Ministerial Statement by the Minister of Health, the Hon. Kim Wilson, JP MP

Mr Speaker and Honourable Members,

I know everyone in Bermuda is getting into a state of preparedness for the potential arrival of Covid-19 to our shores. I want to give this House and my Honourable colleagues assurance that the Government is taking proactive steps to effectively respond to this global outbreak.

Some persons may be aware that the Office of the Chief Medical Officer is ordinarily a small team. However, additional staff have been seconded to the Ministry of Health from elsewhere in Government and the Bermuda Hospitals Board to provide additional manpower. Consequently, there is a growing team fully engaged in getting the country ready.  For example, I can share that among the steps completed by the team.

Hand sanitizers have been ordered, which will contribute to the essential hand hygiene needed to protect ourselves and prevent spread. Though we have to remember, of course, that good old fashioned soap and water achieve the same aim, so wash your hands often and well.

To underscore the importance of hand washing, a video has been produced and disseminated regarding good hand hygiene.

The Office of the Chief Medical Officer has provided guidance to various business organizations across the island, including the Association of Bermuda International Companies (ABIC), the Association of Bermuda Insurers and Reinsurers (ABIR) and the Bermuda Chamber of Commerce, stating actions which can be taken by the business community to help respond to the emerging public health threat COVID-19.

The 911 telephone operators have adjusted their ordinary protocols with enhanced questioning of callers, in order to deal with situations involving a possible case of COVID-19, to ensure that everyone gets the right services and the right care by deploying the appropriate emergency services.

At the airport, there is a Public Health Nurse covering every incoming flight. Additionally, supported by their senior managers, customs officers have been questioning arriving travellers asking the appropriate travel history and health related questions of incoming passengers in order to identify any person needing additional public health follow up.  

A poster has been sent to healthcare facilities to print and display on their doors, advising individuals with respiratory symptoms and/or a relevant travel history to call ahead before entering the premises, in an effort to limit any potential exposure risks to others.

Mr Speaker, I truly have to emphasize this point: if you have fever, cough and difficulty breathing call your healthcare provider promptly and share your previous travel history. It is important to remember to call first...don't just show up.

In addition, Mr Speaker, the Government has created a poster detailing COVID-19 prevention tips. The Ministry of Health is encouraging people to print and display the poster in their workplaces, community clubs and public bulletin boards. This was issued with a previous press release but it is on our website for persons to print and display.

Religious organizations were sent guidance to share with their congregations to assist in spreading the word about preventive measures the population can take now.

Long term care facilities have also been sent guidance and information to assist them in handling questions and prepare. And a further document has been created entitled, "Guidance for hotels, guest houses, and Airbnb Operators in Bermuda". 

Mr Speaker, the Government has been actively planning for cruise ship season based on the threat of COVID-19. All cruise ship lines serving Bermuda have been contacted and they have shared their individual policies for the health screening of passengers. By liaising closely with shipping agents, Government personnel are preparing for the planned arrival of cruise ships to the island.

Under the International Health Regulations, all ships must forward a Declaration of Health (form) to the Department of Health which must be received at least 24 hours before the ship’s arrival. The declaration will detail any instances of infectious diseases on-board and lists any previous ports of call. By having this information in advance we can make decisions based on risk assessments and in-line with the International Health Regulations as to whether or not we need to intervene in any way. We also carry out full inspections of cruise ships on request in order to issue Ship Sanitation Certificates.

Mr Speaker, I have to highlight a reminder that all arriving travellers will undergo a travel risk assessment upon entry into Bermuda and could have their health monitored and movement on island restricted for up to 14 days.

Those who have spent time in jurisdictions considered at very high risk will be given health instructions for follow-up and monitoring for 14 days.  There are government officers at all ports of entry to assist with managing the situation and port officials are in continuous communication with the Ministry of Health's Epidemiology and Surveillance Unit (ESU).

Travel advice for residents and visitors is updated daily on the Government's website. Please read the advisories before you decide to travel. We have been updating information to the public on a daily basis to try to ensure everyone knows how to prepare and what to expect.

I also want to stress, Mr Speaker, that preparing for and managing a potential outbreak is not a one-agency undertaking. The Ministry of Health is working closely with stakeholders from different disciplines and sectors of society to plan and prepare for this global risk. The Ministry’s Public Health Emergency Response Team (or PHERT) includes representatives from Customs, Immigration, Skyport and Cedar Aviation to ensure all parties are working collaboratively.

In addition,  the hospital has been under active preparations to deal with a potential seriously ill and critically ill COVID19 patients in Bermuda.

BHB has escalation plans in place, which identify options for Emergency, Intensive Care Unit and Acute Care Wards to cope with an influx of patients in the event of a pandemic.

Plans are in place to increase bed capacity if needed, such as postponing elective surgeries, discharging stable patients, and using additional beds in other areas.

There are negative pressure rooms in Emergency and on each floor of the Acute Care Wing. Negative pressure rooms stop the air flowing out of patient rooms, keeping the rest of the hospital safe. 

The hospital also has an entire floor –30 beds– with an independent air filtration system which can potentially be used for cases, should that need arise.

Mr Speaker, I remind the public again that it will be critical for people who can be cared for at home to stay there, so that hospital services can focus on those most in need. No one with COVID-19 symptoms should turn up at the hospital without calling ahead first to inform healthcare personnel of their symptoms and receive advice on next steps. The hospital has seniors and people with existing medical conditions who are more susceptible to infection.

Moving on, Mr Speaker, in addition there are a number of activities underway which should be completed imminently or in the near future, including the following:

The Government is in the process of enabling duty relief measures for hand sanitizers, N95 masks and other personal protective equipment in the fight against influenza and COVID-19. Once implemented, the duty relief will apply to items imported. An announcement will be made once it is in place.

With respect to N95 masks, Bermuda does have a supply for a majority of health personnel and we are in the process of ordering more. It is well known that these masks are in global short supply but we are working to acquire masks as quickly as possible through our international partners.

Nevertheless, it should be noted that the use of face masks during outbreaks of viral illnesses such as COVID-19 has only been shown in scientific studies to be effective for protecting healthcare workers and to reduce the risk of sick patients spreading the disease. Based on that evidence, the World Health Organization recommends the use of face masks by:

• People who have respiratory symptoms such as coughing, sneezing or difficulty breathing;
• People who are providing care to individuals with respiratory symptoms; and
• Healthcare workers, when entering a room with patients or treating an individual with respiratory symptoms.

Mr Speaker, I have to stress that wearing a face mask alone is not guaranteed to stop infections in any of these circumstances and should be combined with other personal protective measures, such as hand hygiene and keeping your distance from people with symptoms.

In addition, a Rapid Response Team of doctors and nurses will be created in collaboration with community healthcare professionals to increase capacity for detection of potential cases of COVID-19. 

Furthermore, additional nurses are currently undergoing training to deal with investigation and case management when there are suspect cases in the community.

As I have indicted previously, Bermuda currently sends all our tests to the Caribbean Public Health Agency to obtain scientifically valid, true and reliable results that will protect individuals and the community. Four to five days is the standard turnaround time to get a valid result and so far Bermuda has done eight tests to date – the three results received were all negative and we await the others. Mr Speaker, I would like to reiterate that currently there is no commercially available scientifically valid rapid test that can provide instant results in the world.  However, we are exploring additional testing options in collaboration with local and international partners, and the Government will ensure that tests can be conducted locally at the earliest opportunity.

Finally, Mr Speaker, we continue to work on identifying a suitable quarantine facility for the potential incidence of persons who are well enough to self-quarantine but are not residents. And the COVID-19 helpline remains in development as this is a much-needed resource for the concerned public.

Mr Speaker, I want to remind us all that while there are many unknowns about COVID-19, experience to date indicates that about 80% of people only have mild to no symptoms and will not need hospital care at all.

Of the rest, a portion will be able to receive medical care at home; and a small percentage may need critical care services with intensive medical management.  Therefore, we do not anticipate a situation with COVID-19 that would require the large populations to be relocated.

Mr Speaker, in the event that a case is identified locally, the Ministry of Health will inform the public immediately. We have received several media queries and seen social media posts falsely alleging the existence of local cases. This is categorically untrue and the public should remember that such information would only come from the Ministry of Health.

However, in the event of a local case, the way to protect ourselves and prevent community transmission will be to heed the orders from public health professionals, remain isolated as instructed and practice the simple measures extensively stressed already:

• Frequent hand-washing with soap and water or use of hand sanitizers,
• Cough into your elbow or tissue,
• Frequent disinfection of surfaces,
• Avoid close contact with  anyone with cough and fever symptoms,
• And, if you have fever, cough or difficulty breathing call your health care provider...don't just show up!

Mr Speaker, this is a matter of utmost seriousness and it is a time for calm, rational action. Just like we prepare when a hurricane is coming by calmly getting our homes and supplies ready, so too we should engage in calm and measured preparations for a potential Covid-19 arrival. This is not a time for panicked actions or irrational fears. The biggest thing we have to fear is fear itself. Remaining calm in our actions and steadfast in our preparations will ensure that we can properly and successfully manage this global situation.

Thank you, Mr Speaker