MHMS FIJI
MHMS FIJI

All posts by superadmin

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

​​

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.

COVID-19 Update 26-01-2022

COVID-19 Situation Update

Wednesday 26th January 2022

Transmission Update:

In the past 7 days until 25/01/2022, 1,162 new cases were recorded in the Central division, 210 new cases in the Western division, 1 new case in the Eastern Division, and 51 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.

Since the last update, we have recorded 223 new cases of which 113 new cases were recorded on 25/01/2022 and 110 new cases in the last 24 hours ending at 8 am this morning.

Of the 223 cases recorded, 116 cases were recorded in the Central Division; 92 cases were recorded in the Western Division, 11 cases were recorded in the Northern Division, and 4 cases were recorded in the Eastern Division.

The national 7-day rolling average of cases as of 22nd January is 246 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 the week of 24/01/22 (this week) is not yet complete therefore the appearance of a downward trend may not be accurate. There are also deaths in 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 40 9.9
Western 29 8.2
Northern 22 15.7
Eastern 3 7.8

​​An analysis of the first 94 deaths recorded in the third wave has shown 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 that 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 – 19 5 1.5
20 – 29 3 2.1
30 – 39 1 0.7
40 – 49 3 2.9
50 – 59 16 17.7
60 – 69 19 36.6
> 70 47 164.7

For the first 94 deaths in the third wave, the rates of death, when adjusted for population, have been highest in the age groups beginning from age 50 and upwards. The 5 deaths in the under 19 group were for children with significant underlying medical conditions present since birth.

Table 3: Deaths by Vaccination Status

Age Cohort Total COVID deaths Total Vaxxed/Unvaxxed Deaths per 100,000 Vaccinated Population Deaths per 100,000 Unvaccinated Population
>18 89 35/41 6.1 90.2
12 – 14 1 0/1 0 2.5
15 – 17 1 0/1 0 6.5

An analysis was done for the first 91 deaths in the vaccine eligible population during the third wave. When adjusted for population in the fully vaccinated (received 2 doses) and unvaccinated (received 0 doses) adults in Fiji, we can see that death rates per 100,000 population are 6.1 deaths per 100,000 for fully vaccinated adults and 90.2 deaths per 100,000 for unvaccinated adults. This means that unvaccinated adults in Fiji have been dying from COVID-19 at a rate 14.7 times higher than fully vaccinated adults during this third wave. The 2 individuals in the 12-17 age group who died were not vaccinated. There have been no deaths in individuals who have received a booster dose (3rd dose) of the vaccine.

New deaths to report

There are 12 new COVID-19 deaths to report from the period 8th January 2022 to 22nd January 2022.

Two deaths were from the Central Division, five from the Western, one from the Eastern, and four from the Northern. Three of the individuals who died were below the age of 18 years old and were not eligible for vaccination. Two individuals had congenital medical comorbidities from birth, which contributed to the severity of their sickness and demise. Out of the nine individuals who were in the target age group for vaccination, six people were fully vaccinated and three were unvaccinated.

The deaths of individuals below the age of 18 were reported today after a thorough investigation done by the Ministry.

The first COVID-19 death to report is of an 8-year-old female from the Northern Division. She died at home on 12/02/22. She had a significant congenital medical condition that likely contributed to her death. She was not eligible for vaccination.

The second COVID-19 death to report is of a 13-year-old male from the Northern Division. The child presented to Nabouwalu Hospital on 06/01/2022 and was admitted. Sadly, he died on 15/01/2022, nine days after his admission. He had a significant congenital medical condition, and an assessment made by medical consultants confirmed that his pre-existing conditions contributed to his death. He was not vaccinated.

The third COVID-19 death to report is of a 70-year-old male from the Northern Division, who died at home on 14/01/2022. He was not vaccinated.

The fourth COVID-19 death to report is of a 10-day old female infant from the Northern Division. The infant was born to a COVID-positive mother, without any complications at birth. She sadly passed away at home before she could be brought to the hospital. A post-mortem COVID test was noted to be positive. She was not eligible for vaccination.

The fifth COVID-19 death to report is of a 98-year-old female from the Western Division, who died on arrival at Lautoka Hospital on 16/01/2022. She was fully vaccinated.

The sixth COVID-19 death to report is of an 81-year-old female from the Western Division, who died at home on 16/01/2022. She was fully vaccinated.

The seventh COVID-19 death to report is of a 74-year-old male from the Western Division, who died on arrival at Tavua Hospital on 18/01/2022. He had pre-existing medical conditions and was not vaccinated.

The eighth COVID-19 death to report is of a 75-year-old female from the Western Division, who died at home on 20/01/2022. She was fully vaccinated.

The ninth COVID-19 death to report is of a 72-year-old female from the Central Division, who died at home on 21/01/2022. She had pre-existing medical conditions and was fully vaccinated.

The tenth COVID-19 death to report is of a 46-year-old female from the Western Division, who died at home. She was not vaccinated.

The eleventh COVID-19 death to report is of a 78-year-old male from the Eastern Division, who died at home on 21/01/2022. He was fully vaccinated.

The twelfth COVID-19 death to report is of a 79-year-old male from the Central Division, who died on arrival at CWM Hospital on 22/01/2022. He was fully vaccinated.

There has been a total of 791 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 4.1, with a case fatality rate of 1.32%.

We have recorded 774 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, 54% (n=84) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild, 24% (n=37) are categorized as moderate and 19% (n=29) as severe with 5 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:

258 tests have been reported for January 25th, 2022. The 7-day daily test average is 458 tests per day or 0.5 tests per 1,000 population.

The national 7-day average daily test positivity is 45.8%. The high positivity rate is an indication of widespread community transmission.

Public Advisory:

The analysis of the first 91 deaths in the vaccine eligible population during this third wave has revealed that fully vaccinated adults have an almost 15 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 vaccines work to prevent severe outcomes of COVID-19.

We also continue to record lower than expected hospitalizations due to COVID-19 despite the current resurgence in COVID-19 cases throughout Fiji. This decoupling of the relationship between cases and severe outcomes is a result of the protection afforded by the vaccination program. The reported deaths today (including the three children) have been confined to individuals with high medical risk and who have died, either at home, on the way to the hospital, or within a few days of admission. These 2 factors (comorbidity and adverse health-seeking behavior) also make it difficult to narrate more precisely the extent to which COVID 19 contributes to the death of patients.

The deaths of the 3 children announced today are a sad reminder of the legacy of COVID 19; that, as cases increase to very high numbers in the community, our most vulnerable are at increased risk of being infected and suffering from severe disease. We know that severe disease is rare in children, but this risk increases should they have significant underlying health conditions.

By vaccinating and maintaining our COVID safe measures, we protect the vulnerable among us. We have mentioned in the past that the vaccines are 80% protective against severe disease and death and not 100%.  As such, if community transmission is high enough, rare outcomes will become more frequent.

Looking after the vulnerable needs to be a community-wide effort. The public needs to be aware of the symptoms of severe COVID-19 disease, and early presentation to a health facility when severe symptoms are present, are critical protection measures that we should know and act upon.

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.

Non-communicable diseases (NCDs) and COVID-19

Based on severe disease and death data, it is obvious that nationwide resilience building will need to focus on preventing our developing chronic diseases, and ensuring that those with chronic diseases are well controlled. Both involve building up the good habits of exercise and a healthy diet, and good attendance to medical follow-up and ongoing treatment for those with chronic disease.

Our health statistics over the last few years show that over 80% of total deaths in Fiji are attributed to NCD deaths, and between 30-40% of these are premature deaths. To put an average figure on NCD deaths per year, we record around 5828 deaths annually (average 2015-2020). NCDs have been on the rise for many decades, and whilst this is partly due to better reporting, the inescapable fact is that lifestyle changes need to be made at a community-wide and individual level. The 3 waves of COVID 19 have clearly demonstrated the need for each of us to choose healthier lifestyles and to support each other when one makes such a choice. Choices around physical activity, food portions, and food choices are now more important than ever before. This virus and its many variants will remain endemic for a long time to come and the consequences will reduce BUT OVER A LENGTH OF TIME.

Even if you have a chronic disease, making the healthier choices outlined above will make you stronger and more resilient in the face of this virus.

Employers and community leaders can help to mainstream the support system for vulnerable persons by creating a list of vulnerable persons in their communities, providing support to help them secure good access to medical care, ensuring oversight so that the vulnerable are tested early when they develop flu-like symptoms and provide a supportive environment to ensure that the sick are encouraged and empowered to seek treatment and not delay in seeking health care. In this way, we are working together to protect the most vulnerable, and to direct health care service towards those who need it most in our community.

Promotion of Better Health Seeking Behavior

The Ministry will continue to strongly promote better health-seeking behavior moving forward. The Ministry had committed to facilitating regular outreach services and undertaking community-wide health awareness and promotion activities even before this pandemic. We have escalated our effort further during the current pandemic, however, it is clearly visible from the death data that untimely seeking and accessing health care remains a crucial challenge. The Ministry recognizes that there are factors outside the health sphere that impact health-seeking behaviour, and we appeal to everyone to assist in addressing these factors so that the impact and benefits of health care are appreciated by all who need the care.

Vaccination

The booster dose program began at the end of November 2021. As of January 24th, 68,099 individuals have so far received booster doses of the Moderna COVID-19 vaccine from the 142, 240 persons considered eligible. This represents a 48% 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.

International Travel

International travel will continue to need ongoing reviews. We note the WHO advice that national authorities should lift or ease international traffic bans, as they do not provide added value, and continue to contribute to the economic and social stress in countries. In addition, they can adversely impact global health efforts during a pandemic by disincentivizing countries to report and share epidemiological and sequencing data.

We will however continue to apply a multi-layered risk mitigation approach to potentially delay the exportation or importation of the new variant, including via the use of entry/exit screening, testing, or quarantine of travelers. These measures should be informed by a risk assessment process and be commensurate with the risk, time-limited, and applied with respect to travelers’ dignity, comfort, convenience, and rights.

We will continue to ensure adequate measures such that all travelers are screened for signs and symptoms of COVID-19, are vaccinated, and adhere to public health and social measures at all times

Building Resilience

As we go through the current wave of COVID-19, Fijians need to adopt practices that build resilience. We know that there remains a high risk of resurgence of endemic variants and the arrival of new variants. Our socioeconomic survival depends on our ability to build and sustain individual and community-wide resilience. We should expect that COVID-19 will be endemic, however, we need to appreciate that “endemic” doesn’t mean harmless. Endemic means that we expect continued circulation of the disease in the community,  the baseline levels of which are yet to be determined. Leptospirosis, Typhoid, and Dengue are endemic in Fiji and they are associated with serious outcomes, especially when the number of cases increases to outbreak levels.  Building resilience means that we must adopt healthier lifestyles, make COVID safe behavior a habit that we adopt and support others to adopt, mainstream medical and community-wide oversight over vulnerable persons so they can have timely access to health care, and build up community surveillance mechanisms that use health and non-health data sources to alert us of impending disease outbreaks.

Our objective is to live with the virus and at the same time ensure a high level of transmission suppression, and prevention of severe outcomes.

 

COVID-19 Update 24-01-2022

COVID-19 Situation Update

Monday 24th January 2022

Transmission Update:


Since the last update on 21/01/2022, we have recorded a total of 987 new cases; of which 656 new cases were recorded on 22/01/2022, 81 new cases were recorded on 23/01/2022 and 250 new cases in the last 24 hours ending at 8 am this morning.

Of the 987 cases recorded, 859 cases were in the Central Division; 62 cases in the Western Division, 18 cases in the Northern Division, and nil cases in the Eastern Division.

Overall, there have been 61,898 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.

Our national 7- day rolling average is 179 daily cases calculated for 20th January 2022.
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 rates for the Central, Western, and Northern Divisions indicate an upward trend.

There are 11 new COVID-19 deaths to report from the period 13th January 2022 to 23rd January 2022.

Five deaths were from the Central Division, three from the Western, two from the Eastern, and one from the Northern. Two of the people who died were below the age of 18 years old, both had pre-existing conditions from birth, which contributed to the severity of their sickness and deaths.

The remaining individuals were at a higher risk of severe disease due to their ages or underlying medical conditions. 5 of the people who died were not vaccinated, one had only received his first dose, 3 were fully vaccinated, and 2 were not eligible for vaccination.

The first COVID-19 death to report is of a 4-month old infant from the Western Division, who was brought to a remote nursing station on 13/01/2022 in a severely weakened state. He was medically assessed and stabilized by the attending medical staff and a COVID test was done which was noted to be positive. Sadly he passed away before he could be transferred to Lautoka Hospital, despite the resuscitation efforts of the attending medical staff. Records show that the infant had been born with medical complications and was lost to follow-up. He was not eligible for vaccination.

The second COVID-19 death to report is of a 71-year old female from the Eastern Division, who died at home on 15/01/2022. She was not vaccinated.

The third COVID-19 death to report is of a 50-year old male from the Eastern Division, who died at home on 16/01/2022. He had received only the first dose of the COVID-19 vaccine. This means he was not fully vaccinated.

The fourth COVID-19 death to report is of a 15-year old male from the Central Division who was admitted to the CWM Hospital on 17/01/2022.  He had a significant pre-existing medical condition which contributed to the worsening of his COVID-19 complications. He died on 19/01/2022 and was not vaccinated.

The fifth COVID-19 death to report is of an 83-year old female from the Central Division, who died at home on 20/01/2022. She was fully vaccinated.

The sixth COVID-19 death to report is of a 75-year old female from the Central Division, who died on arrival at Nakasi Health Center on 20/01/2022. She had pre-existing medical conditions and was fully vaccinated.

The seventh COVID-19 death to report is of a 67-year old male from the Central Division, who died at home on 20/01/2022. He had pre-existing medical conditions and was not vaccinated.

The eighth COVID-19 death to report is of a 74-year old female from the Western Division, who died on arrival at Lautoka Hospital on 20/01/2022. She had pre-existing medical conditions and was fully vaccinated.

The ninth COVID-19 death to report is of a 54-year old female from the Central Division, who died at home on 21/01/2022. She was not vaccinated.

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

The eleventh COVID-19 death to report is of an 80-year old female from the Northern Division, who died on arrival at Labasa Hospital on 23/01/2022. She was not vaccinated.

There have been a total of 779 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 4.1, with a case fatality rate of 1.32%.

We have recorded 756 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:

Using the WHO clinical severity classification, 61% (n=103) of the admissions of COVID-19 positive patients are categorized as asymptomatic and mild, 25% (n=42) are categorized as moderate and 20% (n=12) as severe with 4 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 transmission in the community. These patients are admitted with COVID-19 rather than for COVID-19. The number of people being admitted for COVID-19  remains low compared to the previous wave.
Testing:

512 tests have been reported for January 23rd, 2022. . The 7-day daily test average is 528 tests per day or 0.6 tests per 1,000 population.

The national 7-day average daily test positivity is 51.8%. The high positivity rate is an indication of widespread community transmission.

Public Advisory:

The deaths of a 4-month-old infant and a 15-year-old child with underlying health conditions are sad reminders that,  as cases increase to very high numbers in the community, our most vulnerable are at higher risk of being infected and suffering from severe disease. We know that severe disease is rare in children, but this risk increases should they have significant underlying health conditions.

We must all do our best to reduce the transmission of COVID-19 to protect our vulnerable. 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).

Following the Vaccine Plus Approach means that everyone has a role to play to protect themselves from the current outbreak, as well as future outbreaks from other new variants that can arise. The approach means that the Ministry and Govt will provide the opportunity for all eligible Fijians to access safe and effective vaccines that protect us from severe diseases and deaths due to COVID-19. It also means that we take responsibility for adhering to the COVID transmission suppression protocols on an individual basis, as well as on a collective basis in all community settings we engage in – whether it is at work, in school, at our local house of worship, or during a traditional ceremony. The Vaccine Plus Approach means we are collectively and equally responsible for our protection and our health, as well as the well-being of the most vulnerable in our communities.

We are also strongly advising anyone who is in the high-risk group (people over the age of 50, pregnant women, those with non-communicable diseases) and develops any COVID-19 symptoms, to please come forward to be tested and reviewed by our medical teams. Symptoms include cold or flu-like symptoms such as runny nose, sneezing, nasal congestion, sore throat, cough, body ache, fever. If you test positive you will be placed on a care pathway that will involve monitoring and escalation of care if required. We also need everyone to be aware of the symptoms of severe COVID-19, and to immediately seek emergency medical care if they are present. The symptoms of severe disease are Shortness of breath or difficulty breathing, pain or pressure in the chest, confusion, coughing blood, difficulty staying awake, pale, grey, or blue-colored skin.

Non-communicable disease (NCDs) and COVID-19

A predominant contributor to severe outcomes in all the waves of COVID 19 in Fiji has been NCD-related comorbidities such as heart disease, kidney disease, diabetes, obesity, and hypertension. The Ministry of Health and Medical Services attributes 5,700 deaths in 2020 to complications related to NCDs. In addition, NCDs place an additional heavy burden on the Fijian society in the form of lost hours of work and healthcare needs.

Given the severe negative health effects of overconsumption of sugar, sugar-sweetened beverages, and sugar-filled processed foods, the Ministry wishes to advise the public to curb sugar consumption by members of the public and promote healthier alternatives, such as the use of natural honey. In addition, the promotion of a healthy diet, regular exercise, and maintaining optimal control of the NCD through appropriate medications needs to be an integral part of building resilience against diseases for the vulnerable in our communities.

Employers and community leaders can help to mainstream the support system for vulnerable persons by creating a list of vulnerable persons in their communities, providing support to help them secure good access to medical care, ensuring oversight so that the vulnerable are tested early when they develop flu-like symptoms and provide a supportive environment to ensure that the sick are encouraged and empowered to seek treatment and not delay in seeking health care. In this way, we are working together to protect the most vulnerable, and to direct health care service towards those who need it most in our community.

Building Resilience

As we go through the current wave of COVID-19, Fijians need to adopt practices that build resilience. We know that there remains a high risk of resurgence of endemic variants and the arrival of new variants. Our socioeconomic survival depends on our ability to build and sustain individual and community-wide resilience. We should expect that COVID-19 will be endemic, however, we need to appreciate that “endemic” doesn’t mean harmless. Endemic means that we expect continued circulation of the disease in the community,  the baseline levels of which are yet to be determined. Leptospirosis, Typhoid, and Dengue are endemic in Fiji and they are associated with serious outcomes, especially when the number of cases increases to outbreak levels.  Building resilience means that we must adopt healthier lifestyles, make COVID safe behavior a habit that we adopt and support others to adopt, mainstream medical and community-wide oversight over vulnerable persons so they can have timely access to health care, and build up community surveillance mechanisms that use health and non-health data sources to alert us of impending disease outbreaks.

Our objective is to live with the virus and at the same time ensure a high level of transmission suppression, and prevention of severe outcomes.