By 6 June we were approaching the important milestone of having 20 per cent of our population tested, putting us in the top three countries in the world for per-capita-testing.
Premier Hon. Alden McLaughlin
Published 30th October 2020, 3:18pm
Mr. Speaker, it has been over seven months since our first case of COVID-19 was confirmed on 12 March. On 14 March we closed our borders as we started our response to the COVID virus by introducing the hard and soft curfew regimes. But thinking back, it seems so much longer than that. I thank God for His mercies and I also thank the Caymanian people for their forbearance over these many months as we charted our response to the threat of COVID-19.
It has not been easy over these many months Mr. Speaker. To try to eradicate the virus, to save lives and protect health, we acted decisively. We closed our borders, put curfews in place to limit movement, and required most of our people to stay home, indeed with many working from home. Add to this the closure of all our schools and restrictions put on access to elderly care homes, our hospitals, and the prisons. Access to beaches was also restricted. When it was safe to do so, we removed most restrictions in phases over several months. Hopefully, things have gotten better, and we are not where we were in early March, but the impact of COVID-19 has been disastrous to our Islands; especially to our economy. Not only did our tourism sector come to a grinding halt but all local business has been hit badly during the period of lockdown. The same thing has happened around the world, Mr. Speaker. The impact of COVID-19 has been tough for business and for our people, including our children and the elderly. But it has also been tough for Government. But despite the challenges, there is no doubt that it is the strength of our response, and the understanding and compliance of our people that have helped to almost eradicate the virus here and has enabled us to return to some sense of normalcy. And because of this, much of the local commerce, save for tourism, has for the most part been able to return.
We are indeed in a much better place now than we were in the early phases of our response – but I shall never forget the direness of the situation as we all saw the news reports on television. We watched in horror early in the year as this deadly virus caused havoc in China, and throughout Asia, moving to Europe and eventually to North America. It seemed there was no stopping it. By the time we had our first confirmed case of COVID-19 in March there were more than 125,000 people infected and almost 5,000 deaths across the world. The entire country of Italy, with over 60 million people, was in lockdown. Today there are more than 45 million confirmed cases across the world and more than one million deaths. Those are staggering numbers and they continue to rise.
Mr. Speaker, as we started our COVID-19 response I could not have predicted these numbers, but the potential for calamity was obvious early on. And as our world, both here at home and abroad, began to change in March we all understood clearly that in the weeks and months ahead our priority had to be to keep our people healthy and to save lives. As I said several times over those months Mr. Speaker, we can rebuild an economy, but we cannot bring people back to life.
I am appreciative Mr. Speaker that my Government along with the Governor, the Deputy Governor, the Chief Medical Officer, the Medical Officer of Health and others all agreed that saving the lives and the health of our people had to be at the forefront of Government’s decisions and actions. We saw what was playing out in much larger countries that had many more resources than us, yet we were determined that our fate would be different.
Many thoughts went through my mind in those early days and I, like many of you Mr. Speaker, got very little sleep, given the hard decisions I knew had to be taken. But often on those nights when I was alone with my thoughts and worries, a quote from Winston Churchill kept returning to me.
“Things are not always right because they are hard. But if they are right, one must not mind if they are also hard".
I have reminded myself of this regularly over the past months as we took the difficult decisions that we needed to take, knowing that what we were doing was hard, but believing that the reasons we were doing them were right.
Whilst the lockdown of the country began in March, Mr. Speaker, Government along with our medical experts had been keeping an eye on COVID-19 from late December 2019 when the virus was detected in Wuhan City in China. By 20 January the Republic of Korea, Thailand and Japan were also reporting cases of the virus.
On 31 January the World Health Organization (WHO) declared the outbreak to be a public health emergency with 9,826 confirmed cases globally then. The virus had now spread to 19 other countries with the global risk assessment level rated as high by the WHO.
So, Mr. Speaker, in late January I and the Health Minister held a cross-Ministerial meeting with Chief Medical Officer Dr. John Lee, and key personnel from the Health Services Authority, the Ministry of Health, the Ministry of Employment and Border Control, the Customs and Border Control Agency, and others, to gauge our readiness to deal with COVID-19 and to explore what was needed for us to do our own testing.
We also discussed the readiness of our health system, including the potential number of beds and ventilators, personal protective equipment, and other equipment that could be needed if the worst was to happen. Our goal was to bring in enough equipment as we could to be better prepared to deal with the virus. And over time we initiated broader plans to help us prepare should COVID-19 inevitably reach our shores.
Meetings were also held with the wider medical community which, like Government, was extremely worried over the potential damage the virus could bring.
On February 3rd we held our first press briefing, which included the Health Minister, Chief Medical Officer Dr. John Lee and Medical Officer for Health Services Dr. Samuel Williams giving the public useful information on the virus and providing assurance that we were preparing to manage the virus when it arrived here. We confirmed that Government had also been working with international public health agencies such as the Pan American Health Organization; the Caribbean Public Health Agency and Public Health England regarding plans and protocols to deal with the virus. Mr. Gary Wong, with Customs and Border Control, also provided the public with an update as to the precautions being taken at our seaports and airports to protect our Islands from COVID-19.
The additional scrutiny at the border assisted our decision on February 26th to deny entry of a cruise ship, the MSC Meraviglia, where a crew member had been isolated with flu-like symptoms. At the time our borders were still open to incoming tourists at the airports and via cruise ships, but we were watchful for anyone with flu-like symptoms.
On Feb 29th, the Costa Luminosa stopped in Grand Cayman. The ship had confirmed to local authorities that no one onboard had any flu-like symptoms. However, there was a 68-year-old passenger who had suffered two heart attacks aboard the ship and was in need of urgent medical care. He was taken to Health City Cayman Islands where he was put in isolation at the facility’s Medical Intensive Care Unit and treated for his cardiac condition.
On 3 March our preparation continued as we activated the National Emergency Operations Centre (NEOC) in anticipation of the national threat posed by the virus. Government also put in place travel restrictions for people coming into the Cayman Islands from mainland China where the virus originated and was rampant, as well as suspending all non-essential official business travel.
Also, in early March we welcomed a consultation team from Public Health England (PHE), led by Ms. Autilia Newton, to discuss our strategies on COVID-19 prevention as well as to support our efforts to upgrade the Health Services Administration laboratory services to enable on-Island testing for COVID-19.
PHE also conducted scientific modelling to predict the likely impact of COVID-19 on the Islands. The results of this were quite sobering and indicated that with no intervention almost 1,000 persons across our Islands could die because of the disease should it strike here as it was doing elsewhere. This bolstered our view that the strategy to be undertaken had to include firm interventions to suppress the virus to save lives and protect the health of a large segment of our population. We instinctively knew that in our small Islands of close-knit communities, saving lives and keeping people healthy had to be our paramount concern.
Mr. Speaker, on March 9th we learned that there were five people at Health City Cayman Islands being tested for the virus - four staff who isolated at home, and the fifth being the cruise visitor from the Costa Luminosa who was a patient at the hospital.
By March 12th it was confirmed that the cruise visitor at Health City was indeed COVID-19 positive. Fortunately four healthcare staff that treated the patient were negative. We awaited one more test result and had also arranged to test more staff from Health City.
The confirmation that we had COVID-19 in the community was indeed a watershed moment for us in the Cayman Islands, as was the death of the cruise visitor two days later on the 14th.
On the afternoon of March 12th we held a press briefing to update the public on events and to again provide assurances that we were taking the situation most seriously. I also advised that Cabinet would hold an emergency meeting the next day to consider various options, including increasing travel bans on more countries and other measures.
I noted then that “We are going to have to make some radical and drastic decisions that are going to impact social behaviour, travel and, indeed, people’s economic circumstances. But we believe that unless we do so, the results will be potentially devastating, indeed tragic, for these Islands. We will not allow, because of a lack of willingness to make hard decisions, the situation to obtain, which is currently the case in places like Italy and the United States.”
Mr. Speaker the words of Churchill had stayed with me - “Things are not always right because they are hard. But if they are right, one must not mind if they are also hard".
Over time Health City would report that some staff had unfortunately tested positive for COVID-19, the hospital was closed for two weeks and staff were quarantined. Fortunately all staff at Health City recovered without complications.
On March 13th His Excellency the Governor, the Health Minister, the Chief Medical Officer Dr. Lee and I updated the public on Government’s response to suppress and eventually eliminate the virus from our shores. These measures included:
· A further ban on travel from those countries that presented a risk given the high number of growing infections, hospitalizations as well as deaths.
· That effective March 16th we would ban all cruise ship visits, initially for 60 days. This was later amended to start from Sunday, March 15th. All educational institutions would initially close from March 16th until April 27th. Children, as we came to understand, were unwitting ready carriers of the virus.
· A ban was placed on all public gatherings involving more than 50 persons until further notice.
I also advised that there were other interventions under consideration to reduce the risk of the virus gaining ground in our community. These would be advised the following week.
And so on Monday, March 16th, at the press briefing I advised the country that the Government had held a series of meetings over the weekend with representatives of several of the main business sectors. I also confirmed that other similar meetings were planned that week with other business sectors. Discussions focused on the potential implications of the disease on our Islands and the various interventions being considered by Government to suppress the virus. I have to say Mr. Speaker that I was appreciative of the positive, and patriotic, response of our business sector to working with the people of these Islands during a time of crisis.
I also advised the country that Government, along with the Governor, the Chief Medical Officer, and other relevant persons had agreed that other interventions to suppress the virus were needed. These were:
Given what we knew would be challenging economic times ahead I also advised the following:
With the quick closing of borders around the region, several people who wished to leave our shores became stranded here. Thanks to the Governor’s Office we were able to create an important travel air bridge with the United Kingdom using British Airways. Thanks, too Mr. Speaker to the Deputy Premier and Cayman Airways we were also able to organize emergency repatriation flights to the United States and eventually to other regional countries once borders reopened. Both the BA and CAL flights were instrumental in allowing those needing to leave the Islands to do so, and for those residents stranded overseas to return home.
Mr. Speaker to date over 3,000 people have arrived home on the repatriation flights, and 7,460 people, including over 1,600 Caymanians, have departed these shores. Mr. Speaker, I am told that included in the arrivals are 1,307 Caymanians, 1,226 residents, and 225 visitors who have arrived so far this month. These repatriation flights will continue for the next few months but we do anticipate that over time other airlines will also fly in as CAL and BA move back to commercial flights with necessary safeguards in place.
Mr. Speaker we knew the closing of our airports and seaports, save for cargo, mail and express delivery services would cause economic hardship for people, businesses, and eventually even Government. But this was unavoidable if we were to sufficiently suppress the virus.
By March 23rd the number of positive cases locally had increased and many residents, particularly students, were returning home from countries with large numbers of COVID-19 cases. Government mandated the set-up of quarantine facilities with the assistance of several hotel properties. The protocol of testing those quarantined prior to release was also implemented. This testing, coupled with mandatory isolation, has helped ensure that we were not allowing imported cases of COVID-19 from readily entering the local population and adding to whatever numbers we had here already. If anyone still doubts the wisdom of this I can say today that almost every flight that has brought people here has had COVID-19 positive persons onboard.
By this point there were a number of strategies being advised by the World Health Organization that Government, the Chief Medical Officer and our health officer thought sensible, including the need for social distancing to suppress the virus. The virus spreads easiest when people are in proximity to each other – keeping people apart as much as possible was necessary to prevent the virus moving from one person to the other. We saw this work in China, as they locked down, as well as in other parts of Asia and Europe.
On March 24th as ‘shelter in place’ measures were being introduced to keep people home so as to help protect lives, we had our first suspected case of community spread of the virus. Community spread was later confirmed on March 31st. This was another watershed moment for us. The new measures taken to suppress further community spread included night time curfews across all three Islands and further limiting the number of persons allowed to congregate to 10. There were exemptions for some businesses - supermarkets for example. Public transport was also shut down. Restrictions were placed on those able to visit our hospitals, elderly care facilities and prisons in order to protect these at-risk communities.
An entity we called Curfew Time was created as the competent authority responsible for deciding and issuing exemptions that allowed businesses and their staffs to operate legally and move about during curfew hours. An Online Self-Assessment Tool was also launched to help people understand whether they were experiencing any COVID-19 like symptoms. This was in addition to the COVID-19 telephone hotline that was set up.
On 28 March new shelter in place public health regulations were issued bringing into effect what came to be called a soft curfew during the day. These regulations mandated that individuals should remain at home unless they were either exempted persons under the regulations or determined exempt by Curfew Time. Individuals were also allowed to travel to essential places such as supermarkets, banks and pharmacies on certain days and between certain hours of the day. Exceptions for daily exercise were also allowed and later fishing from shore was added. Night time mandatory curfews became known as the ‘hard curfew’.
I am grateful to the Royal Cayman Islands Police Service and in particular Commissioner Byrnes and Customs and Border Control and all those who assisted in patrolling our streets, watching over us from the sky, and for manning roadblocks and check points to ensure that no one was out and about in breach of the soft curfew or night time hard curfew.
By April 1st confirmed COVID-19 cases had grown to 22, and so Mr. Speaker we increased restrictions further to better protect health and lives. During the first full week of April the alphabet system that had previously been adopted to restrict the days people could shop at supermarkets was expanded to almost all activity in the Cayman Islands, allowing people to go out for essential services based on the start of their surname. Everyone was under full lockdown for the days of the week that didn’t allow them out, save for purchase of food or medical reasons, with Sunday being a hard curfew day for all.
These curfews were part of a multi-pronged strategy to keep people apart and to limit the density of people congregating so as to suppress the virus. The other part of the strategy involved ramping up our testing capability.
April had challenges with the first COVID-19 case on Cayman Brac reported, followed by our decision to close public beaches indefinitely on 13 April. Regrettably Mr. Speaker there were too many people not appreciating the risk and who were behaving irresponsibly on beaches. Mr. Speaker, we had seen what had happened in the US when beaches remained open, people acted irresponsibly and new cases of the virus spiked afterwards. Keeping beaches open was not worth the risk.
It was also in April that we had another watershed moment with the purchase of 200,000 test kits from South Korea at a cost of $4.4 Million US dollars. The purchase of these kits came about with the help of several people including those who assisted us in making the initial contacts in South Korea, the Governor’s office, the British Embassy in Seoul and two benefactors who helped toward the purchase and shipping costs of the test kits. This purchase was important and allowed us the ability to increase our testing strategy beyond those who were symptomatic or who we thought potentially had COVID-19.
On 21 April we began mass testing for the virus on all frontline staffs and on 28 April a British Airways flight brought us extraction kits and swabs, which along with equipment already on-Island, provided support for the mass testing protocol. It was my belief that the results from the mass testing would reveal that the percentage of positive rates would be reduced. By the end of April our beloved Islands had the fourth-highest per-capita COVID-19 testing rate in the Caribbean and we were number 46 in the world among a list of 173 countries that were testing. At that point 1.4 per cent of our population had been tested, giving us a higher testing rate than the Netherlands, Sweden, France and the United Kingdom. By 6 June we were approaching the important milestone of having 20 per cent of our population tested, putting us in the top three countries in the world for per-capita-testing. That put us in a very good place.
Having implemented in March and April the measures needed to suppress the virus we also started to think about the conditions that would allow us to be able to reverse the restrictions. We knew that any removal of restrictions had to be done in a phased manner, allowing a minimum of two weeks before further changes so that we could detect any increases in the numbers of people infected. Our planning recognised five broad suppression levels from Level 5 Maximum Suppression (where we were then at) to Level 4 High Suppression, Level 3 Moderate Suppression, Level 2 Minimal Suppression and Level 1 All Clear.In moving between these levels we also had to be confident that our medical community was prepared to manage any increases in positive cases that might occur as more people interacted with each other. By this time not only had we increased our testing capacity, but we had increased the number of emergency beds available to us as well as available respirators and Personal Protection Equipment.