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PREMIER’S REMARKS: National Update on TCI’s COVID-19 Response

Good Evening Turks and Caicos

Great things are achieved when there is unity and when persons work toward one common goal. In this instance, residents across the TCI have been working together as one unit to keep ourselves safe and we are grateful for the spirit of cooperation. We appreciate that this is not easy for moving societies to shelter in place and to on the drop of a dime as it were, change how we live and interact but we have seen and enjoyed high compliance rates and this is commendable. I am a firm believer that only good can come from following expert health advice and I encourage us all to continue to do just that.

TCI took the decision several weeks ago to declare a State of Emergency and to introduce measures to mitigate against and contain the spread of Co Vid 19; and these steps were taken ahead of any confirmed cases. Additional measures followed to further ensure the safety of our people by restricting movements and within the past few weeks under Curfew conditions beginning March 26th. This was all in an effort to reduce the spread of the virus and to contain same. Because of these early measures, TCI is in a good place and must not take any steps to lose these early and important gains.

Health’s Modeling

The Ministry of Health over this period has worked on modeling with the Public Health England team using recognized tools. Based on these models and looking at our population size and demographics including numbers of persons in each age group. The models showed projections for the TCI which estimated the following:

  • Based on estimates of 80% of the population being susceptible, this would mean that 34, 363 persons could be expected to be infected. A significant number of these persons would be asymptomatic.
  • The most significant morbidity and mortality (deaths) will be in older age groups, especially people over 75 years of age
  • The estimated case fatality would be 344 persons
  • 760 severe cases requiring hospitalization
  • over 320 critical cases requiring intensive care
  • 236 deaths
  • Duration of the outbreak predicted to be 8-9 weeks with 50% of cases expected to be identified in the first three weeks.

This model reflects what could happen without the aggressive interventions which have been implemented in the TCI, namely, shelter in place, closure of the borders, education on hygiene and protective measures and enforcement of social distancing. These measures are working to help us avoid these high figures and reduce the burden on our health care system. We are also using these measures to help protect our most vulnerable groups, those being the elderly and those with underlying medical conditions. Evidence is clear that these individuals are at the greatest risk for poor outcomes including death.

Additional modeling is being done and we will be shared with you as time progresses to help everyone understand the reasoning behind the strategies being implemented here in the TCI.

Additionally, today’s Dashboard shows 9 positive cases and 13 suspected cases. We are informed by Team Health that in these results there are persons that are connected to each but there are also those who tested positive and who have no connection to other positive cases and no recent travel history. What we are told this means is that, these individuals have contracted the virus in country and additional measures must be taken to reduce the spread.

Curfew

Today members of Cabinet met in a Special Meeting to discuss TCI’s COVID-19 Response and to review the measures currently in place against the modeling completed by Ministry of Health. The Minister of Health together with members of his Ministry’s Team presented a full analysis of TCI’s state of affairs and offered advice as we approach the end of the 21 day Curfew.

Today we determined that it is in the best interest of all to have the Curfew extended further. A decision has then been taken to extend March 26th Curfew first imposed to May 4th, 2020.

Again, the Curfew will be extended until May 4th, 2020.

The following decisions were also taken:

Businesses

Like we did over the Easter weekend, there will be a complete closure of businesses each Wednesday and Sunday each week beginning Sunday 18th April

Airports

Airports will remain closed to Regional and International Flights until May 4th

Cruise Port

Based on CDC guidelines and following consultation with the cruise industry, the Cruise Port will remain closed until June 30th, 2020. This will remain under review and a decision will only be taken on its reopening after further consideration of CDC advice and after consultation with the Cruise Sector.

Vulnerable

The provision to protect vulnerables under TCIG’s full or partial responsibility will remain in place until May 4th, 2020

Schools

Schools will remain closed until May 4th.

Conclusion

It is so important that we continue to practice social distancing, that we stay at home and that we follow good hygiene tips. We will get through this together and we will be better for it once we follow health’s advice which we have already begun to realise and benefit from. We ask that you too continue to take this approach. Together we are strongest and we must remain our brother’s keeper. We assure you that health remains our top priority and will continue to drive all decisions. But likewise we are not close minded to the impact that this will have on our local economy. Over the next few days and weeks, you will be advised on important next steps and we ask only that you pay attention to official TCI Sites and official Notices.

May God Bless Us All and May God Bless These Beautiful by Nature Turks and Caicos Islands.

EXTENSION OF LOCKDOWN MEASURES

Good evening Turks and Caicos. It’s the Governor. I’m following on from the Premier’s 6 o’clock address. Myself and the Premier are doing what we are asking you to do - social distancing – so we are recording this from different locations and indeed we were in different locations today for Cabinet. 

We thought it important though, that you hear the same message from both of us, said in our different ways, and this decision is important enough that it anyway bears repetition. 

Id start by saying that while in one sense, this was a significant decision to make in Cabinet, in another it was very straight forward because the facts, presented by the Minster of Health and his officials, took us to the conclusion we are both presenting this evening

WHATS THE PRESENT POSITION:

On 23rd March TCI announced its first case of COVID-19. That date – 23rd March is important because, if you like, it acts for us as day zeroallowing us to model ourselves against others who have already been through this.

You will recall we moved quickly and by the 26th March we had imposed a curfew and a further 24 hours later we were in lockdown. Schools had already closed and flights were suspended.

TCI now has a total of 9 confirmed cases with 13 tests outstanding. We expect those tests to return to us imminently so these numbers could change, overnight, and if the modelling we were presented with today is accurate, they well might.    

Within this positive group of 9 we can so far identify particular clusters of cases and a small number of lone cases, although that may change. Generally speaking these are not 9 random people but the infection is presently, more often than not, found in groups. 

One confirmed case has very regrettably passed away – he had underlying causes – and another has left the country.  Of the remaining seven confirmed cases, one is hospitalized and six have mild symptoms and are not presently placing a significant strain on our Hospital.  We wish them all well.  We want them all to come through this, with us, knowing each and every one of them has TCIs full support. 

With this as background the order of business, today, was to determine whether we should relax the emergency regulations Cabinet put in place, that expire as Tuesday turns to Wednesday this week. In doing that, and understanding the impact this has on the lives and livelihood of so many on the Islands, we focused on public health, and it was health that led the debate.

Let me first therefore, in my own words, try and tell you what I heard in Cabinet and which I believe guided our decisions today.

The key fact is that TCI is still finding new cases and our health professionals have also identified local transmission.  We are not catching this from those who have been abroad or who are foreigners, we are catching this now from each other, even if weve stayed in the Islands. We also have had no positive case yet, that shows a person in TCI is clear from infection. All this suggests there is a reservoir of the active virus on TCI. 

That means there are people – maybe you – maybe your neighbor – maybe me - could be infected, without them knowing it, and are spreading the virus in the community.  Lifting the restrictions now, in these circumstances, would undo all thats so far has been achieved.  So bottom line up front – we are going to extend.

SO WHATS BEEN ACHIEVED SO FAR?

What Ive so far said sounds bleak so, as balance, I want to tell you what the medical professionals believe you have achieved, so far, so you know your sacrifice even to date was worth it. 

What the models are telling us is that, in the worst case, if we had done nothing back on the 23rd March, and had the virus gripped us like its gripped others, we could in the future be facing over 760 severe cases, over 320 critical cases requiring intensive care, and a staggering 236 deaths.

But because of what you did, so long as we continue to do what we have been doing, that is not going to happen. We are being told, by international experts that because TCI went hard and went early we are not going to face the national trauma that others are now facing.  We have also bought ourselves time to build further medical capacity – something the Minister of Health is firmly fixed on. 

Medical professionals know social distancing has an impact starting around day 10. It then takes a further 10 days to have a significant impact. Thats true even with populations that have been less disciplined than we have been. Our compliance rate is very high which increases our odds of a good outcome considerably.

This means that in a couple of more days we will already have had a significant impact on the spread. We are, if you will, starting to get properly on top of the problem even if we havent yet finished it off or indeed reached the moment when most countries find they are most vulnerable. At the moment we are winning.

At this point, because which week you are on in terms of the progress of this pandemic is important, its worth saying again that our first confirmed case was on Monday 23rd so this Monday we will be entering the start of so called “week four”.   IT may be of course the virus was on the Island some time well before this but you have to start with a fact and not an assumption.

In large populations it seems it takes eight weeks before the spread starts to fall.  But in smaller populations, with aggressive social distancing, the belief is that with these sorts of measures – rigorously imposed – the spread might start to fall in around week’s five to six.

But the key point, the inflection point –  the moment when we might reasonably expect a significant increase in cases - comes around this time - week four to five.

Therefore if TCI follows the normal trends the next two weeks are when we are particularly vulnerable. Science suggests, as far as science presently can, that we are starting to approach the point when we should expect more cases – perhaps far more cases - to test positive than we have been used to. 

We say that now so you are prepared, you dont lose faith in what we are all doing (it would be far worse if we were not) and also you dont let your guard down.  We may have flattened the curve, but there is still a curve and we are still climbing it. 

The good news is that Im being told by experts that the number of positive cases at this point are relatively small and also – compared to many – well controlled – and the actions we have all been taking have helped turn around a situation from one that could have entirely overwhelmed us, into something our health professionals now have a fighting chance of tackling – not through cure but through care.  But the Minister of Health is best placed to talk to this given his leadership of it.

WHAT ARE WE GOING TO DO:

The first is we are not going to panic or knee-jerk.  There are three things that allow us to stay steady. The first is you. The overwhelming majority of you have been magnificent. We are the envy of many – including my own home country the UK – in how much weve come together and embraced this.  There are very few in the region, either, that can match our solidarity on this not because its been forced but because its been embraced.  My personal thanks to every political leader, religious leader, community and secular leader and role models of all different types, in all your different forms and across many different age ranges - who have stood up and lent your moral support to this national effort.

Second, we continue to be in front of the problem. We are going to maintain that. Where you see other countries in the region bringing in over the top draconian measures, or using over-the-top rhetoric, its because they initially went late and soft.  We dont need to copy them.  We absolutely dont want this to feel like punishment, it needs your active buy in and support.

Third, what we have, that others dont in the region, and few do globally, is a well regulated system of seeking exemption. That has dramatically reduced the numbers able to move and when they are moving limiting it to particular times. My thanks again to the amazing response we had from those essential services who worked so positively with us to keep the numbers they needed to the lowest possible number. Only 5% or so of the population has an exemption and as I say, that isnt a free pass but very tightly controlled. 

WHAT DOES THAT MEAN IN TERMS OF WHAT WE ARE GOING TO DO?

The result of all of that is that we will be continuing with all the regulations we have had in place, to date, until 6am on 4th May.  Schools will also stay closed at least until then. In other words we will continue, steadily, as we are. 

With one exception, those of you running essential services with agreed exemptions, and the vast majority of you who have now developed a new pattern of life – curfew at night – lockdown during the day – will see very little change. Again the vast majority of you had got this but for the avoidance of doubt we have now made it law that there can only be one adult per family at the supermarket; if you have to be accompanied because of a care issue please write in for an exemption. 

The one significant change we are making, and for the same reason we gave over the Easter period, will be that we will be closing supermarkets and other businesses, not utterly vital to the islands life support, on a Wednesday and a Sunday. That will give respite, and the ability to regroup, to our front line, 24/7, law enforcement officers.  We do that because they need to hold the lockdown and curfew and also we do not want them exhausted, and the criminals well rested, when we lift in May.

Daily physical exercise remains as it was save that we’ve made it explicit that water sports, including kite boarding and paddle boarding are not permitted. I should say those really committed to these sports locally have been very responsible in this regard, we just wanted to make it clear to the tiny minority who were not.

Looking outside our borders will absolutely keep our borders shut to inward passenger travel until at least 4th May.  Those wishing to leave the Islands still may, and we will - over the next week - be setting up a system whereby if you do wish to leave, you can register so demand can be gauged which should generate affordable flights.

Our Cruise Port will be shut to cruise liners until June 30th (although in some ways this is covered because the US ban stretches far further forward than this).

Our medical professionals have also briefed us that inter-island travel brings, with it, the risk of introducing the virus to all of the islands, some of whom have elderly populations and where medical care is less sophisticated than Provo or Grand Turk. So inter-island travel now is restricted only to the most essential travel. You will in short need an exemption. 

We will continue to keep these dates and restrictions under review, but as we announce these today our strong hope – that with far more data to hand and better capability in play we can start to take off these restrictions in early May, while still keeping in place protections for the most vulnerable.  When we do, we will remove the restrictions in a phased way – much as they were initially implemented – so there isnt a violent shift from one set of protocols to another. 

CONCLUSION:

Forgive my length of explanation. But I believe you deserve it; we are all asking a great deal of each other so we all need access to the same advice, understand why we are doing what we are doing, but also – crucially – understand that what weve all done, so far, has been beyond worth it.

The last two and a half weeks have saved us from the very worst ravages that this epidemic could have brought. We may not have reached the highest number of infectious cases yet – but we should be getting close. And weve bought ourselves some time to not only dramatically reduce the numbers that might have overwhelmed our hospitals but also some time for those hospitals to increase their capacity to manage a problem that has probably not yet reached its peak.

You couldnt have done more TCI – now its a case of us all holding our nerve and holding the line weve all drawn in the sand. Science tells us cases will increase before they fall away. But weve got it and we are much stronger today than we were three weeks ago, and thats the position the Premier, myself, the Cabinet and the country intends to hold.  

Good night TCI.

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MINISTRY OF HEALTH’S COVID-19 UPDATE #32

The Ministry of Health would like to advise the public that as at 12am on 11th April, 2020:

THE TCI CONTINUES TO RECORD NO NEW COVID-19 DEATHS.

IN THE PAST 24hrs, THE TCI HAS RECORDED A NEW POSITIVE CASE. THIS BRINGS THE TOTAL NUMBER OF CONFIRMED POSITIVE CASES TO NINE (9). One confirmed positive case is currently under hospital care, another case has passed away since confirmation and one case has since left the TCI. Proper infection prevention and control measures were utilized during this entire process.

THE NEW POSITIVE CASE IS AN INDIVIDUAL THAT WAS ALREADY QUARANTINED AS A SUSPECTED CASE.

The number of suspected cases of COVID-19 in the TCI REMAINS UNCHANGED AT NINE (9). THIS IS DUE TO AN INDIVIDUAL IN QUARANTINE/OBSERVATION DEVELOPING RELEVANT SYMPTOMS WITH NO RECENT TRAVEL HISTORY. The nine suspected cases are persons (eight residents and one visitor) experiencing relevant symptoms but with no recent travel history or pertinent contact. Two suspected cases are under hospital care.

All persons met the WHO case definition for a suspected case of COVID-19. Samples have been collected and sent for testing, and we are currently awaiting results.

QUARANTINE/OBSERVATION NUMBERS REMAIN UNCHANGED AT 68. This includes: The active confirmed cases (patients in the TCI that are currently infected) (7), contacts of confirmed cases (10), the suspected cases (9), persons under investigation (3), relatives/contacts of suspected cases/persons under investigation (37), and TCI residents returning from overseas (2). Persons under observation/quarantine are either not displaying symptoms or have not meet the case definition for COVID-19.

On 1st April, 2020 the case definition for COVID-19 was amended for TCI; a travel history is no longer needed to fit the criteria. Given the closure of the TCI borders it is likely that new case would be as a result of local transmission.

A TEST RESULT RECEIVED OVER THE PAST 24hrs HAS CONFIRMED A SUSPECTED CASE TO BE POSITIVE FOR COVID-19. To date, a total of sixty-two (62) test results have been received, with fifty-three (53) confirmed to be negative and eight (9) positive confirmations. Persons confirmed not to have COVID-19, and their contacts, were moved from quarantined status and asked to continue following proper guidelines from the Ministry of Health. Those cases confirmed positive are in isolation with contact tracing aggressively continuing.

The Ministry of Health takes this opportunity to remind the public of offenses committed under section 18 of the Emergency Powers (COVID-19) Regulations 2020 in regard to false Statements/information. You do not have to be the originator of the statement/information in order to be charged under the law.

Please note the following definitions:

• A suspected person is someone who meets the case definition as outlined by WHO and CARPHA - and is experiencing symptoms.

• A person in quarantine is an individual on island who has come from infected country(ies) or may have come in proximity to suspected or confirmed cases - and have not exhibited symptoms.

Let's continue to reduce the risk by:

1. Washing our hands for 20secs or more
2. Practicing social distancing
3. Prepare your home, office and other surroundings by following the advice of the Ministry of Health and other credible health agencies.

For more information, please visit the Ministry of Health website, www.gov.tc/moh/coronavirus; email: This email address is being protected from spambots. You need JavaScript enabled to view it.; or call our hotline numbers, (649) 232-9444 and (649) 333-0911, if you or someone you know has symptoms or signs of COVID-19.

Confirmed COVID-19 Inpatient at TCI Hospital

JOINT PRESS RELEASE FROM TCI HOSPITAL AND TCI GOVERNMENT

(Providenciales, Turks and Caicos Islands – Friday, 10 April, 2020): The Turks and Caicos Islands Hospital wishes to advise the general public that a patient who was recently admitted and under clinical management and isolation at Cheshire Hall Medical Centre has tested positive for COVID-19.

The male resident in his 30’s was admitted to the facility on April 3rd 2020 with severe acute respiratory infection and has no co-morbidities. He also had no recent travel history. The inpatient was transported to the emergency department via ambulance on the date of admission using established protocols.

The male met the case definition of COVID-19 and was classified as a suspected case. A sample was collected and tested. Strict infection prevention and containment procedures continue to be enforced across the medical centre and were followed as a precaution in this case.

The now confirmed COVID-19 male remains in stable condition and is receiving supportive clinical care. He has been notified and is the only confirmed COVID-19 patient currently under clinical management and isolation at the facility. TCI Hospital and the Ministry of Health continue to provide support and guidance to the relatives of the affected person given the diagnosis. Due to patient confidentiality, no further details can be released.

The positive test result will be reflected in the April 11th 2020 TCI COVID-19 National Dashboard. Pending the receipt of any other case test results over the next 24 hours, the number of suspected cases will decrease by one (1) and the number of confirmed/positive test results will increase by one (1) due to this specific case.

The Turks and Caicos Islands Government - Ministry of Health Team commenced immediate contact tracing and persons identified in the process are required to undergo screening and quarantine as deemed necessary and as a risk mitigation measure.

Persons are reminded to contact the Ministry of Health hotlines if they are experiencing a cough, fever and/or shortness of breath via 649 333 0911 or 649 232 9444 for screening and guidance.

MINISTRY OF HEALTH’S COVID-19 UPDATE #31

The Ministry of Health would like to advise the public that as at 12am on 10th April, 2020:

THE TCI CONTINUES TO RECORD NO NEW COVID-19 DEATHS OR NEW POSITIVE CASES. THE TOTAL CONFIRMED POSITIVE CASES REMAINS AT EIGHT (8). One confirmed positive case has passed away since confirmation and another case has since left the TCI. Proper infection prevention and control measures were utilized during this entire process.

The number of suspected cases of COVID-19 in the TCI HAS RISEN SLIGHTLY TO NINE (9) SINCE OUR LAST UPDATE AS AT 09-04-2020. The nine suspected cases are persons (eight residents and one visitor) experiencing relevant symptoms but with no recent travel history or pertinent contact. Two suspected cases are under hospital care.

All persons met the WHO case definition for a suspected case of COVID-19. Samples have been collected and sent for testing, and we are currently awaiting results.

QUARANTINE/OBSERVATION NUMBERS HAVE INCREASED OVER THE PAST 24hrs TO 68. This includes: The active confirmed cases (patients in the TCI that are currently infected) (6), contacts of a confirmed case (6), the suspected cases (9), persons under investigation (4), relatives/contacts of suspected cases/persons under investigation (41), and TCI residents returning from overseas (2). Persons under observation/quarantine are either not displaying symptoms or have not meet the case definition for COVID-19.

The increase in quarantine/observation numbers is primarily as a result of the Public Health Team contact tracing efforts

On 1st April, 2020 the case definition for COVID-19 was amended for TCI; a travel history is no longer needed to fit the criteria. Given the closure of the TCI borders it is likely that new case would be as a result of local transmission.

NO NEW TEST RESULTS HAVE BEEN RECEIVED. To date, a total of sixty-one (61) test results have been received, with fifty-three (53) confirmed to be negative and eight (8) positive confirmations. Persons confirmed not to have COVID-19, and their contacts, were moved from quarantined status and asked to continue following proper guidelines from the Ministry of Health. Those cases confirmed positive are in isolation with contact tracing aggressively continuing.

The Ministry of Health takes this opportunity to remind the public of offenses committed under section 18 of the Emergency Powers (COVID-19) Regulations 2020 in regard to false Statements/information. You do not have to be the originator of the statement/information in order to be charged under the law.

Please note the following definitions:

  • A suspected person is someone who meets the case definition as outlined by WHO and CARPHA - and is experiencing symptoms.
  • A person in quarantine is an individual on island who has come from infected country(ies) or may have come in proximity to suspected or confirmed cases - and have not exhibited symptoms.

Let's continue to reduce the risk by: 1. Washing our hands for 20secs or more 2. Practicing social distancing 3. Prepare your home, office and other surroundings by following the advice of the Ministry of Health and other credible health agencies.

For more information, please visit the Ministry of Health website, www.gov.tc/moh/coronavirus; email: This email address is being protected from spambots. You need JavaScript enabled to view it.; or call our hotline numbers, (649) 232-9444 and (649) 333-0911, if you or someone you know has symptoms or signs of COVID-19.