 A pleasant good morning, everyone, and welcome to the press conference on the COVID-19 virus. With us today, we have the Chief Medical Officer, Dr. Sharon Belma George. We have the Acting National Epidemiologist, Dr. Dana DeCosta-Gubes, and also the Director of the Ezra Long Lab, Dr. Wayne Felicia. Welcome. First, we will have Dr. Sharon Belma George who will give us a brief introduction. Let me thank my colleagues for being here with me today. I think it's important that a holistic view of our system is here present to ensure that any information that you have is well covered. I want to recognize and thank the members of the media as you are an extremely important stakeholder as we manage COVID-19 and other health-related illnesses. I just want to thank you for the support to ensure that accurate information, to ensure positive behavior change is noted through our communities as we manage our wave at this point. This morning, we thought it important as we note we are in a new critical position for COVID-19. We thought it important that we present to you and to the public our progress so far as we see increasing cases and to also indicate to you the various aspects of the health sector what our challenges are so that it's very clear we were dealing with a health system with its constraints and for St. Lucia as the developed world and in the region, COVID-19 has put a new level of strain on everybody's existing health system. So we want to indicate to you what the challenges are and also indicate to you how we are managing and what plans we have moving forward to strengthen the system to bring that curve down. So we thought it important that we express this to you today. Hence the reason why our entire team is here and some of our persons from the ground to explain to you how we are managing this wave. It will also give us an opportunity to clear up a lot of the misinformation that is out there that is causing a level of unnecessary anxiety and panic. So it is extremely important that anything that is not clear to your viewers, your listeners, it will give us an opportunity to present that information to you. And if there's any information that you would like cleared up, we are making ourselves available to provide that information to you. So our national epidemiologist will be giving you an update of the analysis of the St. Lucia situation to date. We'll give you an idea of the strains on the various health sector areas and how we are managing now and also some information on the new variant that we have. We recently got information that we have present. Thank you. Thank you, Dr. Belma. Now we'll have Dr. Gomez who will give us an update on the current situation of COVID-19 in St. Lucia. Thank you. Good morning to all. Thank you, Seyamu. So we will start with a small update with what's going on in St. Lucia to present. Next slide. So currently we have 969 cases. We have 461 active cases with 495 recoveries and 13 deaths. We have one individual who is currently critical in ICU. Next slide. So if we take a closer look, like we said in the previous slide, we have 969 cases with an incidence rate, which is really the rate that we have in new cases in our population at present. That is 53.5. We have a percentage positivity over 4.2 percent and the case fatality, which is based on the number of deaths that we have to date of 1.3 percent. If we take a closer look at the data and we look at what is going on from the past, for the past 14 days, which is from the 26th of January, which is yesterday, to the 13th of January, we had a total of 408 cases, average number of cases per date of 29 with a daily infection rate of 16.1, as compared to the previous 14 days, which is from the 30th of December to the 12th of January. We had 206 cases, so we noticed that these cases have doubled during that period of time. And also the daily infection rate went from 8.1 between the 30th of December to the 12th of January, and right now it's at 16.1. Next slide. So if we do the weekly analysis, because we really want to show what exactly is going on, for up to the 31st of December, we had 353 cases. Then we went up to the 6th of January, having 380 cases, so minimal change. The incidence rate went up from 19.5 to 21 between the 31st of December to January the 6th. Then we started seeing an increase as of the 13th of January with 502 cases, with the incidence rate going up to 27.7. Then on the 21st of January, we have 755 cases, with the incidence rate almost doubling at 41.7, and currently we are at 969. So we can see the great increase in cases, which correlates with the increase in the incidence rate or the number of new cases that we are seeing currently in our population. Next slide. So when we look at our epidemiological curve, it's the same thing. During the time of April, we had minimal cases. We experienced our first wave between October to November, obviously preceded by something during the time of October. Then the cases decreased, and it was basically quiet. During December, we started seeing increases in cases, up to now where we have an exponential increase in cases. Next slide. So if we were to compare with the graph at the bottom, in terms of the COVID-19 distribution by months, we would notice that you can make the comparison between December and January. The number of cases in December is like almost three times, or even more than three times the amount in January, is almost more than three times the amount that we're seeing in December. So this is the magnitude of the situation that we faced with right now. Again, in the graph above, confirmed cases by epidemiological weeks, which we saw in the epidemiological curve at week 40, which would correspond to the first week in October. Then we started seeing our first wave, which decreased the number of cases up to about the 5th of December thereabouts, which would correspond to week 49 and 50. After week 49 and 50, which correspond to the 5th of December, the 12th of December, we started seeing an increase in cases thereafter into the festive season. Next slide. So of the cases that we have, what can we say about the cases? We have 55% of those cases are females. The age range that is most affected, as we can see from the graph at the bottom, is the age range between 20 to 59. The age range above 60 is affected but not as much, which is one of the reasons that affected our decision in having the tracking devices as to who we give the tracking devices. In the age range less than 20, we notice it's also been affected, but between 20 to 59, this is the age range where we see in most of our cases, as well as the gender being females are the ones, 55% of those presenting with the infection. Next slide. I just wanted to say something on the deaths, let me just slide there. For the deaths, we've seen the age between 39 to 83 have been affected and we're seeing that most of the deaths are between ages 45 to 80, where we have persons at that time developing, which is the age range that you expect persons to have on the line conditions or to develop any on the line conditions. So this is the age range where we have most of our fatalities or our deaths diagnosed. So looking at the health districts or the health regions, again, castries is the region that is most affected, followed by Grosile and Babuno. The graph to the top shows it based on the incidence rate, which is how it should be calculated, and the graph at the bottom shows it's based on the number of cases diagnosed per district. Right now it's basically the same, so we have castries, Grosile, Babuno, the same for incidence rate as for number of cases. I just wanted to touch on quarantine a bit and to show how the lack of adherence to quarantine has been affecting and you can draw a correlation between persons not adhering to quarantine or breaches in quarantine and how that has affected our number of cases. So for November, so the blue is persons going to the hotel, the orange is persons on home quarantine, and the yellow is persons on facility quarantine. So for November, we see minimal persons going on home quarantine. In December, we have a larger number of persons going on home quarantine. So if we look at the cumulative incidence of COVID-19 cases and the cumulative arrivals on home quarantine, we can see that as there has been an increase in persons going on home quarantine, so have we had an increase in our cases as well, so we can draw some degree of correlation between the two. Next slide. This map also talks about the correlation between the two. We've been able to plot where we've seen the majority of our cases and also, so in the red is the incidence or the positive cases that we've seen and the green and the different shades would let us know exactly where the quarantine cases have been. So we noticed that we have the greater density in areas where we are seeing that persons are going for quarantine. If you look up in the north, we see the greater density of individuals going on home quarantine and also we see the greater density of cases being identified there. And you can see a couple of spots in the south with the density. You can notice the darker green and the bigger circles for the number of positive cases, hence drawing a correlation between the two. Thank you. Thank you very much, Dr. Gomez, for this presentation. Before we go to Dr. Belma, we want to recognize the presence of the medical director of the Owen King EU Hospital and also the respiratory hospital, Dr. Lisha Eugene Ford and also the Medical Office of Health, Dr. Grensford Joseph. We will now have Dr. Belma George to speak on the new variant and also adherence to protocols. Thank you very much, Ms. Neptune. Now, as Dr. Gomez has presented to you, our epidemiological analysis to see how we note the increase in cases from the beginning and up to this point before focus on the last few months. As you would imagine, the rapid increase in cases within a short period of time, this has affected our capacity to manage and it has also encouraged us to put new measures in place within a short period of time. Within our COVID-19 plan, this was one of the things that was included, the management of increased cases that is the management of a surge. I'll give you an example of one of the things that was in place to manage before. In our previous management of COVID-19, our admissions criteria, our discharge criteria as well as Dr. Gomez indicated earlier, even our capacity for quarantine in the earlier stages, our policy in the early days, everybody had to be kept within government quarantine and that has kept us safe within our management. We had during the month of December over 1,500 persons coming in, which overwhelmed our capacity to be able to provide a more secure form of quarantine, so a model for home quarantine had to be put in place, which we got the breaches, we were aware of the breaches, has also, as we indicated before, provided an extra risk to us getting new cases from persons who may not adhere. Some of the other issues that we have had to deal with is the vast numbers of persons coming to our respiratory clinics. Initially, we've been able to manage everyone coming. We set up five respiratory clinics to ensure access to care that is the Grozellay Poly Clinic, the Leclerc Wellness Center, the Denry Hospital, the Sufer Hospital and the Viewford Wellness clinics. As you note, the increased incidence of cases between castries and Grozellay, we noted a lot of persons coming, so we very quickly had to double up on our staffing and we did have a week where the numbers were more than the staff could manage during that period and as soon as we were alerted, we got the authority to increase the number of physicians and nurses to try to manage and also to change some of the policies that occurred to reduce the numbers. One of those being our respiratory centers were the sites where, for example, travelers, the new requirement for travelers needing a test, they would come to our respiratory clinics to get their tests done. We had to quickly change that, train the medical staff at the hotel so that they can take the sample at the hotel and send it to our lab, so that way it reduced staff coming to, visitors coming to our respiratory clinics and further overwhelming the system. We've also indicated that the smaller guest houses, et cetera, would use their private physicians and different physicians to take those samples to reduce the number of persons coming so we can concentrate on persons coming in 4K at the clinics. So these are some of the measures that we've had to put in place and also when there are issues with the tourism sector, they use private physicians to manage to take the samples so that less of both their staff and visitors would access our clinics at the same time. In terms of the respiratory hospital, I will, Dr. Eugene will speak to how they've managed the increased cases coming in and Dr. Felicia will also discuss the testing issues. Dr. Gomez will speak to how we, the new models that we have in place for home quarantine and in the first phase of our management, all of our cases we kept within our institution for care with the increasing numbers and that was part of the plan to have various models for managing asymptomatic or persons who are very mild. So we had to, within short notice, go to the second module of isolation at home and set up clinical teams within the community to monitor those people and to liaise with the internists within the respiratory hospital on care to ensure that those persons are managed and transferred as needed. In terms of where we are, Dr. Gomez mentioned that we had 13 COVID related deaths. This is one of the issues I want to clear up. We term COVID related deaths because we test persons who die for COVID-19. Our patients who've passed away, our people who've had, and I want to make it very clear one death is too many. Our plan from very early was to contain the cases, reduce spread because we are aware that we have a vulnerable population for COVID-19 and part of our plan is the strengthening of our patients with chronic diseases and our elderly to protect them, to reduce and to prevent them from getting sick because one death from COVID-19 is too many for us. So the 13 is too many. But we use the term COVID related death. I want to make that very clear. I am at no point saying COVID killed somebody and I am not saying that nobody died of COVID. Our patients have other underlying conditions. Our patients that we have had to date a range of other underlying conditions which could have also caused their death. Now it is a known fact that COVID-19 exacerbates an already existing health condition. It makes it worse. So I am not in a position to say COVID killed any one of them or to say it is not COVID. What we are saying, this person passed away and was positive with COVID-19. Okay, I hope that is clear when we use the term. I do not think that any of our patients to date have had only the COVID pneumonia and passed away. I think everyone had other conditions. The medical director can also clear this up. But I just thought that we make it very clear. Now in terms of the UK variant, that is B117 variant, if you would recall, I think it was December 14th when the public health agency of the UK made it public this new variant. Now, just for you to know, at least six variants have already emerged of COVID-19. And COVID-19 is not behaving any different to viruses. Viruses are simple organisms. They are known to mutate frequently. So this is not unusual. Just as we see influenza mutates every year, every year we need a new influenza vaccine. It is a similar case that is happening with COVID-19 where it mutates, it changes and some of the characteristics of the virus also change. So in December, we were alerted, the world was alerted on this new variant. What they noted on the variant, and let me also indicate that they also medicated that this variant was circulating from September. So it was a lot of months when this variant was already existed. So what the analysis indicated, this most likely is already everywhere. We were alerted in December, but it was already everywhere since September. So that's like four months that it was, the countries were open. So the likelihood, the risk of it being in other countries was very high. And some countries quickly started testing and noted that they did have it in circulation. Of significance of this variant that they noted was the fact that the transmissibility was high 70% more. So that is when, for example, we would note with one person getting COVID, we get one or two cases. If it is easier to be transmitted, it means for every one case, we expect to see more persons developing the illness. The in what the research is showing to date is that the form of the disease is not more severe. That is, it is affecting people the same way. So the death rate is not more. The signs and symptoms are not more severe. It is not killing people more. People are not suffering more with it. The only change that they have noted at this point in the research is that it is transmitted faster. Now of significance for us as public health persons, the first thing we ask, will our PCR test pick up COVID? Has it changed significantly that we can't pick it up? And our PCR testing, it allows us to get a positive for COVID. But within the region, there isn't the capacity to do the gene sequencing to test for the new variant. So in December, we're quite proactively the director of CARF for Dr. St. John called an emergency meeting of all of the agencies for the region to have a discussion on how we move forward for the region. And this is where CARF indicated that they will accept samples when we get positive tests with very high viral loads. They gave the countries an allocation that we can send and it has to meet a certain condition for it to be sent over to them so that they can test. Now, so St. Lucia as with the other islands took the opportunity and some samples were sent from our positives in December because remember it was in December that this information was shared with us. CARF facilitates the countries. CARF is not able to do the gene sequencing and they outsource it on behalf of countries. So there is a delay in countries getting the results. I had indicated in previous press conferences that we had sent samples to CARF and that we were waiting. On Sunday, we received those results from CARF on the presence of this variant and on Monday, as we tried within 24 hours to provide the public and the press with information. This information was shared with us on Sunday and then on Monday, we provided that information to the public as we tried to do as much as possible within 24 hours. The other information that we have received in relation to the new variant is that the vaccines that have been produced and approved are effective against the new variant. So this was the other concern that we had that being that this is a new variant, we were concerned and it has been indicated to us at this stage that the vaccines are effective against the new variant. So I really want to acknowledge a support from our public health agencies because in a timely manner CARF provided us with an avenue to be tested and this is something we expected given that it was, this variant was already there since September, but at least it gave us the capacity to test and the virologist from WHO has already indicated that he will be liaising with Dr. Feliciae to assist us in developing the capacity for gene sequencing. So that is already on its way so it will provide us with an opportunity not just for the new variant but for other infectious diseases within our public lab. So I think this is it for me for the update on at this stage. Thank you very much Dr. Sharon Belma George for this comprehensive information. Before we move to Dr. Feliciae we would like Dr. Gomez to provide us with information on home isolation measures currently being undertaken for case management and also she'll also speak on the rollout of the monitoring devices. So as Dr. Belma alluded to earlier on we've started, we've begun isolating persons at home however for the isolation of individuals at home there must be a certain criteria that must be met. Ideally the individuals would have to have their own rooms and their own bedroom and a bathroom allotted to them at home. Of course as with every situation we assess the situation, whoever is doing the assessment, we assess it in order to work around with the situation or the conditions that that persons have. As with everything you will have challenges but we have set up teams, medical monitoring teams in order to assess individuals who are in home isolation and mostly it would be individuals who are asymptomatic or persons who have very mild symptoms who we believe will not decompensate whilst at home. On the other circumstances persons who we monitor and we believe are not doing well at home then we have capacity within the hospital to send them in for treatment. Now the purpose of isolation basically is to contain the disease. Home isolation does not come without its challenges because persons who may be asymptomatic like we said these are the individuals that we're targeting for home isolation persons who are asymptomatic or who have mild symptoms. If they're not feeling well then obviously they will find it difficult to stay within the homes. So we are asking the public that with this new model that we're introducing we will be having persons monitoring individuals on a daily basis and we'll also be having the medical teams who will go out to the homes to do the assessments of these individuals. But we're asking persons also to comply with the adherence of the measures and to remain within isolation. We also would like to thank the public because they've been very vigilant. We are getting messages where they're calling the lines they call in 311 they call in the epidemiology unit when they have cited persons that have been in breach of quarantine and also if they have been in breach of isolation. And together with the Royal Central Police Force and all the stakeholders we have been able to get these persons and bring them into care once there is any breach of any of our protocols. In terms of the monitoring devices which we'll introduce on the 18th of July it is something new to the public. There has been a mixed reaction in terms of the reception. But overall it has been I could say looking at the situation it has been received well. Persons are complying. Persons are purchasing the devices and they're wearing it. But like I said it's a new process and it's anything that's new will come with its challenges. Based on the we have certain age range and we have persons that we exempt from wearing the devices and this is based on what we see with the epi pattern or the behaviors that we are seeing on ground. So we ask in persons to be patient with us as we roll out these devices and there will be delays. Persons will be frustrated. We have been getting feedback from the ports of entry as to how frustrated persons can be. But it is a new process and we are trying our best to remedy the situation. So we ask persons to be patient and we're also aware of some of the verbal abuse that the persons at the ports of entry the staff at the ports of entry have encountered as a result of this. But we know persons can be frustrated. You come from a long flight. You may be tired. You may have children. But like I said it's a new process and we do ask and we implore the public to be patient with us as we try to roll out this. Because based on what we've seen and what I just spoke to and alluded to in the presentation it is important that persons adhere to the protocols and the quarantine measures in order for us to curb and to try to limit the spread of the disease in St. Lucia presently. Thank you Dr. Gomez. So of course you spoke on the two devices which was rolled out on January 18th that is the Biointellicense Biobutton and also the Amber Research and we ask in persons to cooperate and to take you make use of these devices. Now we will move on to Dr. Feliciae who would speak on testing the current situation as it relates to testing capacity also the reason why they would use put priority for travel and also high risk. Hello good morning everybody. I'd like to first congratulate everyone here sitting here with me on the fantastic job that they've been doing. I know they've been having sleeveless nights working hard entirelessly developing strategies where we can best handle this pandemic something that's known for overwhelming systems, persons and creating a lot of anxiety within the population. The Ezra Long Lab from March of 2020 started developing and started doing testing for the South School to virus and through that entire period we've developed processes and improved our capacity. When we initially started our turnaround time or time from sampling to time of delivery of results extended from seven to at times 14 days we were able to bring that down in the months of June, July and through even the initial weeks of January to 24 hours 12 to 24 hours consistently at least delivery of the results to the to the Ministry of Health and to the general public within three to four days just more due to clerical issues and the way we send out the results. So that level of consistency assisted in decreasing the level of anxiety within the population with this sewage which is almost consistently high with the daily numbers being within the 40s to 50s and we've been finding that we're getting a lot more samples and this has increased our turnaround time to almost 40s. It's forced us to look at our processes from sample collection at the various sites from reception of samples from the mere processing the analytical aspect of it and then the delivery of it and just look at every single system and see where we can develop efficiencies and how we can reduce that and bring it back to the 12 to 24 hours that we've had. The team has taken on different strategies so we should see that decreasing within the next few days hopefully by next week so we should see going back to what we've been accustomed to delivering and reducing the anxiety level. To note we've processed almost 25 samples within St. Lucia and 62% on that over the last four months a substantial amount approximately 15,000 and the large majority of the positives have come over that period as well. So we have our challenges we're trying to overcome them we've done we've already started implementing some of those strategies to reduce it and there should be some changes noted within the next few days. We also have as Miss Neptune influenced there are ranks of priority and when we see ranks of priority we know that everybody's a priority and but there are persons who are more severely ill and it affects also different workplaces the workflow at the hospital persons who are traveling so we try to organize some level of priority for these people but we push through as much as possible to date we process almost between 250 to 300 samples per day that should increase over the next 24 to 48 hours so we should see increased numbers and as those numbers increase hopefully we can see that some of the strategies that the Epidemiological Department Ministry of Health and other government agencies have implemented should reduce the number of positives we we should that should be coming our way. CAFA has provided support for us throughout this testing process and the gene sequencing is another component that they've added the outsourcing it from what Dr. Belma just referred and that means that they're sending it to us reference lab that can we are going to be in discussion with Pao with the virologist Leonel Grash to see how we can develop that capacity on island so that's some level of training that we're going to undergo and hopefully we could start detecting other variants apart from the the UK variant or whatever other variants that exist within our society. Thank you Dr. Felicia but before we move on to Dr. Belma perhaps you can speak on the value of the COVID-19 PCR test compared to the antigen test. When we started with the detection of the SARS-CoV-2 virus the PCR test was initially what existed and was confirmatory and by PCR it means it it is able to detect part of the viruses RNA or fabric of the virus and the human body then can respond to that level of infection by developing what we call antibodies that fight antibodies then develop after a period of time seven to ten days so they then develop an antibody test which exists and then we do know that the body most of ourselves develop what we call an antigen or protein on the cells which proves that you have some you've had an infection so they develop an antigenic test now these tests are reliable up to a certain percentage so we have to be mindful in the use of it the like any test it always depends on the quality of the sampling that is done it also depends on the patients the exact time in which the patient is in the infection so they can be used but they need to be interpreted properly so they can be used properly so the SARS-CoV-2 the PCR is definitely the confirmatory test the antigenic test is a test that can detect um where the large majority of the positives actually positives but some of the negatives almost now some of the negatives have to be confirmed still so you will find yourself having to do one test and do another test and there's always the argument whether you just go for one rather than do two or three tests just to confirm it so in the physician world within Saint Lucia we we're at discussions to see which is the best strategy to approach this we know that do know that the antigenic tests and serological tests are out there in Saint Lucia but we need to educate ourselves and the public at its proper use what do we do when we have the different results and what happens you might do one test and have to do another test one test being negative now whether it be the antigenic the PCR or the serological test does not mean that you cannot get exposed 24 hours or five minutes later and then develop a test later so we need to be mindful that we educate ourselves we educate the public and we approach the whole diagnostic of this properly thank you I will now call on Dr. Lucia Eugene who will speak on the revised discharge policy and also the capacity at the respiratory hospital good morning everybody just so that persons know we now have we've changed or we've now used we're now using our the new WHO CDC guidelines when it comes to discharging and that these guidance came out on January the 18th of this year so you realize that persons actually spend less time in the hospital or isolated whether it's at home or in the hospital of course the WHO would have made these changes supported by science so we're looking at for symptomatic patients that's for COVID-19 patients you're looking at 10 days after the onset of symptoms plus at least three days without symptoms and that would include symptoms like fever and also without respiratory symptoms and for asymptomatic patients that's for COVID-19 you 10 days after you've gotten the positive COVID-19 test I need to make it clear that even though persons are clear for COVID-19 doesn't mean that they may not need to stay more time in hospital because persons don't only come for COVID-19 you may have a patient who came in who has COVID-19 a positive test or feeling unwell but they do have other comorbidities so once we have cleared this person and we've told them that they no longer COVID-19 positive we would have to transfer that person to OKUH for them to be managed for the other comorbidities because we cannot discharge you until you're actually stable to go out that person might go to OKUH they might opt to go to St. Jude's Hospital because they're from the south and in some cases person might want to go to the private hospital tapioff hospital okay we also have the rest of the beds I think we had 44 beds if I remember clearly 44 beds we had pending and this has been handed over to us about two weeks ago so now we're looking at a bed capacity of 126 beds at the respiratory hospital and of course we have divisions of negative positive and suspect cases we have to separate them we also have a particular word for TV because we do not want to make our TV cases which are respiratory cases with COVID-19 cases so that is a separation that is very much important and other than that I think in addition to the just want to let person know that in addition to the extra beds you'd obviously need extra staffing and then arrangements are already being made to bring in extra nurses extra physicians the clinical support staff the porters the domestics all of these are in it's happening already in the pipeline so it's a situation where changes are being made slowly to accommodate the increase in patients that are coming in thank you very much I will now call on Dr. Belma George to give us some closing remarks thank you very much miss miss Neptune as we indicated through our various team members we are noting the increases in cases and we are adjusting the system to manage the patients in a safe way and to continue in terms of the surveillance within the communities and also to contain one of the things I forgot to indicate that later this week we'll also be including two other hotels as isolation and also as quarantine units to assist us in containment and isolation of persons once this starts we'll provide you with the with that information but we are already preparing to start off with two new facilities to assist us to manage the increases we from the Ministry of Health we understand the level of concern and anxiety that is out there however we what we are advising the public and also the US media house is an important stakeholders and partners is to ensure that the information that is provided supports the Ministry of Health to ensure we can get proper behavior change as we move forward what is going on in St. Lucia is not unusual even in the developed world a lot of what we're experiencing now is the same that has happened even developed countries and in the region with the increasing numbers and the backlog of cases that we are seeing with our neighboring islands and the increases at the at the clinics but that is not an excuse to to relax and hence why we we're implementing measures to manage the increases in a very safe way as much as we understand the concern and the anxiety that is out there as a country we need to maintain the focus in previous reviews and updates I have outlined all of the risks that we have faced and all of the risks that we still face for community spread they are still here and they all still exist but for us as a country we need to maintain our focus on what do we need to do at this point to bring our curve down we note there are two things that we we continue to see which is increasing the number of persons when we do contact tracing one persons with respiratory signs and symptoms if you have respiratory signs and symptoms you can visit our respiratory clinics that are indicated I also want to indicate that we have set up an outpost based on the high incidence that we've seen in the north and the VG complex where persons can come in for health education to be seen to be tested as well as one of the the new measures that we have put in place to deal with the the increases if you have signs and symptoms do not go to workplaces do not go to social activities do not visit family this is leading to us getting so many more positive cases per person and this is extremely important because while you are symptomatic the possibility of transmission is a lot higher so we are pleading for persons with respiratory signs and symptoms if you're not feeling well avoid public places this is one measure which will really assist us in controlling this curve at this point the other issue we have like we came out as soon as we noted the increase in cases for testing and we noted that we were falling behind in our 24 48 hour target we informed the public of this this is a challenge that we are facing and we let the public know that there is now a delay if you have been tested for COVID-19 you need to stay home in quarantine or isolation until you get a call of your result we have delays in giving the results do not assume that you are negative and leave wait until you get confirmation before leaving so anyone doing a test should not be out in public places this is extremely important wait we are experiencing delays but wait until you get your result before going out before socializing and before going to work this is creating another issue for us with persons some persons symptomatic and they are going out putting other people at risk the other very important point that we need to highlight action on our part personal responsibility it is very easy to blame visitors to blame illegal people to blame home quarantine we see all the blame going around it is not a point for us here to blame it is a point for action and every single one of us have to take personal responsibility if we don't do it for ourselves we need to do it for our families because we all have vulnerable people within our family this is where we live this is where we work our actions because at the phase we are in the early part of January we were seeing a lot of people who attended social activities at this point we are getting their families and their friends and their workplaces so we have people who did everything right and it's not about blaming but people who did everything right and have a relative who did not and get it innocently let us take a level of personal responsibility especially this week with our reduction in activities this is how we break the chain of transmission by reducing the movement we have seen with an increase in social activities we always get an increase in cases this curve we can bring it down if we work together and if we do the responsible thing and this is where we need to focus because we'll get through this this wave and it will not be our last wave we anticipate managing several waves during 2021 but the timing at which we can bring this wave down a lot faster with personal responsibility in terms of us not socializing ensuring we wear our mask in public places and the director of health education is sitting at the back they've used every single medium available to speak to the public on what we can do to keep ourselves and our families safe I think everybody in St. Lucia knows about hand washing how to wear mask and physical distancing these are basic easy measures and the social activities that put us at risk so more than ever as we are this critical juncture we really need the support of the public and you the media stakeholders we really need your support to drive that message home for you your family and for all of us I'm here let us leave the panic let us leave the anxiety and let us stay focused on what we need to do at this point to to manage this this this curve that we are seeing here thank you thank you very much we will now take a few questions from the media first if you could please state your name and your organization can I question you in regards to the new variant you said that 70 percent more transmissible I'm just asking are our childhood measures adequate even that it's a more infectious disease yes the new variant the transmissibility is what is increased the physical the social and infection prevention control measures are still the measures that's advised to to manage countries with the new variant so the same way I'm staying a safe distance from other persons and putting your mask these are the same measures to to prevent and to reduce transmission unlike the unlike the other 12 COVID related deaths there was one patient without a medical history who did test positive and subsequently passed away has that individuals cause of death can establish to me everybody had underlying conditions there was no medical history I wasn't sure what does that mean no medical history I was the first press releases this month to do with the she said there was one I don't know exactly which case you're speaking about but in terms of even the cases that have medical or non-medical conditions we still examine them total in its totality to ascertain and there are cases that we regardless if you have any co-mobility the circumstances under which you die we'd have to do postmortem zone so if I knew which case you were talking about I would tell you give you a bit much better information but but subsequently it was known she just indicated that we had one when we reported we were not aware and reported that we did not know but that was at that time of reporting it was subsequently identified what the the health conditions were so you are correct when we did report it but yes so there was an issue yeah apologies I did not remember I guess I just thought of what came after the update um to what the measures are to deal with the backlog because we saw a few days ago the 76 cases was between a 70 period so how are we dealing with that specifically um depends on how specific you want me to be I can tell you from moving I've cabinet to move in a draw but what we've done is bring in more clerical people um bring in more technical people to do the testing process um try to get more work stations in terms of computers um things that can actually make the process go a lot quicker um so essentially that and try to increase the working hours without um um of what we've avoided in burnout morning to all Rochelle Gonzalez hot 7 tv employees from different sectors have been reaching out to the media in desperation as a last resort for health as their employers are threatening to terminate their jobs if they miss work to self quarantine as you stated you advise people who are waiting their results to stay at home so um or basically if they refuse to execute tasks where they feel that they are being exposed to the virus so with that said what do you have to say about this situation what message do you have to employers to perhaps dissuade them from this behavior and finally what message do you have for employees going through this persons who are tested persons who are in quarantine persons who are in isolation are provided with a sick leave during that period where they stay at home the public is once again advised that if you are unwell if you have been tested if you are in home quarantine for whatever reason you are to stay in during the period of that time this is a public we are dealing with a public health um issue when you go out you put in your coworkers you put in whoever you go on the bus with you put in a number of persons um at risk which would have a greater um effect on on on the workflow if more persons become exposed so the ministry of health we work with a number of um employees including the chamber um we will be sharing the guidelines which was prepared by the epidemiology unit um with them on the risks based on um ill employees that's one of the things I forgot to do as it came up I will be sharing that with them but it is extremely important the health and safety of the workers has to be the priority and if we are to contain and reduce spread within the workplace it is extremely important that persons with signs and symptoms stay at home or get medical care question what is the procedure when uh COVID-19 a business place or commercial house has someone who has a confirmed case of COVID-19 um is that commercial house supposed to close down shop and um do a deep sanitization or simply as well as the immediate contacts around them and secondly we understand that some business places have taken it on themselves to perform rapid tests is that advisable okay so once we have an individual who's a confirmed case that notification which is the AP unit um the contact tracer's job is to contact the individual who has been confirmed and we do ask the confirmed case to um notify the employer of their status we then get the number of contacts or persons that they may have been in contact with at the workplace and through the employer normally the HR um sometimes the manager they call us and we have this rapport with them and we are able to ask the individuals who they've been in contact with to be quarantined and to go to go in for testing depending on the last date of contact with the confirmed case because um in some instances the confirmed case hasn't been there for quite some time so we have to go back a bit um like Dr Belmalu did too everyone who has been solved is provided with a sick leave to cover them for the the period of time that they will be out of work and the sick leave is a legal document um in some instances the employers have asked us for the the the confirmed case i'm just going off a little bit the confirmed case results we are not in any position to give anybody's results at the end of the period of isolation of the confirmed case we do issue a letter saying that this individual has been confined for a certain period of time it is signed by one of our um medical officers um and that is a legal document the sick leave is also given to the confirmed case and that sick leave is also legal document for the period of time that that individual so they're given two documents basically the sick leave and a discharge from isolation letter in the event that they do need it so these two are legal documents and there is no reason why the employer should be asking of us or be asking of the employee that is returning to work their their their their negative results having said that um once we've communicated with the institution that the the they have a confirmed case in the workplace we get the contacts they are solved they are quarantined for the period of time pending receipt of their results and also pending the the the time which is the 14 days which is the incubation period which has not changed up to now it still continues to be 14 days from the last date of contact with the confirmed case in some instances we do ask the employers to um to do a deep cleaning because at this time you have persons at the workplace there is a lot of anxiety there is a lot of emotions running because there is a confirmed case however persons at the workplace are supposed to be adhering to measures whilst at the workplace i know in in many institutions they have implemented measures which is the three measures that we always talk about the hand washing the face mask the frequent sanitization of the the surfaces we have seen persons they're passing around in institutions and cleaning up and sanitizing after them so these are the measures that should they should be put in place we've spoken about the opposition on the antigen test and how it can be which Dr Felicia spoke to about it can give you false negatives and it can give you a false sense of security because of the specificity and the sensitivity of that test and what it detects and when it detects persons have called the epi unit they have called 3111 sorry 3111 saying that they have a confirmed case in their workplace we now have to ask them whether that individual has had an antigen test because we know that a lot of workplaces a lot of their employees are going out and doing the antigen test so we have to ask them whether it is an antigen test or whether it is a dna pcr which is the gold standard for diagnosis of arm COVID-19 we want persons to know that if it is an antigen test that is positive they should get the pcr done to confirm it is pretty similar to an hiv test you do a rapid in the field you have to confirm with an elizer to ensure that you are really positive so this is our situation and this is the stance of the ministry of health as it pertains to antigen testing and a confirmed case in the workplace the ministry has done an excellent job as far as driving home the message as the protocols are concerned social distancing and limiting social activity but i wanted to ask about the the protocols last year some of them were relaxed a bit for the christmas and new years considering the third wave and the rate of infection today or this month was that decision medically appropriate can answer um throughout the year from march we use our epidemiological analysis to amend the protocols and the policies as we move forward what we use is the data coming out in terms of the rate of increase of cases and that is a discussion that happens at the level of the command center this is then taken to the wider nemac grouping which includes a wide cross section of services across society during december we we noted a reduction of the rate of increase of cases and in discussion with the wider team a decision was made to relax some of the measures i think the main one that was we went from i think a group of group we allowed family activities during the season i think that was the main measure that was taken if my memory is right so we did reduce but what was put in place because our greatest gap our greatest issue that we have seen throughout the year of implementing those policies is the enforcement of those policies so uh policies put out and s is put out but in terms of getting adherence on compliance on the ground um this really has been our biggest issue so the the biggest problem we saw during december was not the change in the policies because if they were still restrictive they still allowed very small groups there are certain things that we stopped to reduce the crowding like the fireworks etc we cancelled all staff parties and all activities we we stopped a lot of the the social activities um associated if the season but what we noted which put us at great risk during the month of december was the non-adherence to to home quarantine and the non adherence to these very same um policies there were many um big parties there was crowding within the cities there was a lot of um big groups within shops and outside we got a lot of different activities um happening which we were able to pick up through the contact tracing process that we saw in january so i think there was some level of relaxation of measures into the december month but the biggest issue was the non-compliance of the measures that were put in place um during that month and i think you're aware of the limitations that exist with trying to enforce um on the ground um in all of those various communities i think all of you live here in st lucha all of you were able to see what was going on with the level of activities while we live in a COVID environment my final question is still on testing capacity is the azure long lab the only lab in st lucha with the capacity to do PCR testing and if not can we delegate some of the testing to private labs possibly for specifically PCR testing um i will just touch on one and i will let dr felicia deal with testing one of the decisions that has been made to relieve the load on our azure long lab is the exit testing a decision has been made that the the exit testing because at least two developed countries accept antigen testing so this um a decision has been taken that the private labs will be allowed to do that for persons for exit travel but i will let dr felicia who's the lab director explain the situation in relation to just to speak on PCR testing on any testing um any laboratory or um institution deemed the laboratory would have to means certain requirements from a safety from a technical perspective from an hr perspective and also from a legislative perspective so um i don't think we've restricted any other lab from but it would be more that once they can meet the necessary requirements that they send in an application to the ministry of health and once they can meet the requirements and they're able to assist in the workload i don't see any issues clear up um go ahead okay um miss napton just wanted me to clear something up in the plan for covid 19 that we did one of the things that i wanted to to also clear up which miss napton reminded me because we have been getting a lot of calls and there's been a lot of misinformation the ministry of health has not prevented any private practitioner from managing patients if respiratory symptoms or seeing covid 19 patients some practitioners are managing those privately some are not this is a decision of the private practitioner so the public is required to call a private practitioner to see if they will be seen or not but we have ensured that we have set up a set of accessible clinics throughout the island for anybody who needs care for respiratory signs and symptoms physicians are also able to take the swab within their private office and send it down so everybody does not have to go to a respiratory clinic you can check your private and i know that is some misinformation where people think the private sector is not allowed to see there are private physicians who have been managing and see those patients but the public should call their private physicians to find out if they can go there if they could get tested there and not if they don't feel comfortable coming to one of our um respiratory um clinics and it has been the the policy of the government to ensure that covid 19 treatment and care is free of charge to the public so we do not charge for the visit we do not charge for the test and the test Dr Felicia will tell you cause in excess of 150 us per test that has been provided free of charge um to the public when it comes to testing i think there is something that the public needs to understand why certain decisions are taken a disease such as covid 19 with all of its implications the clinical team and i rely on the team from the azure lung lab to request and to guide as to what they want in making their diagnosis a decision of positive or negative determines whether someone is released back into society freely so you must understand the importance of us as clinical persons to ensure that whatever test is being used is able to give us that level of confidence in terms of the results because it is going to allow us to make um a very important decision as to who stays in hospital and who may be allowed to go home and and mingle so i thought it important that that the the testing discussion that that point is also um taken into consideration because just imagine if um someone who works with you or lives if you has to do a test you'd want to know that if we release that person to go back that there is a good enough percentage in terms of the accuracy of the result that was given thanks thank you we have no more questions from the media but we also have dr eugen who would like to speak on the matter i just wanted to add to what well he stepped out mr riani easy to have asked about the COVID related deaths we had and whether these individuals had any comorbidities i just wanted to state that even though these individuals did have comorbidities we have to i do not want persons to think that because i do not have a comorbidity i should not worry because you know nothing's really going to happen to me this is a new disease and um we are still studying it not only locally but it's actually been studied on an international level we have to look at complications that may exist so it's a situation where just because you don't have a comorbidity but you got ill okay i did not die doesn't mean that you don't we you later on you you already know what's going to happen later on because the new disease and persons are still following up persons who have recovered from the disease to see their complications so we just want to make sure that persons don't feel okay i'm okay and i don't have any comorbidities so nothing really is going to happen to me i'm just going to write that illness it may not be there it may not be so at all also we have to look at the health seeking behavior in tan lucha a lot of persons really i know women tend to go to the hospital or the clinics or the private physicians very often because um that is how women usually they get pregnant they feel unwell they go to the doctor um but sometimes men don't really do that they may very well wait until they're very ill so somebody may be walking around and they don't even know they have a comorbidity they may have the high blood pressure they may have diabetes they may have another illness and they they say oh my pressure goes up sometimes i think sometimes i feel unwell but they never really go went to check so we we have to be careful when we say that we are okay and we don't have any problems but sometimes we do have a comorbidity that may be captured when you actually admitted or go to the hospital and you do blood tests and you realize oh my god i'm actually ill and i was not away so i just want persons to to not think that because i don't have a comorbidity that i'm okay lastly i think that's one of the pointers we may have missed and i'm just going to put it in there um one of the ways in which the ministry of health has worked towards um building up our capacity to deal with cases that are COVID-19 positive we do have patients on home isolation in the absence of my colleague who is not here dr shannasee who is the senior medical officer for the um primary health care services i could tell you that they're working along the hospital with the hospital to develop community teams where they have teams in the north and teams in the south they're working to make these teams more robust we have worked along with that primary health care department to allow them to know what criteria um of patients um should stay home clinical criteria who should stay home and who should be referred to the hospital so with the teams being on board you know they're working on it um we will be able to see um out of x number of persons how many persons that are home isolated in our home isolation and which of these individuals we have to keep an eye on so that information will be constantly shared with us at the hospital so that if a patient is removed from home isolation that quickly has to be admitted at the hospital it would not be a new case for us it would a case that will be already be informed of the co-morbidities of the unwell etc and then when they come to the hospital it is something that we already anticipated already known about that case okay so it's a joint effort between departments under the ministry of health thank you very much and dr eugen ford while we have come to the end of the press conference on the cobit 19 virus i want to thank members of the media for participating and also the panel for providing us with such information very important information on behalf of the entire production team at the ministry of health i am fennel neptune thanks for watching