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Critically Ill Infant Suspected of COVID-19 Passes Away

JOINT PRESS RELEASE FROM TCI HOSPITAL AND TCI GOVERNMENT

(Providenciales, Turks and Caicos Islands – Friday, 3 April, 2020): The Turks and Caicos Islands Hospital is saddened to advise that an infant passed away shortly after admission to Cheshire Hall Medical Centre.

The infant was transported to the facility via private vehicle on 2nd April 2020. She was admitted to the inpatient unit around midnight in critical condition. Although COVID-19 infection is statistically rare in this age group, given the presence of the pandemic and out of an abundance of caution, she was classified as a suspected case and met the latest case definition of COVID-19. There were other medical findings, which also could have potentially accounted for the infant’s passing.

The public health team was notified and a sample was taken as a differential for posthumous overseas testing. Due to patient confidentiality no further details can be released.

The Turks and Caicos Islands Government - Ministry of Health Team commenced immediate contact tracing and persons identified in the process are required to undergo quarantine and/or screening as a precautionary measure. The Department of Social Development has also been engaged as per protocol. TCI Hospital and the Ministry of Health wishes to offer our most heartfelt condolences to the grieving parents. Further support and guidance have also been provided.

A travel history is no longer needed to meet the criteria for COVID-19 given the closure of national borders. A suspected case is someone who meets any of the following revised case definitions:

(a) A patient who presents with acute respiratory illness (fever and at least one sign/symptom of respiratory disease (e.g., cough, shortness of breath), and with no other etiology that fully explains the clinical presentation.

(b) A patient who presents with any acute respiratory illness and having been in contact with a confirmed or probable COVID-19 case in the last 14 days prior to onset of symptoms.

(c) A patient who presents with severe acute respiratory infection - fever and at least one sign/symptom of respiratory disease (e.g., cough, shortness breath) and requiring hospitalization and with no other etiology that fully explains the clinical presentation.

A probable case is a suspect case for whom testing for COVID-19 is inconclusive. A confirmed case is a person with laboratory confirmation of COVID-19 contagion, irrespective of clinical signs and symptoms. The Ministry of Health is working closely with the TCI Hospital in regard to the matter.

Suspected COVID-19 Admission at TCI Hospital

JOINT PRESS RELEASE FROM TCI HOSPITAL AND TCI GOVERNMENT

(Providenciales, Turks and Caicos Islands – Thursday, 2 April, 2020): The Turks and Caicos Islands Hospital wishes to advise that there was another admission of a suspected COVID-19 patient at Cheshire Hall Medical Centre. 

On April 1st 2020, a middle-aged male who is now classified as a suspected case of COVID-19 was admitted to the facility. This classification was made on the basis that the patient presented with severe acute respiratory infection and had no recent travel history.

The patient was transported to the emergency department via private vehicle. The patient is currently receiving supportive clinical care. The public health team was notified and a sample was collected for overseas testing. Due to patient confidentiality no further details can be released.

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

A travel history is no longer needed to meet the criteria for COVID-19 given the closure of national borders. A suspected case is someone who meets any of the following revised case definitions: 

(a) A patient who presents with acute respiratory illness (fever and at least one sign/symptom of respiratory disease (e.g., cough, shortness of breath), and with no other etiology that fully explains the clinical presentation. 

(b) A patient who presents with any acute respiratory illness and having been in contact with a confirmed or probable COVID-19 case in the last 14 days prior to onset of symptoms. 

(c) A patient who presents with severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease (e.g., cough, shortness breath) and requiring hospitalization and with no other etiology that fully explains the clinical presentation.​​​

A probable case is a suspected case for whom testing for COVID-19 is inconclusive. ​​A confirmed case is a person with laboratory confirmation of COVID-19 contagion, irrespective of clinical signs and symptoms.

The Ministry of Health is working closely with the TCI Hospital in regard to the matter. 

 

MINISTRY OF HEALTH’S COVID-19 UPDATE #23

The Ministry of Health would like to advise the public that as at 12pm on 2nd April, 2020:

Over the past 24hrs, THERE HAS BEEN NO NEW CONFIRMED POSITIVE CASES RECORDED IN THE TCI. 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.

TCI suspected cases of COVID-19 increased to nine (9): The nine suspected cases are TCI residents returning from countries with local transmission and contacts of a confirmed case (9). One (1) individual is experiencing severe symptoms and has been admitted to TCI Hospital for care. All nine persons met the WHO case definition for a suspected case of COVID-19, thus they are experiencing symptoms. Samples were collected and sent for testing, and we are currently awaiting results.

The increase in suspected cases are as a results of individuals (2) displaying symptoms and meeting the case definition for COVID-19.

Persons under quarantine/observation (291)—The confirmed cases (5), contacts of a confirmed case (18), possible contact of a confirmed case (12), the suspected cases (9), symptomatic person/s under investigation (1), relatives/contacts of suspected cases (18), persons travelling from highly affected countries — UK, Austria & Spain (5), TCI residents (223). Persons under observation/quarantine are either not displaying symptoms or have not meet the case definition for COVID-19.

The decrease in quarantine/observation numbers is primarily as a result of the expiration of the quarantine period for several individuals, they have been removed from quarantined status.

No new test results were received over the past 24hrs.

To date, a total of twenty-seven (27) test results have been received, with twenty-two (22) confirmed negative and five (5) 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.

List of Licensed Public Service Operators for Use During Government Approved Times

In an effort to assist individuals in need of transportation services during the TCIG approved times should they need to move during the curfew, the Ministry of Home Affairs along with the Ministry of Health and the Road Safety Department publish for your convenience a list of licensed Public Service Operators available to offer transportation. 

 

Grand Turk

Lucerne Freites-Francis 244-9067

Antonio Clarke - 231-1806

Antonio Fulford - 241-6243

Robert Forbes- 343-5311

Jamal Williams- 331-3449

Charles Glinton - 243-5886

Curtis Lightbourne- 231-3116

Andy Lightbourne- 244-4724

Trevor Missick- 241-8028

Sharad Garland- 242-3529

 

Providenciales

Ron Higgs - 246-1059

Bloniva Green - 246-6031

Samuel Handfield- 241-0985

Flint Handfield - 242-2240

Edith Morris - 442-0666

 

North and Middle Caicos

Max Campbell- 231- 6285

 

Kindly note that these persons are licensed to offer public transportation services on each Island under which they are listed.

 

 

THE SCIENCE BEHIND COVID 19 AND CHANGES TO THE REGULATIONS

Good evening Turks and Caicos, it’s the Governor speaking, speaking on behalf of both myself and also the Premier. The Premier will talk on Friday about the support and stimulus package.

From me a Wednesday evening update for you. This is our fifth day of lockdown and curfew.  So far so good - and the first thing to say is thank you. We are collectively doing the right thing.  It’s causing, we know, inconvenience and in some cases serious hardship.  Most people I speak to understand instinctively why we are doing this but we thought we would use tonight to try and describe the underpinning facts of why we are doing what we are doing.

The Science:

If you can bear it, a quick science lesson - because it’s the science that is guiding us on this. You’ll have heard lots of people describe ‘flattening the curve’.  As far as I can, I want to describe to you what that means and why what we are doing does this.

All virus’s spread at different rates.  There is a scientific scale of measuring infection - this isn’t random - so, for example, measles is ‘nine’ which means that we would expect one measles case to infect nine others.  For Influenza the infection rate is 1.3.  If the rate is ‘one’ then one person infects one other person.  A figure less than ‘one’ means the disease is in decline and may die out.   

COVID19 is thought to be around 2.2. Much less infectious than measles but considerably more infectious than influenza. What this means is that, on average, one infected person passes it on to 2.2 other people. As with all statistics that quote averages this means that there may be many people that only pass it on to one, and one person that passes it on to many, but as I say the global average is 2.2

You see this in the way COVID19 spreads. One person infects two, two people infect four, those four infect eight (in fact because it’s an infection rate of 2.2 it’s now starting to become more than simply doubling) so let’s say that eight cases becomes 17 and then 17 becomes 37. You get the picture, we now have a very dramatic rise as we saw in Italy and in cities such as New York.  It’s out of the cage and it’s spreading and multiplying at a factor of 2.2. Not good.

The number one purpose of everything you are doing is to change the maths on this spread. What we need to do is bring this down from 2.2 to certainly under 1.5, in truth we want to get it to under one.  But Below 1.5 we can start to impose ourselves on this virus and bring it under control. We have to do that because our medical services can manage a much flattened curve but they couldn’t possibly manage the sort of increase I described as it grew at 2.2

The good news is that all the medical opinion we can draw on - here in the Island, public and private, and that expertise we can draw on elsewhere, including some very eminent epidemiologists in the UK, tell us that TCI is doing all the right things to achieve this. We got ahead of it and we clamped down on it, and if we can hold the line we are going to not only get through but present an example to the world about how to do this.

Separate to this there is a secondary benefit. The better the lockdown we achieve, the more chance there will be that we generate in the population a slow-burn immunity that builds over time. These will be people who have in some way been exposed to the virus but have either had no symptoms or very mild symptoms. 

It’s reasonable I think for us to assume, given how large our tourist sector was, that the virus must have been on the Islands before it was first properly identified. Some immunity will have been starting to develop.  

With testing - coming in from the UK and also being procured from the US - there’s sophisticated modelling that can explain this and as we reach a tipping point we will know that. While there will continue to be cases in TCI, there will be sufficient immunity in the population to prevent its rapid spread here. We will be seeking data to make smart decisions around this. 

With the Territory having developed its own immunity - with the borders still closed - we can start to restart the local economy and get money moving through and round it. Businesses will be able to open. Fear of each other will subside.

Indeed, these Islands are small enough, the measures we have all taken together restrictive enough, and the data we may be able to collect around immunity important enough, that it may well be that TCI becomes an example of how to do this - that does our brand - as an extraordinary place and a healthy place to visit - no end of good.

It also allows us to start to see a medium term future where a tourist visiting TCI who we know is safe can come to an extraordinary destination that they know is not only beautiful, but is safe. But let’s be honest with each other that’s some way off in the future although something we are working towards. 

Adjustment to the Regulations

Laws can help moderate and guide behaviour but it’s by far best when a people know why they are doing something than be told to do something. Self-denial, self-discipline and good judgement are so much more powerful than say the threat of vehicle confiscation. Please, err on the side of caution. Because you can do something doesn’t mean you necessarily should do something.  

We said we’d keep everything we were doing under review and we have been. Broadly we think we are in the right place.  Matters that have now become clearly the way to do things - which haven’t caused enormous inconvenience but have severely cut down traffic and movement - we yesterday captured in law; so, for example, you may not drive to your place of exercise.

We have removed takeaways, drive-throughs and restaurants from being described as an essential service. From the last few days it’s clear they aren’t - we can get by until the end of this period without them, wonderful as they are.

We do it based on medical and Policing advice.  With TCI Islanders and Residents being the sociable society we are, some risk becoming the equivalent of the local bar, the spot some meet and engage, and it also gives a license for movement we could not reasonably police.

This covers every form of takeaway, no exceptions.  There is the possibility of the Governor granting exceptions but I think that will be unlikely over this period of lockdown unless it’s in direct support of an effort to alleviate hunger.

It’s also now clear in the law that you have to be on a route from your home to your allowed destination (a supermarket is the best example). Much of this ‘law’ wasn’t required because people were demonstrating great common sense but it is a tidying up exercise for those who might take advantage, a week or so in.  Beyond that we’ve kept matters very much as they are. It’s working. 

We had an interesting piece of false news start to generate today. It wasn’t malicious just wrong and it originated from a South African website - that isn’t a recognised authority on medical statistics. 

To be clear, we still have only 5 (five) confirmed cases in TCI.  The authoritative way to know - what our health professionals on the front line know - is the TCI dashboard that we disseminate daily and is on the MOH website. Please stick to TCI sources, we hold the data because we collect the data. We want the public to know.

This wasn’t malicious or dangerous it was just wrong. There have though been several instances on social media recently that haven’t just been wrong they’ve been dangerous. Before focussing on the tiny number who are malicious amongst us, let me say somethuing about the vast majority.

This is not the time to stifle decent debate - indeed the future of these Islands are starting to be decided during this time in terms of whether we remain safe, recover, and can once again prosper.  

But what this short period is not, is an opportunity for us to stigmatise anyone who has COVID19. For all you know you may be one of the fortunate that had it, suffered few if any symptoms, but passed it on to others. Or - if we all lose control of this through our casualness - it’s very probably true that it will be someone very close to you, who you love, that ends up with this virus. It doesn’t discriminate.

If you see someone originating or spreading hate or misinformation, designed to cause fear, then there is now a Police Unit - well skilled in following leads across the internet - that you can report to. Their email is: This email address is being protected from spambots. You need JavaScript enabled to view it.. That’s This email address is being protected from spambots. You need JavaScript enabled to view it.

Stopping the Sloops

I’ll finish on one point I flagged yesterday on Social Media. A large sloop of many hundreds was turned around yesterday on the High Seas between here and Haiti. I was on a call today with the US Ambassador and US Coast Guard in Bahamas; the number of combined assets we have operating presently in this space has significantly increased.  That frustrating battle continues every night - we should be more proud of those involved in this work tonight, than ever. But for those who can connect to Haiti do send them the message. You have our continued attention and you will be stopped. 

As of tonight we are okay. We are in a much better position than many others. In terms of health, we can see a route through this, not through hope but through understanding the science, determined to capitalise by doing this once and doing this right. That’s what you are doing TCI; you are a resilient lot and resilience is the order of the day for the next few weeks. The reward is there if we stay firm; as firm we must.

Day five is drawing to a close and day six is soon to begin - soon we will be announcing the end of the first week. We can do this.

Good night TCI

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