake of the Ministry of Agriculture “Grow From Home” Gardening initiative and eating correctly-portioned meals.

Division by division we’re taking this campaign to the grassroots, conducting home visits to conduct checkups, operating local clinics that offer NCD-related care, building capacity among healthcare staff through virtual training sessions, and informing people of our telehealth system.

When we’ve deployed mobile vaccination teams to reach vulnerable NCD patients, we’ve also arranged for deliveries of medicine and offered special outpatient treatment to those who need to be treated at home. Other times, we arranged for these patients to be treated by private practitioners.

This work is ongoing. There are many more people we need to reach with good information so that they can prevent the rise of NCDs, and with reliable diagnosis and treatment so that we can save lives.

Changing daily habits –– which sometimes have been entrenched for decades –– is not easy. It requires patience, it requires empathy, it requires to resolve, but I’m telling you today that it is worth it. It is worth it to help our loved ones, and it is worth it to help ourselves.

To sum it up, targeting NCD-related care and addressing the root causes of these diseases is vital to our response to COVID-19’s inevitable progression towards becoming endemic. I am the PS for Health and Medical Services and it is the duty of me and my team to help Fijians contend –– not only with a single virus or variant –– but with all diseases, all viruses, and all of the health challenges they face. Combating NCDs is part of our COVID-19 response and part of a larger effort to build a healthier Fiji. So, today I’m asking members of the media and the broader community to help us get the message out on how we can stop this scourge together.

On a personal note, I was told that someone has been posting using a fake profile using my likeness. I do not have any public social media profile, so if you see someone using my image, please report the profile. I put out all of my public messages on the Fijian Government and Ministry of Health and Medical Services Facebook, Twitter, and Instagram pages.

I have no issue with being made into a “meme”, but please do not try to pretend to be me on social media.