Pregnant health staff among 9 deaths as Fiji imposes new movement rules

Health officials recently carried out another emergency c-section to save a baby after the mother, a 44-year-old healthcare worker contracted COVID-19, dying days later, one of nine new deaths announced today as the Ministry of Health imposes new movement restrictions, including revised curfew hours in the West and a requirement to be fully vaxxed, for more than 14 days, to travel within Fiji.

Permanent Secretary for Health Dr James Fong said the healthcare worker, who was not vaccinated, also had other pregnancy-related complications prompting the c-section delivery to facilitate the baby’s survival. The healthcare worker died five days later stemming from complications linked to COVID-19. Her baby is said to be recovering well.

She is the third COVID-19 positive pregnant mum to have suffered the same fate in the outbreak. She is also not the first healthcare worker to have died from the virus in the outbreak and is unlikely to be the last, according to Dr Fong.

“In the past weeks, a fellow doctor also succumbed to COVID 19 and we may, unfortunately, see more of our fellow health workers and front liners get severe disease in the near future,” Dr Fong said.

“In our daily statements, we talk about the daily toll in terms of cases and lives lost. The toll in terms of mental and social suffering is high. Frontline health workers are integral to the global response to COVID-19. In hospitals, clinics and homes around the world, health workers are taking on significant personal risks. This is the same in Fiji.

“This current crisis is demonstrating the essential, tireless, innovative and too-often undervalued role of health workers and our frontline colleagues in ensuring strong, resilient health systems for everyone, everywhere. They work long hours, sacrifice time with their families, and endure the stresses that this pandemic places upon them as individuals, professionals, and the entire health system. Delivering health services in an environment of constrained resources will often mean providing access to life-saving care at the expense of comfort. Maintaining sensitivity and empathy during the provision of service has never been more important.

“This virus has and will continue to affect our health care workers from community transmission and through the course of duty. We know that community transmission in Suva-Nausori is at such a high level, that it is more likely that a healthcare worker will pick up the virus in the community than in the hospital when they are wearing full personal protective equipment.”

Changes made within the MOH to respond to widespread transmission

Dr Fong said in light of the changed approach in the central division from a containment one to mitigation, the ministry has had to make changes to the workings of their healthcare teams to ensure they are fully protected.

“We have transitioned from having our health care teams working in work bubbles during the Containment phase, to our current Mitigation phase strategy of escalating the infection prevention and control measures and personal protection measures to ensure that all potential and known exposures to COVID 19 cases are as low risk as humanly possible.

“We have reorganized our PPE distribution program to ensure that the large stocks we have are always readily available to all health care workers at the frontline, especially those who work in Critical Care Units and Emergency Departments. “

The ministry has also made sure that health care workers are vaccinated, well trained in PPE use and are diligent in helping each other maintain PPE discipline in the workplace, in order to maintain health worker numbers in all our health facilities.

Recoveries as a result of early presentation and care

At the FEMAT Hospital, 70% of patients with significant COVID disease return to their homes after receiving care, 20% are referred to CWM; and, 10% had arrived too late.

In CWM more than 60% of cases with severe disease have recovered with most of the deaths occurring in persons with associated severe comorbidities.

The Maternity Unit of CWM has seen close to 400 cases of COVID 19 admissions since June with 12 of the cases reaching the severe stages of the disease. All but three have recovered.

“The underlying theme in all these recoveries from significant COVID-19 disease is that we were given the opportunity to deal with them early either by admitting the highly vulnerable positive case and monitoring them or supporting a home monitoring program that allowed timely retrieval.”

Details of 9 new deaths

  • 44-year-old pregnant woman, Suva.
    • Presented to a medical facility on 16 July with shortness of breath and chest pain.
    • She was retrieved by a medical team to the CWM hospital.
    • She was assessed by specialists and her baby was safely delivered by emergency caesarean section on 18 July.
    • She died 5 days after admission on 21 July.
    • She was not vaccinated.
  • 72-year-old man, Muanikoso
    • Died at home on 23 July.
    • He was not vaccinated.
    • 50-year-old man, Suva
    • Died at home on 25 July
    • Partly vaxxed having received his first dose in late May.
  • 61-year-old woman, Tacirua.
    • Presented to a health facility in severe respiratory distress.
    • Retrieved her from the medical facility to CWM Hospital.
    • Her condition worsened at the health facility and she died 11 days after admission on 24 July.
    • Her family reported that she had a cough, fever, shortness of breath and a reduced appetite one week prior.
    • She was not vaccinated.
  • 62-year-old man, Suva
    • Died at home on 24 July
    • He was not vaccinated.
  • 60-year-old woman, Vatuwaqa
    • Died at home on 24 July.
    • She was not vaccinated.
  • 75-year-old man, Nausori.
    • Presented to a medical facility in severe respiratory distress.
    • He died on the same day 24 July.
    • He was not vaccinated.
  • 74-year-old man, Nasova
    • Died at home on 24 July.
    • He was not vaccinated.
  • 53-year-old man, Naitasiri
    • Died at home on 23 July.
    • He was not vaccinated.

Vaccination Status of deaths

To date, 280 people have died – 186 due to COVID-19 (184 in the current outbreak and two in 2020) and 94 due to pre-existing illnesses.

According to Dr Fong, “nobody who has been fully vaccinated against COVID19 has died in Fiji.”

New movement restrictions (effective tomorrow, Monday 26 July)

  1. All unnecessary movements in the West should stop. Please stay home as much as possible.
    1. Movement outside your home must only be for approved employment purposes, medical purposes or to get groceries.
    2. To facilitate this the curfew hours throughout the Western division will begin from 6 pm and end at 4 am.

2. All movements from the Central Division to the Western Division will be assessed on a case by case basis and higher priority for approval will be given to those who have completed 14 days after the second dose of the vaccine.

3. All movements from the Viti Levu to the Northern Division and maritime islands will be assessed on a case by case basis and higher priority for approval will be given to those who have completed 14 days after the second dose of the vaccine.

New COVID19 cases today

626 new cases of COVID-19 reported for the 24 hour period that ended at 8 am today. Of this, 79 cases are from the West and the rest are from the Central Division.

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