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COVID Fourth Wave Epidemiological Report from TCI Ministry of Health on January 20, 2022

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Delivered by Dr. Nadia Astwood, Chief Medical Officer

 

#TurksandCaicos, January 28, 2022 – “As it stands, the TCI has recorded 5442 cases of COVID 19 since the start of the pandemic with 1882 cases being identified in January 2022 alone.

The TCI has reported a total 32 COVID 19 related deaths since the start of the pandemic with 6 deaths occurring in January 2022. The fourth wave which the TCI is currently experiencing began at the end of December 2022 and since then 2272 cases have been detected.

To put this into perspective, a similar number of cases was reported for the TCI over the first 11 months of the pandemic between March 23 – Feb 25.

123 cases were identified in October,

117 in November

451 in December 2021.

Cases reported in January 2022 ranged in age from a newborn to 91 years with 53% being female, 73% residents and 64% of individuals being symptomatic.

The highest proportion of cases were observed in the 30-39 years age group which represented 23% of cases. While 8.3% of cases were aged above 60 years, this still accounted for 142 persons. Persons in this age group are more likely to have other comorbidities or underlying chronic non-communicable diseases such as hypertension, diabetes or cancer and are therefore at greater risk of severe disease and poor outcomes.

During this fourth wave and for the first time since the beginning of the epidemic in the TCI, cases have been detected on all inhabited islands in the TCI.

The positivity rate remains consistently high based on testing carried out at the National Public Health Laboratory, this is the percentage of people who test positive for the virus of those overall who have been tested. Although the vast majority of affected individuals reported mild symptoms such as cough and fever, the high overall numbers have translated into hospital admissions when compared to previous months.

As many as 30 hospital admissions in January 2022 had a COVID19 diagnosis which is a reflection of the widespread community transmission the TCI is currently experiencing. Dr Braithwaite Tennant will further expand on the impact of the current COVID19 wave on the TCI Hospitals.

Unfortunately, since December 20th 2021, the TCI has reported 7 COVID19 related deaths with 6 deaths being recorded in January 2022 alone.

Of the deaths in January 2022 (up to January 20)

4 (over 60) 1 (20 – 59)

1 (less than 20)

The most recent COVID19 vaccine report which was submitted on 16th January 2022 reported that:

82% of the eligible population is fully vaccinated (28639)

87% having received the first dose (30526)

14% booster coverage (4859)

Children aged 12 to 15 years:

1st dose 99

2nd dose 622

Overall, the MOH has noted breakthrough infections for those who have been fully vaccinated however the majority of persons experiencing severe disease are either unvaccinated or unboosted.

It is evident that the vaccine is effective in reducing the severity of the illness in the vast majority of cases, however the are many persons in the TCI who are eligible for the booster who have not taken it.

This is also reflected in the hospital admissions where persons who are experiencing more severe disease and are vaccinated are all unboosted. The policy has recently changed whereby persons who have completed their second dose of the vaccine are eligible for the booster as opposed to 6 months.

I would therefore continue to recommend that for those who are unvaccinated to get vaccinated and for those who are vaccinated to get boosted.  This is the best way to protect yourselves, your loved ones and those who you may come into contact with.

Reinfections- The MOH has noted a substantial number of persons who have been re-infected with some persons having been infected last year and are now presenting again with symptoms of COVID19.

Since December 20th 2021, 98 reinfections have been identified.

What we are seeing in the TCI is likely to be the result of the omicron variant which is highly transmissible meaning that it can spread more easily from person to person than previous variants. This variant is responsible for the surges in cases being experienced all over the world and the TCI is no different.

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Ministry of Health and Human Services Conducts Emergency Vehicle Operators Course for Emergency Medical Services Personnel

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Ministry of Health and Human Services successfully conducted Emergency Vehicle Operator Training for Emergency Medical Services Department in March 2024.

The Ministry of Health and Human Services has reaffirmed its commitment to ensuring the safety and efficiency of emergency services across the Turks and Caicos Islands with the successful completion of an Emergency Vehicle Operator Course. Hosted for all members of the Emergency Medical Services (EMS) Department, this course marks a significant step in the ongoing efforts to provide high quality emergency response services.

Tailored specifically for ambulance operators, the course featured a comprehensive curriculum blending theoretical knowledge with practical skills. Participants underwent rigorous training encompassing critical safety practices essential for effective emergency responses. The amalgamation of didactic instruction and hands-on training enabled operators to navigate emergency situations with precision and confidence, fostering a culture of safety paramount for preserving lives.

In times of crisis, the EMS Department emphasizes the importance of well-trained and composed responders. Equipped with the skills acquired through this specialized course, EMS personnel are better prepared to address emergencies promptly and effectively, ensuring timely assistance to individuals in need.

The course, conducted by esteemed expert Mike Massaro, President of Trilogy Emergency Medical Solutions, ran from March 19th to March 22nd, 2024, across all islands. Mr. Massaro commended the EMS Department members for their enthusiasm and dedication to learning, acknowledging their pivotal role in enhancing community safety.

Participants lauded the interactive teaching approach employed throughout the course, noting its effectiveness in making lessons both engaging and informative. Their positive feedback underscores the value of practical, hands-on training in bolstering emergency response capabilities.

Minister of Health and Human Services, Honorable Shaun D Malcolm commented that “I am confident that the principles instilled during this course will significantly contribute to the safety and well-being of individuals accessing emergency services. By investing in continuous training and development, the Ministry remains steadfast in its mission to deliver safe, efficient and reliable emergency care to the people of the Turks and Caicos Islands.”

For more information, please visit the Turks and Caicos Islands Ministry of Health and Human Services Facebook pagE at https://www.facebook.com/tciministryofhealth/.

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Dengue cases rising in Region 

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Dana Malcolm 
Staff Writer 

As of March 26, 2024, over 3.5 million cases of dengue and more than 1,000 deaths have been reported in the region, now, both the US Centres for Disease Control (CDC) and the Pan-American Health Organization (PAHO), are ringing alarm bells about the outbreak as cases swell to record highs.

PAHO on March 28 called for collective action in the region to fight back the growing wave of infections.

“This is cause for concern, as it represents three times more cases than those reported for the same period in 2023, a record year with more than 4.5 million cases reported in the region,” Jarbas Barbosa, PAHO Director said during a press briefing.

For now cases are concentrated in three main countries: Brazil, Paraguay and Argentina which account for nearly all of them, around 92 percent, but infections are on the rise regionally.

According to Barbosa, Caribbean countries must still be vigilant as data is beginning to show increases in areas like Barbados. That is paired with concerns from PAHO that some countries may not be equipped to handle the surge.

Nearly $500,000 was allocated in the 2023 2024 budget to the environmental health department under The Turks and Caicos Ministry of Health and Human Services to help with dengue which had been listed as a public nuisance.

Last year in the Turks and Caicos Islands, only a few rounds of fogging were completed. According to data from the Appropriations Committee around 10% of communities were fogged on schedule. Explaining the low number, representatives of the Environmental Health Department (EHD) maintained that fogging was not the primary defense against mosquito breeding locally.

”Fogging should actually be a last resort, there are preventative measures such as the treatment of swamps, and inspection of residential areas and communities for breeding sites.”

Representatives admitted though that they were still hampered by a lack of resources.

The country declared an outbreak in late 2024. Now there is an ongoing public education campaign to make residents aware of what they need to do to keep their homes safe and free from mosquitoes in addition

The Turks and Caicos Islands EHD also says they have been provided with money to help with garbage disposal in their battle against the vector borne disease.

The Ministry has also contracted entomologists to research what kind of mosquitoes live in the country and how to tackle them.

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31 Turks & Caicos Medical Professionals, Trained in Trauma care

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Dana Malcolm 
Staff Writer 

In a first for the Turks and Caicos and one that some would describe as particularly important, over three dozen healthcare professionals were upskilled in emergency trauma care via Advanced Trauma Life Support (ATLS) certification.

Trauma Care in emergency medicine usually refers to treating patients who are critically ill or have severe injuries and need to be quickly stabilized like gunshot wounds, damaged limbs, crush injuries, and stab wounds.

In 1976 following a plane crash involving a surgeon and his children who experienced substandard trauma care, the first ATLS course was created. It attempts to provide basic training for medical professionals when dealing with acute trauma cases where there is little staff on hand. In fact ATLS is supposed to work with as little as a single doctor and nurse team working together to stop the most critical injuries first, ensuring a better chance of survival.

This is particularly useful for the Turks and Caicos with its small hospitals and limited staff. Health officials admitted this, highlighting what they describe as ‘the pressing need for such training, particularly due to physician shortage, isolated communities in family islands and other barriers to accessing this critical training.’

Recognizing the need, the Hamilton Education Foundation jumped into action, and in collaboration with Massachusetts General Hospital and the American College of Surgeons conducted a Hybrid Advanced Trauma Life Support (ATLS) Demo for 31 doctors in the Turks and Caicos Islands on May 22nd and 23rd, 2024.

Led by Professor Susan Briggs,the foundation describes the course as historic in that it’s the first-ever done outside the United States and says it is;“Crucial for enhancing the quality of healthcare delivery and saving lives in the face of increasing intentional and unintentional injuries.”

With the rise in gunshot injuries in the country, seen through police data since 2020 many residents might be inclined to agree.

While admitting it was difficult to measure if ATLS reduced mortality, a 2016 article published in the National Library of Medicine describes the courses as “very useful from an educational point of view. It significantly increased knowledge, and improved practical skills and the critical decision making process in managing multiple trauma patients”

Rufus Ewing, Former Premier and Executive Chairman of the Hamilton Education Foundation, said, “This initiative aligns with our mission to enhance medical education and improve access to quality healthcare services in the Turks and Caicos Islands.”

The training received broad brush support from the Ministry of Health, TCI Hospital and private sector.

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