STATEMENT BY ACTING CHIEF MEDICAL OFFICER

DR. RONALD GEORGES

COVID-19 UPDATE

December 24^th, 2021

Good Day residents of the Virgin Islands, Season’s Greetings and a happy holiday season to all. 

Today, the Ministry of Health and Social Development is informing the public that we are currently experiencing an increase of transmission of COVID-19 in the Territory associated with the Delta variant. 

Residents would have noticed a gradual increase in active cases over the last two months.  In particular, over the last two weeks cases have risen from an average of around 40 closer to 100 active cases.

As of today, 24^th December 2021 (Christmas Eve) there are 143 active cases with the majority of these 133 residing on Tortola and the balance residing on Virgin Gorda.

Samples from sick persons positive for COVID 19 and who meet eligibility criteria for testing are sent for genetic typing from both the Dr. D Orlando Smith Hospital Laboratory and the Medicure Laboratory. 

The local laboratory at the Dr. D Orlando Smith Hospital has also been using special test kits designed to identify the Delta variant and is conducting evaluations of the kits efficacy based on the results from CARPHA.  

Over the last three weeks 24 samples sent to CARPHA for genetic typing  have returned the Delta variant with one case being identified as Delta plus.  The current spike in cases is therefore due to the Delta variant.   

In this holiday season as we prepare to engage in the many family and social gatherings and enjoy the festivities with our friends, families, and connections let us continue to be mindful of COVID. 

The Omicron variant continue to replace Delta as the dominant strain in various jurisdictions and is now found in 89 countries worldwide. 

While it has not yet been identified in the Virgin Islands it has been identified in the Caribbean region. 

So far, it appears that it is more infectious but causes milder disease. 

Let us therefore increase our vigilance and adherence to mask wearing, social distancing, and hand hygiene. 

If you think you have contracted COVID or are exhibiting the symptoms of COVID please immediately self-isolate and seek to be tested by either a PCR or rapid COVID test. 

You can access PCR testing at the Dr. D Orlando Smith Hospital Tent by registering at https://althea.bvi.care and by calling the Medical Hotline at 852 7650 if you have any symptoms of COVID. 

Alternatively, private medical establishments also provide PCR testing, and rapid antigen type tests.  The PCR test remains the Gold Standard for diagnosis. 

Persons found to be positive will be given a quarantine order and required to isolate for a period of 10 days minimum and must be symptoms free for at least 24 hours before end of isolation in keeping with Centers for Disease Control and Prevention (CDC) and United Kingdom National Health Service  guidelines.  However, persons who are immunocompromised or have severe disease requiring hospitalisation may be isolated for longer periods up to 20 days. 

Earlier this year the Virgin Islands experienced its largest surge of cases of Coronavirus which began near the end of June and lasted until the beginning of August 2021 with active cases peaking at 1638 active cases in the middle of July and had reduced to 142 by August 6th.  Over this period, hospital admissions totaled some 108 persons and 37 persons unfortunately died.   

While the main tools of our control and suppression measures in the past have been curfews, business restrictions and lockdowns, Government policy has moved away from these drastic measures as vaccination rates have increased to just over 60 percent. 

Clusters of cases have been associated with schools, daycares, private and government offices, large and small companies, social gatherings and events. 

The Delta variant at this present time appears to be outcompeting Mu in the Virgin Islands as has occurred in other jurisdictions. 

The current vaccines offer good protection against severe disease, hospitalization and death associated with Delta infection and residents should therefore avail themselves of opportunities to be either vaccinated or receive their booster dose. 

We have to be cognisant of the appearance of the Omicron variant in many countries around the world and its inevitable entrance into the Virgin Islands. 

So far, the Omicron variant does appear to cause milder disease and vaccines do appear to offer protection against severe disease, hospitalization, and death. 

The Government of the Virgin Islands through the support of the UK Government has made vaccination and now boosters available in the Territory.  They have put in place entry quarantine restrictions, a system in place to isolate positive cases, and has made the necessary provisions for cases requiring clinical care at the Dr. D Orlando Smith Hospital.  With these provisions the Government has shifted its strategy to requiring persons to take personal responsibility, while allowing economic and social activity to carry on. 

A word on vaccine boosters and the Pfizer vaccine.  The UK Government has made Pfizer vaccine available for 1^st and 2^nd doses and for Booster doses.  There have been many questions with regards to why Pfizer now and the difference between a third dose and a booster. 

The Oxford University in the UK carried out a large trial to determine which vaccines would be most efficacious as booster doses called COV-Boost.  The findings were that the mRNA vaccines give the best overall increase in neutralizing antibodies and immunity as a booster vaccine.  Pfizer vaccine, an mRNA vaccine was then chosen as the easier vaccine to supply to the Territories.

With the availability of 4,680 doses of Pfizer in the Territory and more to be available in January, it is expected that supply ability of AstraZeneca will be less in the new year. 

As such, Pfizer will now be the vaccine of choice in the Territory.  Persons who have completed their primary vaccination with either a 2-dose regimen like AstaZeneca, Pfizer, Moderna, or Sinovac or a one-dose regimen (Johnson and Johnson) can receive a Booster of Pfizer vaccine 3 months after completion of their last dose.  A booster dose simply provides a recent stimulus to the immune system to boost the levels of neutralizing antibodies and cellular immunity to COVID. 

Persons who are severely immune compromised, e.g. those on chemotherapy, or on high doses of steroid, or on other immune suppressive therapy may be eligible for a third dose which can be Pfizer as well as a Booster dose three months after to ensure that they sustain sufficient immune protection.

Pfizer vaccine roll-out is currently being handled by the BVI Health Services Authority using the published schedule for priority groups of:

1. elderly over 60 years
2. frontline and health workers
3. those who are immune compromised
4. children from 12 to 18 years of age
5. those with chronic diseases. 

Vaccines are being given on a first come first serve basis without appointments.  Persons are asked to go to the vaccine administration location with a form of government issued identification and their vaccine card or proof of vaccination to be registered on site for vaccinations.

From the 4^th of January it is expected that all population groups will be eligible to receive Pfizer vaccine.  The UK Medicines and Healthcare products Regulatory Agency has approved the use of pediatric doses of Pfizer for children from the ages of 5 to 11 years of age and arrangements are being made to make Pfizer vaccine available in the smaller pediatric dosing in this age group.  As of January 4^th Pfizer vaccination will be opened up to all residents.

Given the increased COVID activity in the Territory all residents are asked to continue to be vigilant and abide by the established public health measures and:

1. Limit your exposure to persons outside of your household
2. Adhere to the public health protocols
   
   1. Do wear your mask at all times when within 6 feet of persons
   2. Wash your hands regularly or use hand sanitizers
   3. Maintain a distance of at least 6 feet from persons outside your household
3. If you are sick isolate and get tested as soon as possible
4. If you are positive stay away from others for at least 10 full days and abide by the terms of your quarantine order
5. If your condition worsens do seek medical attention early.
6. Get vaccinated with either your first or second dose and if you are three months after your last dose and are eligible get your booster

I would like to take the opportunity to commend the public for the role they have played so far in limiting the impact of Coronavirus on the Territory.  I ask for their continued participation and support in continuing to limit the impact of the virus here in the Territory and wish all a Merry Christmas, and happy holiday season and New Year when it comes.