PS Health Statement – 09012022
Last Updated on 1 year by Publishing Team
Statement from the Permanent Secretary for Health – Dr. James Fong
The Ministry of Health and Medical Services continues to record lower than expected hospitalizations due to COVID-19 despite the current resurgence in COVID-19 cases throughout Fiji. This is good news. In fact, this decoupling between cases and hospitalizations due to COVID-19 is even more dramatic than it appears on paper because the total number of positive cases we record is an underestimate due to our priority testing regime. We know we have an underestimate, because of the tests we do conduct, a high percentage of the results are positive –- this is the positivity rate.
While Omicron may be mild for nearly everyone it infects, it’s a faster rate of transmission means it may not be mild for our health system. Because even if the percentage of people who require hospitalization due to COVID-19 may be lower, as also seen in other countries, those who are unvaccinated and those with underlying health conditions who are not boosted may still suffer severe disease and burden our health system –– as the Minister mentioned.
I want to be clear that even without Omicron, we were expecting a third wave because this is what has been observed in other countries. And we must also remember that Omicron is likely not the last variant of concern. This tells us that we need to adapt our approach to confronting this virus. It most certainly tells us that we cannot apply an old containment response to take on new variants. Like other nations, our task now is to find an approach to controlling disease incidence and hospitalisations that are pragmatic, ethical, and sustainable for peoples’ livelihoods. As Permanent Secretary for Health, and as a doctor, I am fully aware of the implications of this variant, particularly it’s potential to impact our health services. But I would also find it inhumane, impractical, and unnecessary to force people into lockdown when we know that lockdowns do not work well against highly-transmissible variants.
Therefore, there are two pillars of our approach: One is vaccination, including boosters. Vaccines provide life-saving protection against severe illness from this variant. We must all get two doses, plus a booster as soon as we are eligible –– that is five months after the second dose. The second is prudence: We must continue to use proven, good common-sense measures to limit the spread. As the Minister put it, we must get back to the basics of COVID safety.
I want everyone to understand how our thinking has evolved in step with the latest science.
Given the high transmissibility of the variants Delta and Omicron, knowledge of case numbers and case distribution is less useful for determining what measures we should take to protect the public from exposure to COVID 19. Other factors –– like the number of hospitalisations due to Covid19 –– are much more important. The situation has changed, and our thinking and analysis must change with it. I believe we should move away from making front-page news out of case numbers when those numbers have become significantly less useful for our decision-making. What matters with regards to this variant is hospitalizations due to COVID-19 and ICU admissions due to COVID 19. And both of those numbers are low.
We have achieved high vaccination in those most likely to be infected and we have fully vaccinated 90% of persons over the age of 15. The immunity that has been built through vaccination, together with the numbers of people who have gained some immunity due to prior infection, means that the vast majority of people infected by Omicron will have a manageable illness and can recover from home.
However, there are people who are still vulnerable to severe disease even if they are fully vaccinated. We need to ensure these vulnerable adults receive their booster doses. Until we achieve wider booster coverage, our focus now must be to suppress transmission through basic measures like masking and physical distancing in order to protect these vulnerable Fijians, which include persons over 50 years and those with underlying health conditions, like diabetes, heart disease, kidney disease and asthma, and those who are obese or are pregnant.
Therefore, we will continue to prioritize testing where it makes the most difference in patient outcomes. That means testing must be focused on people at higher risk of severe disease and death. When a person –– who we identify as a vulnerable patient –– tests positive at a Ministry of Health facility, they are entered into a care pathway and care is escalated if severe disease signs appear.
People who are not at high risk from this virus, meaning fully vaccinated and/or boosted patients below the age of 50, with no underlying health conditions, have a different set of protocols. If you fall in this category, and you have any COVID-like symptoms, you should assume you have the virus. You can take a test to confirm that you have COVID-19, but it will not make a difference to what actions need to be taken.
If you do test positive or develop COVID-like symptoms, our advice is that you self-isolate at home for seven days. You should begin your seven-day isolation period from the day you tested positive or from the day your symptoms began. If you need to leave home for an essential purpose, please wear a mask, complete any essential business you have, and go straight back home. We cannot force you to keep yourself at home as much as possible. We cannot keep you from meeting friends. And we cannot count your seven days for you. Instead, we are counting on you to be responsible enough to follow the rules and slow the spread of the virus.
If you are not experiencing severe symptoms, there is no testing required at the end of the seven-day self-isolation. But please continue to strictly adhere to mask-wearing whenever you are with others.
Contacts of cases do not need to be self-isolated, but they should monitor themselves for symptoms and self-isolate if symptoms present.
The festive season has brought the significant movement of people, as families have reunited to celebrate Christmas and New Year. We know there have been gatherings where COVID-safe measures have not been followed, and people have attended gatherings while having symptoms. We ask everyone to continue your observance of COVID-safe measures, and if you have relaxed them, please resume them now. Even at home with guests. If someone is coughing and sneezing around your grog bowl or at your dinner party, politely ask them to take themselves home.
The Ministry of Health and Medical Services is also acutely aware of the medium- to long-term health impacts of a depressed economy and prolonged poor access of our children to education. We need an economy that can sustainably function and we need our children back at school. Speaking from a health perspective, I know that without this, the health of our people will be negatively affected for years to come. We will continue to support the tourism and education sectors to navigate this difficult path to a better economy and better education standards because we understand that our long-term health as a nation is dependent on both these sectors, as well as the other vital sectors that Fiji depends on to thrive. Parents should feel confident that their students are safe in their classrooms due to the effectiveness of COVID-safe measures and practices in schools and in society, including the new social gathering restriction announced by the Minister. In every public setting –– including in school –– good habits can protect us from COVID 19 and the many variants that we expect to come into our shores, as well as many other debilitating and deadly respiratory infections, both now and in the near future.
In conclusion, we need to be guided by the evolving knowledge of this disease and the ways that new knowledge is being interpreted and protocols are being amended by other countries. We are in a very capable position to contend with this wave –– our vaccination coverage is high and our population is relatively young.
I know there are those who are impatient for change and concerned we might be too slow to move forward, and there are others who are anxious at the idea of any opening. We believe that our current approach should satisfy the concerns of both groups. The virus is in the community, our response is changing as it must, and we need to be on track to live with the virus while we control the disease, as early as possible. In order for this to happen, we need to maintain our high vaccination rates and get a booster dose when we become eligible, and we need to support each other to develop safe COVID habits into our daily living routine so that we do not have to rely on mandates and enforcement measures to stay safe.
We should all know by now that COVID-19 is not going away, it will stay with us. We don’t need panic, we need a plan, and we have always had one. If we are all responsible and stick with it, we will get through this together.