Good afternoon residents of the Virgin Islands, I am Dr. Ronald Georges, Acting Chief Medical Officer in the Ministry of Health and at this time I wish to give you an update on the situation in the British Virgin Islands as it pertains to the COVID-19 pandemic.

The BVI is now in a situation of advanced community spread. 

As of the 10^th of July 2021, a total of 5,692 tests were done over the period 3^rd July to 9^th July and returned a total of 989 positive results.  This brings the total number of positives to 1,147 as of the 10^th of July 2021 for an average of 17 percent of persons sent or attending for screening having tested positive.  Today we have 149 additional positive results from the 9^th of July that have so far been reported, with a further 111 samples left to be reported on.

The BVI has seen exponential growth in active cases with a trend of increasing number of daily reports of new cases.  The trend in increasing daily reports of new cases reported appears to have stabilised, however large numbers of new cases are expected to continue to be reported for several days.

As I would have previously described, we expect that the momentum and increase of new cases will continue for a few more days based on previous exposures. 

I must appeal to everyone’s understanding that the BVI is now in an advanced state of community transmission and therefore all persons are presently at risk of contracting COVID-19. 

Geographical distribution and contact tracing are irrelevant at this point because we are in a situation of very high transmission and community spread throughout the Territory.

This means that all persons must simply take urgent and immediate steps to limit their exposure to stop the spread of the virus. 

Testing is less important at this time. It is less important than strict adherence to public health measures and getting vaccinated.  These are the two most important measures for the public to take immediately.

As of writing of this report there are 18 persons at the Emergency Room being evaluated for admission and this includes the triage tent.  Since the 4^th of July, the following admission statistics:

This does not include the 18 persons admitted to the Hospital.  I know that persons may be feeling anxious, but it is important for persons to remain calm at this time as we all work together to bring this situation under control.  I know we can do it, if we all do our part to contain and prevent the spread of COVID-19. 

We are concerned with a number of inappropriate behaviors being exhibited by members of the public, which are not helpful and potentially dangerous to all of us. 

For example:

1. It has been brought to our attention that employers are demanding their employees to be tested before coming to work.
2. We have persons not following the testing schedule and are testing at inappropriate times.
3. There are persons not adhering to public health orders.
4. There are persons who are being abusive to the health staff.
5. There are persons not adhering to the general stay at home order.
6. There are persons who have tested positive who are not disclosing to their loved ones at home of their status and are therefore not taking precautions, among other issues.

People, we have to change all of these things and act responsibility to stop community spread and stop endangering each other.

It is important to note that the Government of the Virgin Islands took the approach of a voluntary stay at home order and closure of some business operations to limit and curtail the current outbreak.  The onus was placed on the public to police themselves and behave appropriately to avoid a hard lockdown and its damaging effects on the society and economy. 

It is therefore imperative, that persons behave appropriately and at the same time the Social Distancing Task Force and the Royal Virgin Islands Police will be further engaged to ensure compliance with measures which we have already outlined which include issuance of tickets and fines to offenders.

Out of concern with all that I have mentioned before, we are now forced to change our current strategy.  

The current strategy for managing the outbreak is now shifted to:

1. Limiting person to person contact
2. Isolating all sick persons and household contacts
3. Changing testing strategy to dissuade mass-testing
4. Increasing Vaccination Coverage
5. Managing ill persons
6. Building resilience and capacity within the health system to manage the upsurge

At this point the following advice is given:

1. Limit person to person contact
   
   1.  Persons should stay at home and respect the stay-at-home order.  We are not in lock-down but we should limit all non-essential movements.
   2. Persons should stay at home and respect the curfew order, again this is to limit non-essential activities and opportunities for person to person spread.
   3. As far as possible, persons should stay within your home bubble and limit contact outside of your home circle.

2. Self-management of Sick Persons

All persons who are sick are advised to:

1. Stay at home and immediately self-isolate.  They should not seek to go to get tested. This is counterproductive and may cause additional spread of the disease.  They should not go to a physician/or health care facility until advised to do so or before calling ahead in effort to avoid infecting others.
2. The online symptom checker is available and persons who are sick should use the online symptom checker to record their symptoms at: http://ministryofhealth.gov.vg/redcap/surveys/?s=XKJALTWCRF.
3. Persons who stay at home should also follow home isolation guidance which has also been made available: https://bvi.gov.vg/media-centre/covid-19-stay-home-self-quarantine-isolation-guidance.
4. Persons who are severely ill or experiencing difficulty breathing or severe dehydration, should call the medical hotline at 852-7650 or call 911 to get further advice or to summon help.

3. Measures for Business Owners and Offices

All Employers and Workplaces should:

1. Ensure that persons who are positive and have received Quarantine Orders should be allowed sick leave to stay home for a period of between 10 to 14 days or as so ordered by the Public Health Department.
2. Workplaces should ensure that no sick employees report to work and implement a daily workplace screening to ensure that anyone exhibiting signs of symptoms should be sent home immediately and follow the guidance for sick persons mentioned previously.  Demanding of testing in this situation is not appropriate and can contribute to further spread.
3. Unvaccinated workers in households with positive cases should quarantine with their cases and should not attend work. 
4. Vaccinated persons who may have or have not been exposed can attend work unless they develop symptoms or test positive.
5. There should be strict adherence to all public health measures. These should be put strictly in place as described in the workplace guidance on government’s website: https://bvi.gov.vg/media-centre/updated-workplace-guidance-prevent-and-reduce-transmission.
6. All business operations should move as much as possible to remote working and as much as possible limit direct person to person contact and the number or customers in the business.

4. COVID-19 Testing
   
   1. Symptomatic Persons

As I described above they should complete the symptom checker and immediately isolate themselves.Where persons are not computer literate or unable to fill the online questionnaire a computer savvy relative or friend should assist. At a later date we may have a phone number available for persons to call for assistance. Given that the BVI is experiencing high community transmission all symptomatic persons should immediately assume that they are COVID positive and act as instructed above.

2. Travel Testing

Travel testing will continue, and consideration is currently being given for the use of rapid testing. It is important for persons to know that rapid testing is completed on a nasal sample and that given the small throughput of rapid testing machines, bulk batching of PCR tests remains the best option.

3. Quarantine Testing

This will continue as per existing protocols.Persons who are fully vaccinated will be tested on the Day 0 arrival by rapid test, partially vaccinated and unvaccinated will be tested on day 4 and day 7 by PCR and released after confirming negative results.

5.  Vaccination
   
   1. All persons should seek to be vaccinated.  Even at this stage two doses of vaccine are better than one, and one dose is better than none. While vaccination severely reduce transmission risk by up to 75% and risk of contracting COVID by between 60-90%; it practically eliminates severe disease, hospitalisation, and death.
   2. There are currently no restrictions on first or second dose vaccinations.  There are ample stocks of vaccine and more vaccine is on the way to augment stocks that are expiring on the 31^st of July 2021. Please just bite the bullet and get vaccinated.

6. Health System Capacity
   
   1. Hotline and Public Health Phones

The public should be aware that the Hotline and Public Health phones are experiencing an inordinate number of calls presently.Persons who are symptomatic should use the online symptom checker to report symptoms and if they are severely ill, they can call the hotline at 852-7650 or 911 for emergencies.

2. Test Reporting

Test reporting is moving to an automated mail merge and some persons would have noticed a new format of quarantine orders and test notifications coming from the Ministry of Health.It is important to ensure that your email address, and phone number are accurately recorded as we will not be able to reach you otherwise if this information is not correct.You should also ensure that particulars such as the spelling of your name, date of birth and all other particulars are accurate as corrections will cause severe delays in getting your results.

As we move to automating sending of previous results, we will address the backlog of persons who have not received their results which again is due to inaccurate or missing information for the most part.

3. Hospital Capacity and Field Hospital

Hospital in-patient and ICU are limited in relation to the demand for care.There are strict admission criteria.Persons will therefore have to make arrangements for care at home.Ensure that you have sufficient supplies of food, water, medications, vitamins, and other essentials.Hospital is limited in the staff to support the field hospital and this will only be activated if and when the situation requires it.

As we continue to manage this ever evolving and fluid situation, I am pleading for your cooperation and understanding.  We have some serious hurdles to overcome as we manage the surge of this disease in the Territory. We can do this once we each take the personal responsibility for ourselves and our families. Let us get through this together!

Thank you very much!