In the past 7 days until 04/01/2022, 709 new cases were recorded in the Central division, 303 new cases in the Western division, 23 new cases in the Eastern Division, and 706 new cases in the Northern Division. The Central Division cases constitute 69% of the cumulative total cases nationally, with the Western division making up 27%, 3% in the Northern Division, and 1% in the Eastern Division.
Since the last update, we have recorded 596 new cases of which 224 new cases were recorded on 04/01/2022 and 372 new cases in the last 24 hours ending at 8 am this morning.
Of the 372 cases recorded in the last 24 hours, 254 cases were recorded in the Central Division; 103 cases were recorded in the Western Division, 6 cases were recorded in the Northern Division, and 9 cases were recorded in the Eastern Division.
The national 7-day rolling average of cases as of 1st January is 278 daily cases.
Deaths:
This curve depicts the weekly death rate per 1,000 population by division since October 2021. Overall, the death rate graphs indicate an increase in the number of COVID-19 deaths in the Central Division, while the other Divisions have not recorded any COVID-19 deaths.
There are two COVID-19 deaths to report.
The first COVID- 19 death to report is of a 75-year-old male from Suva who died at home on 31/12/2021. He had significant pre-existing medical conditions that also contributed to his death. He received his first dose of the COVID-19 vaccine mid July and second dose mid September. He was fully vaccinated.
The second COVID-19 death to report is of a 56-year-old female from Korovou who died at home on 01/01/2022 in respiratory distress. She had multiple pre-existing medical conditions that also contributed to her death. She had received only one dose of the COVID-19 vaccine, which means she was not fully vaccinated.
There have been 704 deaths due to COVID-19 in Fiji, with 702 of these deaths during the outbreak that started in April last year. Please note that due to the time required by clinical teams to investigate, classify and report deaths, a 4-day interval is given to calculate the 7 days rolling average of deaths, based on the date of death, to help ensure the data collected is complete before the average is reported. Therefore, as of January 1st, 2022, the national 7 days rolling average for COVID-19 deaths per day is 0.6, with a case fatality rate of 1.32%.
We have recorded 627 COVID-19 positive patients who died from serious medical conditions they had before they contracted COVID-19; these are not classified as COVID-19 deaths.
Hospitalisation:
Using the WHO clinical severity classification, a greater percentage, 78% (n=98) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild, 6% (n=7) are categorized as moderate and 6% (n=7) as severe with 1 case 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:
864 tests have been reported for January 4th, 2022. The 7-day daily test average is 769 tests per day or 0.9 tests per 1,000 population.
The national 7-day average daily test positivity is 34.2%, which is above the WHO recommendation of 5%. The high positivity rate is an indication of wider spread community transmission.
Public Advisory:
While most of our more severe public health and social measures are based on changes in hospitalization data, the evidence is clear that we do need to keep up with measures to suppress transmission so that hospitalization numbers remain low. The evidence is that Omicron causes less severe disease than other variants. However, it infects a larger number of people in a shorter period of time, which means even a smaller percentage of people becoming severely ill may still mean a large number requiring hospitalization, which will put pressure on our health system.
We have always promoted individual COVID safe measures, even during the period of local cases prior to the current outbreak. However, it is evident that we need to have in place more stringent community-level measures to further enforce the message we are promoting. As such we will be announcing more stringent measures related to masking and social gatherings later this week.
Our testing capability is being tested at present and as such the public is reminded that we will need to prioritize our testing for people at higher risk of severe disease to prevent severe outcomes as well as to suppress transmission.
You should assume you are infected, and self-isolate, if you develop any cold/flu-like symptoms such as runny nose, sneezing, nasal congestion, sore throat, cough, body ache, fever. If you have any of these symptoms, please stay home to prevent infecting others, especially those who may be more at risk of severe disease. You should get tested if you can, but especially if you are at higher risk of severe disease. You are at higher risk of severe disease if you are over the age of 50, or have any significant chronic disease like heart disease, kidney disease, lung disease, diabetes, hypertension or you are obese or pregnant. If anyone in your home is at higher risk of developing severe disease, please try to isolate yourself away from them.
The isolation period is for 10 days. You may stop isolating once 10 days have passed since the start of symptoms (with at least 3 consecutive days of no symptoms) or since the positive test (for asymptomatic cases). The Ministry of Health is using a 7-day isolation period for our own staff, requiring a negative rapid antigen test on days 6 and 7 to help maintain essential health services.
For the general public, a 10 day quarantine period will apply to all individuals who are close contacts of a case. You do not need to be tested if you are a close contact unless you develop symptoms. A close contact is anyone who lives in the same house as a case, or has been in a confined space for at least 1 hour, or has come within 2 metres, or has had any physical contact, in the 2 days before the case’s symptoms started and up to ten days after.
Advice to the public on COVID safe measures
The festive season has brought about the significant movement of people as families reunite to celebrate Christmas and New Year. Gatherings have been observed where COVID-safe measures have not been followed, or people have attended while having symptoms. We ask that if you have relaxed in your observance of COVID safe measures, that you please resume now.
Always carry a well-fitted mask when you leave home, and wear it in any public indoor settings, and outdoor settings where there are crowds. Avoid crowds and poorly ventilated spaces. Maintain at least 2 metres of physical distancing from others when outside your home. Wash your hands frequently with soap and water or use an alcohol-based hand sanitiser. Stay home and do not attend any gatherings if you have any symptoms of COVID-19. Get vaccinated if you are eligible and have not yet been vaccinated. And get a booster dose if you are over the age of 18, but especially if you are at higher risk of severe disease.
Since the last update on 01/01/2022, we have recorded a total of 580 new cases; of which 405 new cases were recorded on 02/01/2022, and 175 new cases in the last 24 hours ending at 8 am this morning.
Overall, there have been 54,939 cases recorded in the 2nd wave, with 69% of the cases from the Central Division, 27% of the cases from the Western Division, and 1% of the cases from the Eastern Division, and 3% from the Northern Division.
Of the 580 cases recorded since the last update, 146 cases were recorded in the Northern Division; 111 cases were recorded in the Western Division, 303 cases were recorded in the Central Division, and 20 cases in the Eastern Division.
Our national 7- day rolling average is 167 daily cases calculated for 30th December 2021.
Deaths:
This curve depicts the daily death count by division since the 2nd wave of this outbreak that began in April 2021. Overall, the death rate graphs for the Central and Western Divisions indicate a declining trend. The differences between the Central and Western are similar to the incidence of the daily cases and are likely a reflection of vaccination levels, COVID mitigation measures, and differences in population density.
There are two COVID-19 deaths to report.
The first COVID-19 death to report is of a 73-year-old male from Wainibuku who died at home on 31/12/2021 in respiratory distress. He had pre-existing medical conditions and was not vaccinated.
The second COVID -19 death to report is of an 84-year-old male from Kinoya who died at home on 02/01/2022 in respiratory distress. He had a significant pre-existing medical condition and was not vaccinated.
There have been a total of 702 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 December 30th, 2021, the national 7 days rolling average for COVID-19 deaths per day is 0.3, with a case fatality rate of 1.32%.
We have recorded 621 COVID-19 positive patients who died from serious medical conditions they had before they contracted COVID-19; these are not classified as COVID-19 deaths.
Tests
As of January 1st, rapid antigen tests conducted in the Ministry of Health and Medical Services health facilities are being added to testing numbers and test positivity calculations going back to December 23rd.
Epidemic Outlook:
The Ministry of Health continues to monitor the outbreak using indicators such as daily case numbers, hospitalizations, test positivity, and deaths.
Occupancy rates in health facilities, the occupancy rate of ICU beds, death rates, and vaccination coverage are indicators to monitor our health response capacity. While we see a low trend across indicators from our health facilities with increasing vaccination coverage for adults, 15-17-year-olds, and 12-14-year-olds in Fiji the current escalation of cases indicates a need for increased readiness and response levels for severe disease and hospitalization.
COVID-19 cases are increasing rapidly globally and especially so in Australia, and the European and Americas region, and throughout Africa. The new highly transmissible variant Omicron is contributing significantly to this increase. As such, we anticipate an increasing number of cases from border quarantine facilities. Increased and sustained surveillance and testing at our borders, communities, and maritime islands are vital to monitor and detect COVID-19 cases for early intervention.
There is an increasing number of cases in all divisions which is anticipated to continue to increase, demanding ongoing surveillance for early intervention to mitigate COVID-19 risks.
Public Advisory:
The Ministry of Health and Medical Services continues to record lower than expected hospitalization numbers despite the current resurgence in COVID-19 cases throughout Fiji. The results of positive samples sent to the Doherty Institute in Melbourne for genomic sequencing have confirmed, as expected, that we have community transmission throughout Fiji of both Omicron and Delta variants of the virus that causes COVID-19.
Omicron is vastly more infectious than Delta. As such, in keeping with what we see in other countries, the Omicron will become the dominant variant.
As Omicron spreads very fast, you should assume you are infected, and self-isolate, if you develop any cold/flu-like symptoms such as runny nose, sneezing, nasal congestion, sore throat, cough, body ache, fever. If you have any of these symptoms, please stay home to prevent infecting others, especially those who may be more at risk of severe disease. You should get tested if you can, but especially if you are at higher risk of severe disease. You are at higher risk of severe disease if you are over the age of 50, or have any significant chronic disease like heart disease, kidney disease, lung disease, diabetes, hypertension or you are obese or pregnant. If anyone in your home is at higher risk of developing severe disease, please try to isolate yourself away from them.
What to expect for the third wave
Omicron has been shown to escape immunity from infection induced by previous infection or vaccination. This means that people that have been previously infected by other variants or have been fully vaccinated with two doses of the vaccine, can get infected with Omicron. However, Omicron is more likely to cause milder disease, with data from the UK and South Africa showing that the risk of hospitalization with Omicron compared with Delta is reduced by as much as 80 percent and, once in hospital, the risk of severe diseases with Omicron is reduced by as much as 70 percent. As with previous variants, unvaccinated people are at higher risk of severe disease. With more than 92 percent of adults fully vaccinated, we expect that our high vaccination rates, plus the infection-induced immunity from the large number of people who were infected during the last wave, will help to lower the number of people that develop severe disease.
We continue to see that the majority of individuals testing positive in medical facilities are presenting for non-COVID medical problems and found to be positive while undergoing routine screening as all admissions to the hospital are currently tested for COVID-19. Also, the vast majority of cases turning positive have minimal symptoms and remain stable
However, severe outcomes will still be expected in some individuals, including those who have been immunized with two doses of the vaccine, especially people with severe underlying medical conditions and/or are over the age of 50. These factors do place a person at higher risk of severe disease, even if fully vaccinated. We have in place measures that ensure that those vulnerable to severe disease are adequately monitored, tested, retrieved, and effectively managed in a timely manner before their conditions worsen. However, we need the cooperation and support of community networks in formal and informal community settings and business settings, working in tandem with the Ministry. It requires that a register of vulnerable persons is established and kept in each of the settings mentioned and leaders in these settings set up a means by which vulnerable persons are checked on. If they do not feel well, they should be tested early and if positive, the nearest medical team is informed so that measures are put in place to ensure early access to medical treatment with any early signs of deterioration.
The current epidemic will impact our testing capacity. Many countries are struggling with testing capacity and we will be no different. As such, we continue to prioritize testing to prevent severe illness and death and to focus on transmission suppression where the risk of transmission is high.
Rapid antigen tests are very good at quickly detecting the people we need to find and isolate: those with high amounts of virus in their nose (who are therefore more infectious). These tests are more accessible than PCR tests, and the turnaround from sampling to result is much faster. However, antigen tests will miss people with lower amounts of the virus early in the disease. With the high prevalence of COVID-19 currently, if you have symptoms of COVID-19 and test negative on a single rapid antigen test, you should still assume you have COVID-19 and self-isolate.
Isolation and quarantine
As announced in previous updates, the Ministry of Health and Medical Services is aware that there are countries that have revised their isolation and quarantine protocols, based on the specific context of the outbreak in their own settings, including severely stretched testing and workforce capacity. The Ministry’s COVID-19 Taskforce has reviewed the evidence, and our specific context, and recommended changes to our isolation and quarantine protocols. The changes have been recommended based on the scientific evidence while taking into account the need to prevent severe disruption to essential services that will arise should a large number of workers be required to isolate or quarantine.
Isolation – a healthcare worker of the Ministry of Health and Medical Services who returns a positive test result will be required to self-isolate at home for 7 days, become asymptomatic, and return a negative RDT test on the 6th and 7th day before they can return to work. They will be required to maintain strict masking for the remainder of 3 days to complete the 10-day isolation requirement before they are fully discharged from isolation. In the unusual circumstances where the healthcare worker’s absence will severely debilitate the health service, processes will be put in place by the respective health care facility to ensure that a safe corridor of movement and work is created for asymptomatic healthcare workers while maintaining the full isolation requirements.
For the general public, an isolation period of 10 days for confirmed cases remains in place as before, with the case able to leave isolation without repeat testing once 10 days have passed since the start of symptoms (with at least 3 consecutive days of no symptoms) or the positive test (for asymptomatic cases). However, non-health workplaces that wish to follow the Ministry’s revised 7-day isolation SOP above will be required to cater for the testing requirement and strict masking requirement at their own cost.
Quarantine – healthcare workers of the Ministry who work in a low disease prevalence area and become a close contact of a confirmed case will be required to self-quarantine at home for 10 days with daily symptoms checking and strict COVID safe measures before they are allowed to return to work. They must be tested if they develop symptoms. However, if the healthcare worker is working in a high disease prevalence area where essential health services are at risk of being severely debilitated by a high number of healthcare workers having to quarantine or isolate, the healthcare worker will be required to return to duty at their respective health facility with strict adherence to COVID safe measures and infection prevention and control measures, undergo regular symptoms monitoring while at work, and have daily rapid antigen testing before the start of the shift. They are to immediately stand down from duties and isolate if they develop symptoms or return a positive test.
For the general public, a strict 10 days quarantine period will apply to all individuals who are close contacts of a positive case. This is the same quarantine strategy used for the Mitigation phase in the central division and the Western Division during the second wave, and so should be familiar with members of the general public.
Maritime travel restrictions
We are seeing an increase in cases in the maritime islands and this was expected given the opening of maritime travel and the many social media postings of crowding in maritime vessels and in social gatherings. Medical Teams and supplies are being set up and being deployed to maritime islands communities reporting a surge in positive cases. In view of the disease outbreak in the Northern division as well as a number of islands in the Eastern division, the following shall be implemented from Tuesday 04th January 2021:
Travelers on boats between Viti Levu and Vanua Levu: In light of the high prevalence of COVID-19 in Viti Levu and Vanua Levu, the Ministry will not require pre-departure testing before traveling to Viti Levu and Vanua Levu. However, strict adherence to personal COVID safe measures during the travel such as mandatory masking, personal hand gel for hand hygiene and ships to ensure the soap is available throughout the trip, careFIJI app on, and passengers are fully vaccinated with 2 or more doses. Ministry officials will be closely monitoring the implementation of the new travel protocol.
Travelers on boats from Viti Levu to Eastern division maritime islands that are currently experiencing disease outbreaks will be restricted to travelers for essential services only, for example, teachers, nurses, Government staff on official trips, those workers (and their families) who are getting posted or transferred to the islands, and permanent island residents who came to Viti Levu for the holidays and are returning to their homes without the need to come back to Viti Levu in the immediate future. This measure is to limit unnecessary population movement into the islands as the Ministry is now facing challenges in the medical evacuation of COVID cases to the main hospitals in Viti Levu as the operations of the contracted medevac providers are also affected by the current outbreak.
Travelers on boats from the Eastern division islands to Viti Levu who have been identified as positive cases or close contacts of cases will be required to complete 10 days of isolation in their homes on the islands, be symptoms free, and with no pre-departure testing required before they are allowed to board the boat back to Viti Levu. Our team on the islands will ensure that these amended protocols are adhered to to protect the traveling population as well as the limited health care capacity on these islands.
Advice to the public on COVID safe measures
The festive season has brought about the significant movement of people as families reunite to celebrate Christmas and New Year. Gatherings have been observed where COVID-safe measures have not been followed, or people have attended while having symptoms. We ask that if you have relaxed in your observance of COVID safe measures, that you please resume now.
Always carry a well-fitted mask when you leave home, and wear it in any public indoor settings and outdoor settings where there are crowds. Avoid crowds and poorly ventilated spaces. Maintain at least 2 metres of physical distancing from others when outside your home. Wash your hands frequently with soap and water or use an alcohol-based hand sanitiser. Stay home and do not attend any gatherings if you have any symptoms of COVID-19. And get vaccinated if you are eligible and have not yet been vaccinated. And get a booster dose if you are over the age of 18, but especially if you are at higher risk of severe disease.
Since the last update on 29/12/2021, we have recorded a total of 805 new cases; of which 316 new cases were recorded on 30/12/2021, 223 new cases were recorded on 31/12/2021, and 266 new cases in the last 24 hours ending at 8 am this morning.
Overall, there have been 54,077 cases recorded in the 2nd wave, with 71% of the cases from the Central Division, 27% of the cases from the Western Division, and 1% of the cases from the Eastern Division, and 1% from the Northern Division.
Of the 805 cases recorded since the last update, 388 cases were recorded in the Northern Division; 134 cases were recorded in the Western Division, and 283 cases were recorded in the Central Division.
Our national 7- day rolling average is 18 daily cases calculated for 28th December 2021.
Deaths:
This curve depicts the daily death count by division since the 2nd wave of this outbreak that began in April 2021. Overall, the death rate graphs for the Central and Western Divisions indicate a declining trend. The differences between the Central and Western are similar to the incidence of the daily cases and are likely a reflection of vaccination levels, COVID mitigation measures, and differences in population density.
There are two COVID-19 deaths to report.
The first COVID-19 death to report is of a 67-year-old male from Raiwaqa who died at home on 29/12/2021 in respiratory distress. He had a number of severe pre-existing medical conditions that have been assessed to also have contributed to his death. He received his first dose of the COVID -19 vaccine by the end of July and his second dose by the end of August. This means he was fully vaccinated.
The second COVID -19 death to report is of a 76-year-old male from Nadawa who died at home on 31/12/2021 in respiratory distress. He had a significant pre-existing medical condition that may have contributed to his death. He received his first dose of the COVID-19 vaccine by mid-July and his second dose by mid-September. This means he was fully vaccinated.
While both these deaths occurred in individuals who have been immunized with 2 doses of vaccine, they both had significant underlying medical conditions and were over the age of 50. It is known that these factors place a person at higher risk of severe disease, even if fully vaccinated.
Persons over the age of 50 and those who have underlying chronic diseases such as heart disease, kidney disease, lung diseases, etc. are strongly urged to come forward and have a booster dose of the vaccine to increase their protection from infection and severe disease.
There have been a total of 700 deaths due to COVID-19 in Fiji, with 698 of these deaths during the outbreak that started in April this year. Please note that due to the time required by clinical teams to investigate, classify and report deaths, a 4-day interval is given to calculate the 7 days rolling average of deaths, based on the date of death, to help ensure the data collected is complete before the average is reported. Therefore, as of December 28th, the national 7 days rolling average for COVID-19 deaths per day is 0.1, with a case fatality rate of 1.32%.
We have recorded 620 COVID-19 positive patients who died from serious medical conditions they had before they contracted COVID-19; these are not classified as COVID-19 deaths.
Tests
As of today, rapid antigen tests conducted in the Ministry of Health and Medical Services health facilities are being added to testing numbers and test positivity calculations going back to December 23rd. Prior to this, only PCR tests were reported, though recently, rapid antigen test positives were also reported, and used in test positivity calculations. Furthermore, negative PCR test results from one lab were not being received nor added to the test count, while their positives were being reported. As test positivity is calculated by dividing positive tests by total tests, this resulted in test positivity being reported as higher than the actual. This has now been corrected. Nevertheless, it should be noted that test positivity remains high and the trend of test positivity remains the same as it continues to increase along with case numbers.
Epidemic Outlook:
The Ministry of Health continues to monitor the outbreak using indicators such as daily case numbers, hospitalizations, test positivity, and deaths.
Occupancy rates in health facilities, the occupancy rate of ICU beds, death rates, and vaccination coverage are indicators to monitor our health response capacity. While we see a low trend across indicators from our health facilities with increasing vaccination coverage for adults, 15-17-year-olds, and 12-14-year-olds in Fiji the current escalation of cases indicates a need for increased readiness and response levels for severe disease and hospitalization.
COVID-19 cases are increasing rapidly globally and especially so in Australia, and the European and Americas region, and throughout Africa. The new highly transmissible variant Omicron is contributing significantly to this increase. As such, we anticipate an increasing number of cases from border quarantine facilities. Increased and sustained surveillance and testing at our borders, communities, and maritime islands are vital to monitor and detect COVID-19 cases for early intervention.
There is an increasing number of cases in all divisions which is anticipated to continue to increase, demanding ongoing surveillance for early intervention to mitigate COVID-19 risks.
Public Advisory:
The Ministry of Health and Medical Services has documented a resurgence in COVID-19 cases throughout Fiji while our hospitals are recording a lower than expected number of hospitalizations from the virus. The majority of individuals testing positive in medical facilities had presented for non-COVID medical problems and were found to be positive while undergoing routine screening as all admissions to the hospital are currently tested for COVID-19. It is likely that this is the impact of the vaccination and booster doses in preventing hospitalization, severe illness, and death. Our briefings have also revealed that almost all the cases turning positive have minimal symptoms and remain stable
Our contact tracing investigations reveal that the additional protection that vaccines provide against infection is evident. However, some recent events of excessive crowding in maritime vessels, sporting events, and social gatherings are proving to be superspreader events contributing significantly to the sharp surge in cases.
The overall goal of the MOHMS COVID-19 pandemic response and recovery is to suppress ongoing community transmission to a level that will minimize hospitalization, severe illness, and deaths, as well as minimize severe societal disruption. We are prioritizing the promotion of individual COVID safe measures (vaccination, masking, physical distancing, avoiding crowds, hand hygiene), followed by settings-based measures (social gathering restrictions, indoor capacity restrictions, ventilation, and curfews). We would like to avoid population blanket measures such as lockdowns, which we used earlier in this pandemic, as such measures have also negatively impacted our communities on other fronts. In our own recent experience, such measures have limited scope in the control of the spread of COVID-19 in Fiji. In addition, with more than 92% of adults in Fiji vaccinated, and with the added natural immunity expected from the large number of people who were infected during the last wave on Viti Levu, we are no longer the COVID-naive population that we were before. The immunity that has been built through vaccination, and prior infection, is evidently having a significant impact in reducing severe disease in this third wave.
We will continue to work towards suppressing community transmission because we know that even if the proportion of severe cases relative to all cases is less in this third wave, a smaller percentage of severe disease in a larger number of cases will still result in a large number of sick individuals admitted to hospital, which could still overwhelm the health system’s capacity to manage. For now, we have a window of opportunity to prevent such an occurrence. This will entail adherence to COVID safe measures and having in place measures that ensure that all those vulnerable to severe disease are adequately monitored, tested, retrieved, and effectively managed in a timely manner before their conditions worsen. The latter needs the cooperation and support of community networks in formal and informal community settings and business settings, working in tandem with the Ministry. It requires that a register of vulnerable persons is established and kept in each of the settings mentioned and leaders in these settings set up a means by which vulnerable persons are checked on. If they do not feel well, they should be tested early and if positive, the nearest medical team is informed so that measures are put in place to ensure early access to medical treatment with any early signs of deterioration.
The 2 covid related deaths reported today highlight the need for such vigilance in persons with significant underlying medical conditions, especially if they are elderly.
We are seeing an increase in cases in the maritime islands and this was expected given the opening of maritime travel and the many social media postings of crowding in maritime vessels and in social gatherings. Medical Teams and supplies are being set up and being deployed to maritime islands communities reporting a surge in positive cases.
Reports of transmission to medical staff as well as staff in other workplaces are increasing, and as such isolation and quarantine measures will impact workplace outputs. The scientific basis for defining contacts and the conditions of quarantine and isolation has not changed. We note that some health authorities overseas are reducing the duration of quarantine and isolation periods. The rationale and evidence in support of these less stringent conditions are context-specific and as such we are reviewing our protocols which we will be communicating soon. All business and commercial entities need to be aware that the situation is continuously changing.
The Ministry of Health and Medical Services has also discussed with the Ministry of Education, Heritage, and Arts the current plans for school opening. We have consulted with the World Health Organisation, and UNICEF, reviewed all the evidence and taken into account our current situation, and we support the planned reopening of schools scheduled for the 4th of January 2022. We will continue to monitor our community surveillance parameters and work with the Ministry of Education to facilitate the safe opening of schools.
Our medical teams have continued to work day and night, and through the public holidays, providing healthcare to the sick, facilitating logistical requirements of medical supplies at the frontline, moving medical teams to areas of disease transmission, providing testing, continuing vaccination booster doses, protecting aged care homes, facilitating outreach to remote settings, establishing medical and community-based line lists that ensure timely follow-up of high-risk individuals, setting up intermediate care facilities with appropriate standard operating procedures, in addition to delivering normative medical care. All these activities have now escalated significantly with this new wave of the virus. At the same time, we are updating our contingency plans to be able to effectively respond to any adverse climatic weather conditions, under COVID safe conditions.
While we have also recalled targeted health staff who are on annual leave, we are very mindful of the fact that many of our staff are tired and in need of rest and recuperation. As such, senior managers have been instructed to be judicious in the deployment of staff for the various activities that need to be implemented. We have reminded all medical teams to remain professional at all times irrespective of the ongoing stressors of the pandemic and difficult individual situations. And we are committed to supporting our teams through these difficult times.
As Permanent Secretary, I am confident that our plans to mitigate this 3rd wave and the potential health impact of any severe adverse weather condition is sufficient. However, our ability to scale up these plans in a timely manner will be dictated by the impact of these natural events and will remain challenging. The need for community-wide support in terms of adherence to COVID Safe measures, instituting measures to deal with the risk of flooding and other impacts of adverse weather conditions, and facilitating ongoing vaccination is urgent and essential.
We need our people to develop and inculcate safe COVID habits into their daily living to safely navigate the current pandemic without relying on mandates and rules to do so. Enforcing settings-based measures and enforced rules are just one of many ways to promote a message to build better population-wide COVID safe habits. These COVID habits will also protect us from many other debilitating and deadly respiratory infections.
In the past 7 days until 28/12/2021, 85 cases were recorded in the Central division, 74 new cases in the Western division, 1 new case in the Eastern Division, and 316 new cases in the Northern Division. The Central Division cases constitute 71% of the cumulative total cases nationally, with the Western division making up 27%, 1% in the Northern Division, and 1% in the Eastern Division.
Since the last update, we have recorded 309 new cases of which 115 new cases were recorded on 28/12/2021 and 194 new cases in the last 24 hours ending at 8 am this morning.
Of the 194 cases recorded in the last 24 hours, 136 cases were recorded in the Northern Division; 6 cases were recorded in the Western Division including 4 cases from border quarantine, 46 cases recorded in the Central Division, and 6 cases recorded in the Eastern Division.
The national 7-day rolling average of cases as of 25th December is 10 daily cases.
Deaths:
This curve depicts the weekly death rate per 1,000 population by divisions since October 2021. Overall, the death rate graphs for the Central and Western Divisions indicate a sustained declining trend. The differences between the Central and Western are similar to the incidence of the weekly cases and are likely a reflection of vaccination levels, COVID mitigation measures, and differences in population density.
There is one COVID-19 death to report.
The COVID-19 death report is of a 62-year-old man from Tailevu who died at home with severe respiratory distress on 25/12/2021. He received the first dose of the COVID-19 vaccine on 14/04/2021 and his second dose on 23/07/2021. This means he was fully vaccinated.
There have been 698 deaths due to COVID-19 in Fiji, with 696 of these deaths during the outbreak that started in April this year. Please note that due to the time required by clinical teams to investigate, classify and report deaths, a 4-day interval is given to calculate the 7 days rolling average of deaths, based on the date of death, to help ensure the data collected is complete before the average is reported. Therefore, as of December 25th, the national 7 days rolling average for COVID-19 deaths per day is 0.1. The 7 day rolling average for COVID-19 deaths per day in the Central Division is 0.1 and 0.0 in the Western and Eastern Division, with a case fatality rate of 1.32%.
We have recorded 619 COVID-19 positive patients who died from serious medical conditions they had before they contracted COVID-19; these are not classified as COVID-19 deaths.
Hospitalisation:
The downward trend in both the new hospital admissions and total admissions in all hospitals admitting COVID-19 patients across the country is consistent with the cases and death trends. There are fluctuations in the new hospital admissions while total hospital admissions continue on a downward trend indicating a sustained positive response to COVID mitigation measures, Population density differences, and differential Vaccination rates.
Testing:
271 tests have been reported for December 28th, 2021. The 7-day daily test average is 301 tests per day or 0.3 tests per 1,000 population.
The national 7-day average daily test positivity is 31.5%, which is above the WHO recommendation of 5%. The increased positivity rate is an indication of the continued surveillance undertaken in high-risk areas to detect cases early and mitigate the risks of community transmission. An increased positivity rate is also an indication of community transmission, indicating the need for heightened vigilance in all communities and adherence to COVID safe measures.
Epidemic Outlook:
The Ministry of Health continues to monitor the outbreak using indicators such as daily case numbers, hospitalizations, test positivity, and deaths.
Occupancy rates in health facilities, the occupancy rate of ICU beds, death rates, and vaccination coverage are indicators to monitor our health response capacity. While we see a low trend across indicators from our health facilities with increasing vaccination coverage for adults, 15-17-year-olds, and 12-14-year-olds in Fiji the current escalation of cases indicates a need for increased readiness and response levels for severe disease and hospitalization.
COVID-19 cases are increasing rapidly globally and especially so in Australia, and the European and Americas region, and throughout Africa. The new highly transmissible variant Omicron is contributing significantly to this increase. As such, we anticipate an increasing number of cases from border quarantine facilities. Increased and sustained surveillance and testing at our borders, communities, and maritime islands are vital to monitor and detect COVID-19 cases for early intervention.
There is an increasing number of cases in all divisions which is anticipated to continue to increase, demanding ongoing surveillance for early intervention to mitigate COVID-19 risks.
Public Advisory:
The assessment of the Ministry of Health and Medical Services is that the current increase in COVID-19 cases represents the beginnings of the third wave of COVID-19 in Fiji. This may be a resurgence of the endemic Delta variant, however, we are also working on the assumption that the Omicron variant is already here, and is being transmitted within the community. We expect that genomic sequencing results of COVID-19 positive samples sent overseas will confirm this in due course. Should this wave be driven by the Omicron variant, based on what we are seeing overseas, we should expect a large number of cases, and we will also expect that infections will occur in vaccinated persons and those who have previously been infected with the Delta variant. However, it is important to remember that those who are vaccinated or had booster doses are far less likely to become sick enough to require hospitalization. The main focus of our vaccination program is preventing severe illness and death, which will also help to limit the strain on our medical services. Any additional protection that vaccines can provide against infection is an added bonus.
The three divisional hospitals are reporting an increase in positive cases admitted to the hospital, however, none of the cases so far are presenting with COVID-related medical problems. They are being admitted for other medical conditions and are testing positive during mandatory testing for all admissions to the hospital.
The overall goal of the MOHMS COVID-19 pandemic response and recovery has always been to minimize severe illness and deaths. This goal remains, along with reducing severe societal disruption as a result of the COVID-19 pandemic our priority is the promotion of individual COVID safe measures (vaccination, masking, physical distancing, avoiding crowds, hand hygiene), followed by settings-based measures (social gathering restrictions, indoor capacity restrictions, ventilation, and curfews). We intend to avoid population blanket measures, like lockdowns, as much as possible as, almost two years into the pandemic, such measures are damaging to our community on many different levels, and in our own recent experience, have limited value in controlling the spread of COVID-19 in Fiji. Also, with more than 91% of adults in Fiji vaccinated, plus added immunity expected due to the large number of people that were infected during the last wave on Viti Levu, we are no longer the COVID-naive population that we were before. The immunity that has been built through vaccination, and prior infection, is expected to have a significant impact on reducing severe disease in this next wave.
We are expecting cases to be reported in the maritime islands given the opening of maritime travel and the many social media postings of crowding in maritime vessels and in social gatherings. These maritime islands, and the Northern Division, were largely spared the Delta outbreak that affected Viti Levu earlier this year. The main advantage in these islands and the Northern Division is that >80% of the adult population have been vaccinated plus a significant number of children above 15. They have also been recently vaccinated and as such waning immunity may be less of an issue. Therefore, we expect that there is a high level of protection against severe disease and hospitalization in the Northern Division and maritime islands. Medical Teams and supplies are being set up and prepositioned for deployment to Maritime Islands.
We are expecting that transmission to medical staff and staff in other workplaces will begin to increase, and isolation and quarantine measures will impact workplace outputs. Based on the current evidence, both quarantine (for close contacts of cases) and isolation (for positive cases) will be for 10 days, and there is no need for exit testing unless a close contact becomes symptomatic during quarantine. The conditions for quarantine and isolation remain the same. We are aware that there are some authorities overseas who are reducing the duration of quarantine/isolation. The rationale and evidence in support of these less stringent conditions are context-specific, and may not yet be appropriate for our setting. We are reviewing the evidence, and our specific context, and will announce any changes accordingly.
All leave for medical staff in the North will be deferred from tomorrow onwards to support the need for extra staff in health facilities.
We have reminded all medical teams to remain professional at all times irrespective of the ongoing stressors of the pandemic and difficult individual situations. And we are committed to supporting our teams through these difficult times. The teams will focus on identifying, protecting, and monitoring the vulnerable and escalate care as required. This will include the focus on booster doses, protecting aged care homes, outreach to remote settings, line listing and follow-up of high-risk individuals, and setting up intermediate care facilities with appropriate standard operating procedures.
At some point, we will need people to develop safe COVID habits to safely navigate the current pandemic and not rely on mandates and enforced rules. Enforcing settings-based measures and enforced rules are just one of many ways to promote a message to build better population-wide COVID safe habits. We are hoping that in due course these COVID safe measures will become habits, as they also protect us from a wide range of respiratory infections.
Since the last update on 24/12/2021, we have recorded a total of 208 new cases; of which 20 new cases were recorded on 25/12/2021, 109 new cases were recorded on 26/12/2021, and 79 new cases in the last 24 hours ending at 8 am this morning.
This epidemic curve depicts the daily positive cases since the 2nd wave of this outbreak that began in April 2021. Overall, for this 2nd wave, there have been 52,953 cases recorded, with 71% of the cases from the Central Division, 28% of the cases from the Western Division, and 1% of the cases from the Eastern and Northern Divisions.
Of the 208 cases recorded since the last update, 145 cases were recorded in the Northern Division; 32 cases were recorded in the Western Division, and 31 cases were recorded in the Central Division.
Our national 7- day rolling average is 8 daily cases calculated for 23rd December 2021.
Deaths:
This curve depicts the daily death count by division since the 2nd wave of this outbreak that began in April 2021. Overall, the death rate graphs for the Central and Western Divisions indicate a declining trend. The differences between the Central and Western are similar to the incidence of the daily cases and are likely a reflection of vaccination levels, COVID mitigation measures, and differences in population density.
There is no COVID-19 death to report.
There has been a total of 697 deaths due to COVID-19 in Fiji, with 695 of these deaths during the outbreak that started in April this year. Please note that due to the time required by clinical teams to investigate, classify and report deaths, a 4-day interval is given to calculate the 7 days rolling average of deaths, based on the date of death, to help ensure the data collected is complete before the average is reported. Therefore, as of December 23rd, the national 7 days rolling average for COVID-19 deaths per day is 0.0, with a case fatality rate of 1.32%.
We have recorded 614 COVID-19 positive patients who died from serious medical conditions they had before they contracted COVID-19; these are not classified as COVID-19 deaths.
Epidemic Outlook:
The Ministry of Health continues to monitor the outbreak using indicators such as daily case numbers, hospitalizations, test positivity, and deaths.
Occupancy rates in health facilities, the occupancy rate of ICU beds, death rates, and vaccination coverage are indicators to monitor our health response capacity. While we see a low trend across indicators from our health facilities with increasing vaccination coverage for adults, 15-17-year-olds, and 12-14-year-olds in Fiji the current escalation of cases indicates a need for increased readiness and response levels for severe disease and hospitalization.
COVID-19 cases are increasing rapidly globally and especially so in the European and Americas region and throughout Africa. The new highly transmissible variant Omicron is contributing significantly to this increase. As such, we anticipate an increasing number of cases from border quarantine facilities. Increased and sustained surveillance and testing at our borders, communities, and maritime islands are vital to monitor and detect COVID-19 cases for early intervention.
There is an increasing number of cases in all divisions which is anticipated to continue to increase, demanding ongoing surveillance for early intervention to mitigate COVID-19 risks.
Public Advisory:
Cases of COVID 19 continue to be identified among travelers into Fiji. All these cases were in fully vaccinated individuals who tested negative on their 3-day pre-departure PCR test and are currently in isolation within hotels, with protocols that have been well-rehearsed in the lead up to border opening and continue to be overseen by MOHMS in the Western Division. All their positive samples will be sent to our partner laboratory in Australia for genomic sequencing. As previously mentioned, if a variant is transmissible enough, stringent border and community measures will only delay the inevitable entry and spread of current and future variants of the COVID-19 virus. To protect ourselves, our loved ones, and our country, we must all get vaccinated when it is our turn and continue to be strict with our covid safe measures.
We are expecting escalated levels of community transmission to be more evident over the ensuing weeks. We are working on the assumption that the Omicron variant is already in Fiji and is being transmitted within the community. We expect that genomic sequencing results of positive samples sent overseas will bear this out.
The widespread community transmission of COVID-19 in the North is evident. This was expected when borders between Viti Levu and Vanua Levu were opened as the North was largely spared the Delta outbreak that affected Viti Levu earlier this year. The main advantage in the North is that >80% of the adult population have been vaccinated plus a significant number of children above 15. They have also been recently vaccinated and as such waning immunity may be less of an issue. Therefore, we expect that there is a high level of protection against severe disease and hospitalization in the Northern Division. Unfortunately, among the unvaccinated, it is unlikely that there is a significant level of “natural immunity” or immunity acquired after infection and thus they remain more vulnerable to severe effects of COVID 19 infection. We also know that immunity may wane faster in some vulnerable people, especially the elderly. Therefore, booster doses for those who were vaccinated earlier in the program, and for vulnerable groups, are essential.
We are also aware that there is an increase in evidence of positive cases in the community within Viti Levu. The feedback from hospital admissions is that we noticed an increase in COVID positive tests even though none of the cases so far are presenting because of COVID disease. This is an indication of escalating levels of infection in the community. The widespread infections that occurred during the outbreak earlier this year, and high levels of vaccination, in Viti Levu are expected to be protective, however, it is expected that waning immunity levels will be more of an issue. Vaccine booster doses for those 5 months beyond their second dose is essential.
In Suva, we currently have defined 65 active cases however we are sure that this is an underestimate and there are many more. We have been informed that there was a particular restaurant in which there was a Christmas party and 4 attendees have been found positive. We are currently doing our usual contact tracing operations; however, we are grateful that a number of attendees, some of whom are symptomatic have presented themselves for testing. This is not unexpected as covid safe measures with vaccination reduce the risk of getting infected but do not remove that risk. Current indications are that all those who tested positive are stable and that all attendees of the function were fully vaccinated. We remain very confident that there are other events and gatherings happening throughout the weekend and expect cases to escalate. We also expect that if fully vaccinated many of these persons will have significant protection against hospitalization and severe disease.
The possibility of reintroducing earlier curfews, placing more restrictions on gatherings, and escalating further our masking mandates is always under consideration, however, we plead with the public to demonstrate good sense and apply these restrictions on yourselves without the need for directives and strong enforcement actions to remind you of the COVID Safe measures.
Moving forward, in dealing with the current situation the Ministry of Health and Medical services will:
Continue to focus on vaccination, suppressing transmission, protecting health services, and monitoring the key indicators (cases and transmission/testing and test positivity/severity/hospitalizations/deaths) to inform local decision-making and adjust divisional and sub-divisional action plans.
Continue to roll out the booster dose program for everyone over the age of 18.
Continue to test if you develop any COVID-19 like symptoms that include any of the following: cough, runny nose, nasal congestion, sneezing, fatigue/extreme tiredness, loss of taste or smell, headache, aches, and pains, sore throat, fever, diarrhea, red eyes, skin rash. Please visit a screening clinic nearest you OR call 158.
Testing will be prioritized for high-risk individuals; vulnerable and symptomatic persons and household contacts. This includes people over the age of 50 years, with underlying health conditions: diabetes, heart disease, kidney disease, asthma, are obese or are pregnant.
Our contact tracing protocols are being escalated, therefore, please keep your careFIJI app switched on when you are out of your house and scan your QR code when entering or leaving any premises
Both quarantine (for close contacts of cases) and isolation (for positive cases) will be for 10 days duration and there is no need for exit testing unless a close contact becomes symptomatic during quarantine.
In all the divisions we are setting up intermediate care facilities to cater to those high-risk individuals who are stable but need facility isolation to ensure better monitoring.
We are deploying more human and other medical resources to the North with particular emphasis on ensuring reserve capacity with PPEs, Oxygen, and Oxygen delivery capacity, and essential medicines and consumables needed for management of cases.
We have in place measures to reduce the risk of people with severe COVID-19 dying at home, or coming to a medical facility in the late stages of severe illness. We do this by:
Strengthening our ability to register positive cases and vulnerable persons on our line listing,
Ensure awareness of the signs and symptoms of severe disease, and facilitate support by us or other personnel to detect early evidence of severe disease
Admit vulnerable positive persons to intermediate care facilities if they cannot be well observed in the home setting.
Strengthening our ability to provide outreach care and case retrieval
These measures however will require extra resources over and above what we have and as such we will continue to work with our community engagement and various community groups to provide support
The Health Ministry and the health care staff in the North have escalated the measures in place aimed at protecting residents of Vanua Levu from the severe effects of COVID-19. Our health care workers are now on-call to protect lives and mitigate community transmission. They are aided by other government officials from various government agencies in the north in tracing contacts, caring for patients who develop severe disease, and monitoring individuals under isolation. We need the public to cooperate with health care workers and adhere to our COVID safe measures to ensure that this surge in COVID-19 positive cases in the Northern Division is managed and contained.
As for the rest of Fiji, please practice responsible social gatherings and diligently adhere to the COVID-19 safe measures. Be wise about your social gatherings, and postpone them if you can. During these pandemic times, it is best that you remain at home and celebrate with your loved ones, rather than gather in large numbers and potentially put at risk the vulnerable members of your families; including those who are unvaccinated. We must all assume that those around us are COVID-19 positive and so we must protect ourselves at ALL times.
