Bermuda Government COVID-19 Update January 12th

Bermuda Government Weekly COVID-19 Update Press Conference

Good Evening Bermuda,

Apologies for the late start this evening. Yesterday, our island reached a significant milestone in our fight against the Coronavirus with the vaccination programme getting underway here in Bermuda.

The Minister of Health, the Hon. Kim Wilson, the Opposition Leader Mr. Cole Simons, the Government’s Science Advisor Dr. Carika Weldon, seniors, essential workers and I received our first dose of the Pfizer-BioNTech vaccine.

Our decision to take the vaccine was to lead by example, and to build public trust. I am confident that this vaccine is safe, effective, and it is vital in our fight against the Coronavirus. I want to thank the professional and friendly team at the Vaccination Centre for making the experience as comfortable as possible, and congratulate the Team at the Ministry of Health for working to put together a smooth process.

Thanks must also go to Government House, who has supplied Vaccines and equipment. This was worked on by the former Governor, Deputy Governor and our current Governor – Her Excellency Rena Lalgie.

Today, I am joined by the Minister of Health, the Hon. Kim Wilson, who will provide you with an update from her Ministry; Dr. Carika Weldon is also here and will speak about the science and development of the vaccine and how it works in the body and discuss genetic sequencing of the virus.

Minister….

Good Afternoon,

There were 813 test results received by the Ministry of Health since the last update and five were positive for COVID-19. All of the new cases are classified as imported with details as follows:

  • 1 resident who arrived on Delta 584 from Atlanta on 6 January 2021 and tested positive on their day 4 test
  • 2 residents who arrived on Jet Blue 62231 from New York on 10 January 2021 and tested positive on their arrival test
  • 2 residents who arrived on American Airlines 308 from Miami on 10 January 2021 and tested positive on their arrival test

Additionally, since the last update, four cases have recovered.

There are 91 active cases, of which;

•        84 are under public health monitoring and

•        7 are in hospital with 1 in critical care;

Since March 2020, Bermuda has recorded 661 total confirmed cases of COVID-19; out of those, 558 persons have recovered, and 12 persons have sadly succumbed to COVID-19.

The mean age of all confirmed positive cases is 43 years (median: 40 years), and the age range is less than 1 year to greater than 100 years.

The mean age of all currently active cases is 43 years (median: 44 years), and the age range is less than 10 years (age group: 5-9 years) to greater than 80 years (age group: 80-100 years).

The mean age of all currently hospitalized cases is 57 years (median: 54 years), and the age range is less than 30 years (age group: 20-29 years) to greater than 80 years (age group: 80-100 years).

The mean age of all deceased cases is 75 years (median: 77 years), and the age range is less than 60 years (age group: 50-59 years) to greater than 80 years (age group: 80-100 years).

The source of all cases is as follows:

  •  179 are Imported
  • 445 are classified as local transmission of which:
    • 385 are Local transmission with known contact/source and
    • 60 are Local transmission with an unknown contact/source
    • 37 are Under Investigation

As investigations proceed, transmission categories may change.  Today’s update has 2 cases moving from under investigation to local transmission with unknown contact/source.

The seven-day average of our real time reproduction number is less than 1 (0.62), and Bermuda’s current country status remains “Clusters of Cases”.

And now on to the exciting news of our COVID-19 vaccine.

I’m thrilled to have seen the very first COVID-19 vaccines provided yesterday by our Ministry of Health team. The vaccine is the hope that we’ve all been looking for in the midst of this pandemic that has cost lives to loved ones, family gatherings, our activities, schooling of our children, and so many other sacrifices.

As we begin the rollout of the vaccine, I know many in our community have been registering their interest. Thank you Thank you Thank you. It is so good to see much interest in getting the vaccine. Our vaccine strategy has been developed based on international best practices, and it has prioritized groups who are most at risk from getting sick from COVID-19.

Our first phase, Phase 1A, is the staff and residents of our long term care facilities such as residence of the Extended Care Unit of the Hospital. For nursing homes and assisted living centres, we are training their nurses to administer the vaccine to those who volunteer to be vaccinated.

This group has had to sacrifice, even more than most during the pandemic. Our elders have struggled with extreme restrictions on their activities, visits from their families, and social activities we take for granted. The staff has also made tremendous sacrifices for their jobs, and we wish to ensure that the vaccinations are given to this group who truly can benefit so much from the protection that the vaccine can provide.

We will also prioritize our frontline healthcare and frontline essential workers. In this context, healthcare workers include all employees of the Bermuda Hospitals Board along with frontline workers from the Department of Health and those employed in the private healthcare industry. Frontline essential workers are those who provide services which prevent social disruption and allow society to function, and who are at risk for higher levels of exposure to COVID-19. These include firemen, police, corrections officers, personnel at the ports of entry, and teachers. People who are 80 years or older are also encouraged to be vaccinated in this first group as well.

Phase 1B: the second group will comprise those over the age of 65, but priority will continue to be given to those who are over the age of 80. This group will focus on those who are clinically extremely vulnerable and the clinically extremely vulnerable people who have:

  • a suppressed immune system such as during and after chemotherapy or after an organ transplant,
  • lupus,
  • severe asthma,
  • Severe COPD.

Phase 2: The third group will be those over the age of 50, again prioritised by those who are clinically vulnerable. Clinically vulnerable are those who suffer with:

  • heart disease,
  • chronic kidney disease,
  • liver disease, and,
  • diabetes.

Following that, the vaccine will be available to everyone over the age of 18 (or over 16 with parental consent) in Phase 3.

If you have questions about whether you are clinically vulnerable, I encourage you to talk directly with your primary care physician for advice.

If you have questions about the vaccination process or if you would like to register your interest in getting vaccinated, please call the COVID-19 Vaccine Hotline at 444-2498, selecting option #2, or fill out the convenient on-line form at https://forms.gov.bm/covidvaccine. If you have any questions about the vaccine itself, I invite you to visit www.gov.bm/vaccines.

As has been reported, the vaccine hotline was overwhelmed with calls yesterday from residents who wish to register their interest in being vaccinated. We had some 700 calls of persons wishing to register to be vaccinated.

This did create a bottleneck in the registration process, and the online form will allow residents to register their interest easily, efficiently, and far more conveniently.

The vaccine registration form asks basic information such as your name, date of birth, address, occupation, and whether you have any pre-existing conditions. Filling out the form should take approximately two minutes, and it is important to note that the information that you enter will be kept private with the Government of Bermuda.

It is also important to emphasize that registering your interest does not guarantee you an appointment at this time. Supplies of the initial delivery of vaccine are limited and must be allocated based on medical need. All submissions will be reviewed by our medical personnel and prioritized based on their assessments. When you submit your registration form, you will receive an auto generated submission receipt. Your submission will be kept on file and you will be contacted as appointments become available. Every submission will be sorted and there is no need for you to re-submit. We do ask that people who registered be patient as we work through all submissions and allocate the appointments.

As of 4:30pm today, the vaccine teams had received 1885 online registration forms and more than 800 email registrations. This does not include vaccine registrations being facilitated by key contact persons representing the fire, the police, corrections offices, ports of entry staff and teachers.

Please do not register your interest if you:

  •  have had any other vaccinations within the last month, as you will need to wait for 30 days;
  • have recently traveled and do not yet have your negative 14 day travel test results;
  • if you are receiving a therapy for any medical conditions as you must consult with your doctor prior to registering your interest; and
  • are in quarantine as you of course must complete your quarantine first.
  • If you have any questions about the vaccine itself – how it works, what side effects there might be, or how it came to be developed quickly and safely, I invite you to visit www.gov.bm/vaccines.

There has been speculation and commentary on various social media platforms about how long the first batch of vaccines will last and when the next delivery is expected. Please understand that we cannot give an exact timeline as there are many variables, such as the uptake within the various groups, and the percentage of individuals in these groups who get their second dose when they have been scheduled to do so. As it stands now, we expect the first batch to be fully deployed by the end of March.

With regards to when the next delivery is expected. The ministry is working diligently with GAVI through the Covax facility to determine the arrival date. We are in qualifying discussions now because the facility may be in a position to initiate a small scale ‘first wave’ of deliveries using the Pfizer vaccine in March, if Bermuda meets the stringent criteria outlined for this initial small scale ‘first wave’.

I want to remind everyone that vaccines save millions of lives globally every year, and have done so for over a century. In Bermuda, there has been a robust vaccination programme in place for decades, and as a result we have seen dramatic decreases in the prevalence of vaccine preventable diseases.

I got vaccinated yesterday, as did the Premier, Dr. Carika Weldon and many others – more than 550 in these first two days! We trust the science, and we are confident that this vaccine is safe. So far, I am encouraged by the outpouring of people registering for the vaccine. It was overwhelming at the call centre at first, but we have since increased our resources to handle the demand, and as I mentioned earlier, we have set up a convenient on-line form to register for the vaccine – https://forms.gov.bm/covidvaccine.

I want to congratulate Dr. Heather Armstrong and the entire vaccination rollout team who put together the plan for Bermuda’s COVID-19 vaccination program.  A tremendous amount of work has been done to get here, and we want to vaccinate as many people as possible so that we can help protect them, their loved ones, and also, help the Island to achieve herd immunity. According to most experts, if we are able to vaccinate 60 – 70% of the population, we can halt the transmission and spread of the virus. That is our goal.

Finally, I want to also remind everyone that the Ministry of Health is hosting ‘Vaccine Awareness – Join the Conversation’ on the Government’s Facebook page, YouTube, and CITV, live, Saturday, 16 January 2021, at 6 pm. This is an excellent opportunity for those who may have questions about the COVID-19 vaccine specifically, and vaccines in general. This programme will allow viewers to post their questions online to have them answered by medical professionals.

Until we achieve herd immunity, though, don’t forget we must continue to avoid the 3Cs: closed spaces, crowded places and close-contact settings.

Thank you Minister, and thanks again to your team for their hard work.

I would also like to extend my condolences to the family who, since our last press conference, so tragically lost their loved one in the latest covid-related death. We as a country must continue our collective efforts so that less families have to say goodbye to their loved ones before their time.

The Government’s science advisor, Dr. Carika Weldon, will now speak about the science  and development of the vaccine and how retractable needles work, and also the results from our first round of genetic sequencing, Dr Walden.

Dr. Weldon…

Good Evening Bermuda, I am pleased to share with you about how the COVID-19 vaccine works, how it was fast-tracked, and the first viral genome sequencing data.

As we all know, Bermuda’s COVID-19 vaccination program started yesterday, after vaccines arrived on island last Friday.

How the mRNA vaccine works

A vaccine typically uses a dead or weakened version of the virus to trigger the body’s immune system to create the antibodies against it. Antibodies are the body’s line of defence against any foreign intruder. Overall, they lead the body to trigger an immune response resulting in the destruction of the 2 disease-causing agent. If a vaccinated person gets infected with the disease, their body is equipped to fight it off fast and prevent sickness. Although most people do not get sick, some still do as the weakened virus can still cause disease. This method has been used since 1796.

To address this issue of vaccination causing the disease, mRNA vaccine have been pursued since the year I was born, in 1990. Using this method prevents someone getting the disease as it gives your body the instructions needed to create a small piece of the virus. This small part that your body will trigger the immune system but cannot give you the disease.

mRNA is a type of RNA, or ribonucleic acid, that is naturally occurring in our bodies. The m in mRNA stands for messenger and plays a central role in how our body operates.

We have all heard of DNA. DNA is the code of life. It is kept safe in each cell in the nucleus to prevent harm or damage. DNA holds the instructions on how to make every part of our body in the form of protein. In order for DNA to make protein 3 the message needs to be carried from the nucleus to the protein making part of the cell; this message is carried by mRNA. This whole process is called the Central Dogma of Molecular Biology.

I will use a cooking analogy to explain this further. We all have our treasured family recipes that have been passed down generation to generation. This cookbook is kept extremely safe as we want to pass it down further to future generations. This cookbook is like our DNA. I know in my family, farine pie is our secret family recipe. Although as nice as the recipe is on its own, we cannot eat the recipe book with the instructions. We have no make the farine pie in order to eat it.

Bearing in mind that we do not want to put the safety of the cookbook at risk, what we do is copy, or write, or transcribe, the same instruction onto an index card. This way we can get the recipe but do not have to worry about destroying the treasured cookbook. We can also even make multiple copies of this recipe on the many index cards and share with the whole famiy. The index card copy of the recipe is like our mRNA.

Now again, having these mobile versions of the recipe is safer, but we cannot eat it. We must still translate the instructionsinto a tangible form of the farine pie we so love. This involves adding step by step what is needed and ultimately we have the finished product. The farine pie is like all proteins in our body, which are the final products our DNA is holding the instructions for.

This process happens for each and everything made in our body. It is happening right now as I speak. mRNA is the key to it all happening as otherwise the key DNA instruction would not make it to the place where the protein can be made.

A vaccine’s aim is to provide active acquired immunity. It is active, as opposed to passive, because your body has to do some work to make you immune. It is acquired as its specific to infectious diseases your body has fought before, as opposed to innate which is a more general to anything that is foreign in your body. The vaccine Bermuda is currently using for its vaccination program is the Pfizer mRNA vaccine. It provides the instructions to make the outer spike (or S) protein of COVID-19 virus. This spike protein coats the outside of the 5 virus and is how it latches to the respiratory tract of those with COVID-19.

By providing the instructions for making part of the virus, our bodies can make the Spike protein ourselves, and then trigger the immune system to create antibodies for any potential future infections.

As you may know, I along with the leaders of our country, received the vaccine on live TV. I am feeling fine, and only suffer from a sore arm where the needle entered my arm. Our healthcare professionals have a very thoughtful safe process which utilizes best practice. This includes a retractable needle.

During my PhD days I had to routinely use a syringe and needle for some of my experiments. These were not retractable and unfortunately a few times I stuck myself with the open needle. It was painful, happened quicky and ultimately stopped my experiments for the day. I commend the Ministry of Health for making the decision to avoid this potential harm.

How the mRNA vaccine was fast-tracked

Only a year ago, the world was what we call normal, and we had only just heard about a new virus that was affecting China. Today we have a vaccine that can fight against this virus and this is a true feat of many decades of science. There are concerns on how these vaccines could approved so quickly and the following points will address this.

  1. Academic research on coronaviruses and mRNA vaccines has been ongoing for decades. As stated before, mRNA vaccines have been studied since 1990. Coronaviruses like SARS and MERS have been studied for decades as well. Once the new SARS-CoV-2 sequence was published in January, the work could for this specific vaccine could be started. This is also why COVID-19 PCR testing was available a few days after the sequence was shared. Another factor that usually stalls research is the lack of funding. Due to the pandemic status, this barrier was practically non-existent.
  2. Safety and efficacy trials which usually happen subsequently, happened concurrently. Other phase 1 and preclinical studies that showed mRNA vaccine platforms were safe was used to approve this approach. Just like every other scientific and medical advancement, Pfizer’s large study had to undergo external peer review and another external review to be published in the prestigious New England Journal of Medicine. The goal of each of these independent review teams is to scrutinize the data inside and out to identify problems before giving approval. It is highly unlikely that all of them overlooked a problem related to safety and efficacy.
  3. Manufacturing and distribution planning happened concurrently with the trials. With much anticipation that the vaccine would be approved at some point, these steps were already discussed to ensure quick turnaround from approval to distribution.
  4. Emergency approval given due to urgency – same as all COVID-19 test kits. Approval not given if unsafe or risks outweigh benefits. Two independent mRNA vaccines 8 produced by competing companies both showing safe data also strengthened the approval process.

Viral genome sequencing

There are three types of testing WHO recommend: RT-qPCR test, which we currently used to diagnose infection, serological or antibody testing, which is currently used to aid epidemiological investigations, and viral genome sequencing.

I am excited to inform that Bermuda has its first viral genome sequencing data and that I will share some key findings thus far.

Just as we can identify each person with their unique fingerprint, each person’s DNA is also unique and can identify them. Viruses don’t have fingers of course, but they do have DNA or RNA that is unique to each one. By doing viral genome sequencing, we can tell strains apart and know how the virus has spread in our community and across the globe.

On October 27th Bermuda had British Airways flight which eventually ended up having 10 positive cases. To investigate this mini-outbreak samples sent to Public Health England for viral sequencing. This includes samples from the flight, along with 12 other samples from around the same time. A total of 21 samples were sent, ranging from cases identified between October 27 – November 18.

Initial analysis of the results show that 8 strains were present on island during this time, with all being imported. 5 of the strains have been imported from the US:

  • B.1.2
  • B.1.234
  • B.1.243
  • B.1.361
  • B.1.369

2 from the UK:

  • B.1.160
  • B.1.177

and 1 from the Asia:

  • •B.1.36

None of the two UK strains are the new variant strain (B.1.1.7) that has caused the new lockdowns in the UK. Both strains identified at the time are both common strains circulating in the UK since March 2020.

Oxford nanopore sequencing will be performed on a portion of the positive samples from mid-November to December, when Bermuda experienced an outbreak in social settings. We will also look to routinely sequencing positive cases to understand how if any further mutations have occurred on island, and aid epidemiological investigations. In addition, samples each month will be sent to CARPHA for sequencing verification, in a similar manner that regular COVID testing is cross verified at CARPHA.

As we continue on with this marathon fight against COVID-19, now having more tools in our toolkit, let us all do our part by following the guidelines that have gotten us all this far, together.

Thank you.

Thank you Dr. Weldon and thank you to your team at the Bermuda Government Molecular Diagnostic Laboratory for all of your commitment and hard work throughout this pandemic, especially during the period of time before Christmas when I’m sure you were testing more samples a day than you ever imagined possible.

Before I begin my remarks, I wish to extend my condolences, on behalf of the Government of Bermuda, to the families who have recently lost loved ones in two tragic incidents on Bermuda’s roads.

Following the vaccination effort that started yesterday, there have been some who have questioned our decision to lead by example and demonstrate our willingness to take the vaccine, due to concerns about our safety.

In response, I would like to address this with two points:

Firstly, we were by no means the first to receive a COVID-19 vaccine. To date more than 10 million people worldwide have taken this vaccine, including over 8 million in the U.S, 2 million in the U.K and millions more across Canada, the E.U and Asia.

Secondly, we as leaders must be willing to lead by example. Our aim was and continues to be to help instil confidence and trust, and to help combat vaccine hesitancy, especially within the black community here in Bermuda.

I appreciate the concern, but there is no need to be worried. We trust the science and we trust our advisors like Dr Weldon, and we can say with confidence that we made the right decision to take this vaccine.

Last week the Government announced an extension of the restrictions already in place.  These restrictions are still in place and will be reviewed by Cabinet next week. However, at this time, there is no expectation that across the board closures will need to be extended.

The Government is also aware of hardships that businesses and individuals are experiencing due to the restrictions that are necessary to control this outbreak.  I reiterate the Government’s commitment to continue to support persons and businesses affected.

The Bermuda Economic Development Corporation has provided grants to support businesses. These grants are to support rent, utilities, employers’ overheads (social insurance & health insurance) to assist businesses affected by closures instituted to control the pandemic. The grant amounts will now be increased due to the extension of the closures announced last week.

In addition, individuals who work in establishments that are required to remain closed, and who were approved for unemployment benefits will have received additional payments from the Ministry of Finance last week following the extension of restrictions.

There is no expectation of a further extension of across the board closures. The Government will continue to work with businesses to share information in advance regarding the precautions required for a safe reopening of businesses.

Yesterday, a story was printed in the Royal Gazette with an inaccurate headline and story regarding taxes on rental income. This story caused concern and alarm with members of the public. The Royal Gazette has since corrected the online version of the story and issued a printed correction in today’s edition of the newspaper.

(Let me be clear) There have not been any discussions regarding the imposition of a tax related to rental income, let alone any decisions made in that effect. It is important that the public know that the headline was not accurate.

What I said was that I expect that the Tax Reform Commission, when appointed, would be able to complete their work so any recommendations that are made, to make our tax system fairer, would be made in time to commence implementation in the next budget cycle 2022/2023. I also provided an example of the fact that there are some persons/families that own dozens of property and pay no taxes on that income, wherein a struggling parent is taxed on income from 3 of their jobs via existing payroll tax.

We are committed to the values of ensuring that our system of taxation is fairer and works better for our workers, and provides even more relief to those persons who need it most by reducing payroll taxes.

As I bring my comments to a close, I wish to express a note of cautious optimism and hope as I did last week…

We now have another vital tool in our arsenal to help to stop the spread of the coronavirus. The vaccine is here, and the vaccine programme is underway. We will use it firstly to protect our seniors and those at high-risk by giving them the opportunity to register, and receive the vaccine if they have chosen to do so.

When we receive additional doses, they will be available to more residents. It is important to note, the vaccine will only be fully effective if a majority of residents choose to take it.

As the Government has stated many times, no one will be forced to take this vaccine, it is not mandatory for anyone. However, I encourage all Bermudians to learn the facts, speak to your doctor – and make responsible, informed decisions. Do not be deceived by misinformation and conspiracy theories.

I hope that seeing me, and my colleagues receiving our first dose has instilled confidence and trust in the effectiveness of the vaccine. But, if seeing us wasn’t enough, I think we can all take confidence from the strength Mr. Horace Rollins showed, who not only took the vaccine for himself, but to protect his wife as well.

Dr. Robert Gibbons, as a medical professional, understands the importance of vaccinations and was more than willing to get the shot along with his wife.  These gestures are the theme that has and must continue to emanate throughout the island as we continue the fight. That the decisions we make are not just about us, but they are about protecting those we care most about and our community.

This week we have taken a big step forward in our battle against the coronavirus, and though we still see some positive cases – today marks the first time in a few weeks that we are able to report no additional cases of local transmission.

Though we have successfully managed the recent outbreak, it is important to remember that since it started we have lost 3 Bermudians, and 8 Bermudians are in the Hospital battling this virus. Our collective decisions impact our fellow families.

We must not become complacent. Please continue to wear your masks, physical distance, adhere to the guidelines and restrictions that are in place, and if you have not yet done so, download the WeHealth Bermuda App which is another tool that will assist our battle.

As always, before I close, I must remind you if you’re feeling overwhelmed or anxious, if you’re a senior who feels isolated, or if you’re caring for loved ones and need someone to talk to the Emotional Well-being Hotline is there for you. The phone number is 543 1111, and the line is operated Monday to Saturday from 5pm to 9pm. Again, that number is 543 1111.

Thanks and I will now take questions from the media….