May 15th COVID-19 Update
Good Afternoon Bermuda. Since the announcement of the end of Shelter in Place and the confirmation that we will adopt a phased approach to our reopening of our economy, there has been much speculation around when we as a country will move to phase two, and what that will look like.
On Wednesday, I shared with you that a Cabinet sub-committee was formed to review our progress and to make a recommendation to the full Cabinet on the timing in moving to phase two. The Cabinet will meet in a special session on Sunday to confirm the full details of what phase two will look like, and the new regulations that will be put into place to ensure that we systematically open our economy. The health and safety of our community remains at the forefront of our approach in the strategy that we execute.
When we announced our multi-phase strategy, we laid out what each phase would look like. For phase two, we stated that our intended expansion of services would include: the reopening of retail establishments with strict physical distancing, and limited allowance of personal services such as hairdressers and barbers with strict restrictions governed by the Ministry of Health, and personal protective equipment use to be required.
I can confirm that this list may be expanded and will perhaps contain some elements originally proposed for phase three. What I have stated above, however, will be at a minimum of what Bermuda can expect to be the essential elements of phase two.
It is my intention that phase two will commence before next weekend but this will be confirmed by the Cabinet on Sunday and will be relayed at Monday’s press conference. The Minister of Health will now present today’s COVID-19 results and an update on the work being performed by her team in the Ministry of Health and also at the Bermuda Hospitals Board. Minister.
The Minister of Health statement
Today there were 244 test results received by the Ministry of Health; and 1 was positive for COVID-19.
As I indicated in a press release yesterday, Bermuda has regrettably lost another victim to COVID-19. My sincere condolences go out to the family and friends of that individual at this difficult time.
Bermuda now has 123 total confirmed positive cases. Their status is as follows:
- there are 45 active cases, of which
- 38 persons are under active public health monitoring, and
- 7 persons are hospitalized; of which
- 2 are in critical care;
- a total of 69 have now recovered, and
- the total deceased is 9.
The average age of all of our confirmed positive cases is 60 and the age range of all of our positive cases is from 18 to 101 years.
The average age of persons hospitalized is 76 and their age ranges from 68 to 89 years.
The average age of all deceased cases is 74 and the age range is 57 to 91 years.
The source of all local cases is as follows:
- 39 are Imported
- 72 are Local transmission, with known contact
- 7 are Local transmission with an unknown contact, and
- 5 are under investigation
While there are some cases for which a contact or source has not been identified, this is not sufficient to constitute community transmission. Therefore, Bermuda’s WHO-assigned country status remains “Local Transmission – Cluster of Cases”.
The plateau in figures shows us that as a country we have done an excellent job of containing COVID-19. This is as good an outcome as we could have hoped for in the midst of a global pandemic. It gives us confidence that the interventions we implemented have had a dramatically positive impact on our management of this pandemic so far.
However, we mustn’t let this good outcome make us complacent. I reported our real-time reproduction number on Wednesday as 0.47… Today, given the recent cases, the reproduction number has gone up to 0.99.
It is still below 1, but the rapid increase is a stark reminder of how volatile the reproduction number is in a tiny population such as ours, and why we cannot rely on it exclusively to inform all of our decisions.
It also reminds us that we have to remain scrupulous with our prevention efforts. This is going to be a long journey… it is up to all of us, to make it through successfully.
I will now provide further statistics regarding the hospital…
There have been 37 admissions for COVID-19 over the pandemic so far. The highest number of COVID-19 patients KEMH has had at any one time is 16. There have been no cases of COVID-19 at the Mid-Atlantic Wellness Institute (MWI).
To date, 536 MWI and KEMH patients have been tested for COVID-19. All patients in two of KEMH’s long term care units have now been tested.
There have been 60 surgeries (emergency, urgent and cancer-related) performed over the last four weeks and 53 babies born between April 1 and May 12.
I would like to take this moment to thank all of the BHB staff for their tireless work during this pandemic; not just regarding COVID-19 management and care, but also for carrying out some of their usual duties under these unusual and, as we well know, highly stressful circumstances. Thank you for all that you do.
The Premier has already touched on the issue most prominent in people’s minds right now…When we will move on to Phase 2.
Understandably, everyone wants to know when Government is going to progress us to the next phase. But what I want to stress is that this much of the decision depends on YOU, Bermuda. YOUR actions decide for us when we move forward. The power to determine how quickly we progress from phase to phase lies in YOUR hands.
As such, I want to encourage everyone to wear a mask at all times when you are not at home or exercising; sign up to HealthIQ.bm; practice physical distancing (which means putting 6 feet of distance between yourself and others); and frequently wash your hands for at least 20 seconds with soap and water or use hand sanitizer if soap and water are not available.
If we do not do these things, we cannot move on to the next phase.
We all want to move to the Phase 2…but we want to do this safely.
Because the real-time reproduction number can fluctuate the Ministry of Health will be using a number of criteria or ‘indicators’ to measure whether it is safe to proceed from phase to phase.
We have proposed a combination of indicators to measure how we are doing with our prevention and capacity, and how we’ve done in minimizing COVID spread.
Behavioural measures that will be monitored will include face mask wearing, physical distancing compliance, number of people reporting on HealthIQ and the proportion of cases that can be linked to clusters.
Performance measures will also be used to confirm that it is safe to move to the next phase. For example, the country classification must remain at “local transmission” or less and there must be a small number of cases reported, minimum hospitalizations and critical care cases.
We will be sharing more on this next week after Cabinet makes certain determinations.
Additionally, the Ministry of Health is currently finalizing guidance for each sector’s re-opening. For Phase 2, this includes guidance for retail establishments, personal services, and so on, which we will announce next week.
In the meantime, stay safe and be well, Bermuda.
And, remember, Phase 1 has not been a green light to party. It was an amber light to proceed with caution. Let’s show that we know how to prevent COVID in our day to day actions, so we prove that we’re ready for Phase 2.
Thank you very much Minister of Health and thank you to your team who continues to work on the frontlines to ensure that Bermuda remains safe. Now, we will have an update from the Minister of National Security on the flight that arrived today, and on the work being carried out by his Ministry, the Bermuda Police Service, the Royal Bermuda Regiment, and the enforcement activities that will take place this weekend. Minister.
The Minister of National Security Statement
(To be added )
Thank you very much, Minister. And much appreciated for that update.
As Premier, I also have responsibility for digital services within the Government of Bermuda. One of the most important factors to the continued reopening of the country is making sure that we are making effective use of technology.
You would have heard the Minister of National Security speak about the Government quarantine facilities operated at Bermuda’s award-winning hotels. To ensure effective quarantining at home right now, we’re having to make use of the Bermuda Police Service who check to ensure that self-quarantine is enforced. Going forward, Bermuda will be procuring a technology solution that will enable strict enforcement of home quarantine. It is hoped that this solution will be in place within the next month so the government quarantine facilities may close. These new technology solutions can also support the move to regularly scheduled air travel as persons will be required to quarantine upon arrival and will be able to be monitored via technology solutions.
Related to that, I would also like to take the opportunity to provide the country with an update on COVID-19 related apps that will be key to our ongoing battle with this virus. It is very important to understand that COVID-19 related technology is a complex and evolving space. Of utmost importance in the success of any solutions we choose is community trust and participation. No matter how good the technology solution may be, if the community does not embrace it, then it simply will not work.
Countries around the world are racing to pilot and test new and unproven technologies that can help address the challenges presented by the global pandemic. Bermuda is monitoring these efforts with a keen eye as to what lessons we can leverage, but the bottom line is this: we are not going to rush to a solution. There is no need to be the first in this particular instance. Unfortunately, on the market right now, there is no one single app that does everything and as such, we are watching each country and the solutions they pilot for insights to guide our efforts.
There are five core areas that we have identified in the COVID tech space:
- First, are leading indicators, which can help inform public health officials to the potential risks of the spread of the virus.
- Second, contact tracing in terms of identifying individuals who are positive and may have been exposed to the virus.
- Third, contact monitoring, to be able to accurately monitor and follow the progression of those contacts to ensure that they receive adequate care and take all possible precautions to prevent any possible future spread.
- Fourth, citizen and stakeholder feedback to ensure the public is informed about the risks and actions they can take to mitigate them. Also, ensuring decision-makers are informed with the right metrics to react quickly to any changing situation.
- And fifth, is access controls, such as quarantine-monitoring solutions, potentially to allow for quarantine to take place outside of a government facility.
We are keenly watching Canada and Norway’s Telenor who have leveraged cell phone networks to provide anonymized information regarding the general movement of the public to understand the risks of potential spread. We have been watching the UK in terms of being a leader in symptom tracking to help provide predictive indications of trends of the virus.
The Health Council has launched healthiq.bm as our own version of tracking this information. If you haven’t gone to healthiq.bm, please do so tonight. Everyone is anxious to move towards phase two, but it’s important that we take responsibility and do the things which are essential as we are still in phase one. So please go to healthiq.bm.
We have been watching Singapore, Australia, and the UK’s pilot in the Isle of Wight in terms of their rollouts of Bluetooth contact tracing technology. These applications require wide community buy-in to be effective, and that requires extensive public education on what they are used for and why in order for people to trust them.
We are conducting our own internal pilots of similar Bluetooth contact tracing technology. We are also conducting an internal pilot of GPS-based technology that can act as a guide to assist essential workers in logging where they go to better inform contact-tracing interviews. The bulk of our focus has been on evaluating solutions developed in collaboration with top universities like MIT and Stanford, as these institutions are best placed to ensure privacy-first approaches.
About two weeks ago we reached out to Bermuda First Technology Working Group for their assistance, and I am grateful for their help in piloting these applications and doing further research so that we may find the best technology solution for Bermuda. This is an example of the collaboration between the public and private sector which is necessary for us to ensure we get our economy back up and running again.
On the digital credentialing solutions, there has been a great deal of talk about the potential for COVID passports to reopen global travel. Additionally, there are conversations about credentials which may be used so that persons who are able to go back to work can actually know that they have a credential on their phone, which states that they are cleared to go somewhere or have completed any particular training which is necessary to be at work. This is an area where we are examining the global developments and are also exploring as a potential pilot opportunity for Bermuda to take a leading role.
One of the biggest areas of focus and a source of particular public interest are the apps to support contact tracing. It is essential that there is a broad understanding of what these apps do, as many Bermudians have suggested that they simply will not use such apps or are hesitant. It is very important that people understand why they mean to use these particular applications when they become available. Contact tracing is a complex process. When someone tests positive, their doctor is informed so that they can tell the patient. Then, the contact tracing team reaches out to map who they know and who they were potentially in contact with. Those contacts are then informed and given instructions on how to mitigate risks. But it is important to note, as the Minister of Health had indicated earlier, that the contacts do not actually know who they were in contact with, as the person who may have been positive for COVID is kept confidential.
The challenge is that this process of notifying contacts can be very time consuming. Every hour that passes between someone testing positive and those that were in contact with them being informed increases the risk of spread of the virus. Bluetooth contact tracing apps can assist with this by greatly reducing this time and will be essential as we move to future phases. They can also assist with notifications of anonymous contacts situations where you perhaps shared a bus or sat in the same restaurant as someone but didn’t know them to be able to inform contact tracers.
However, it is worth recognizing that technology is not a perfect solution. It doesn’t guarantee that you’ve been exposed and can only serve as a guide that you may have been. It is useful to greatly assist the efforts to mitigate the potential spread of the virus if you follow a prescribed procedure to reduce the risk. If someone you have been in recent contact with has tested positive, you can be informed instantly enabling you to make the right choices immediately without waiting for a contact tracer to call you, to significantly reduce the risk that you can pass the virus on to a vulnerable family member or anyone else.
While some persons are willing to receive notifications about potential risks, in order to be more aware before they potentially visit and interact with family or friends, other persons are not so willing. The virus has introduced a great deal of fear amongst many in the community, and a negative stigma around those who may test positive. Some individuals are best being carefully informed by a qualified medical professional, that they may have been exposed so that they can get the support and assistance they need to manage this information.
Before rolling out these forms of solutions, it is critical that we ensure that we have public understanding and participation, as they require a significant proportion of the population to participate in order for them to be effective. As early first steps, as I mentioned before, we are conducting closed pilots to confirm that the technology works at solving the problems we’ve identified. Similarly, we’ll continue to watch other jurisdictions to learn from their efforts and to react accordingly. We are also going to be rolling out surveys to gauge public buy-in and sign-up forms to gain support from the community in regard to expanded trials.
It is also important to note, as we had a meeting on this with the Ministry of Health earlier this week, that any solution which we are going to use will be examined by the Privacy Commissioner to make sure that it meets the privacy requirements which are necessary to have public support.
The success of many of these technologies rely on that support of the people and are an essential tool in allowing us to reopen our economy. They can help us to get people back to work, and make our recovery and moving into other phases more quickly. I ask that everyone to work with us by seeking to understand the role that technology has to play, and the part that you can play in making sure that we can open up as quickly as possible, safely. Technology can help us do that, and that is why the government is going to make investments in this area so that we can get our economy back up and running as quickly as possible.
As a note, I’m pleased to announce that the public bus service will return on Monday 18 May. There will be a press release going out later from the Government of Bermuda today, which will give the modified schedule for the buses. It is important to note that the Ministry of Health requires that all passengers wear a face mask when traveling on the public bus and maintain a minimum of three feet distancing when seated. As a result, seating will be limited to a maximum of 17 passengers with no standing allowed. The Department of Public Transportation will monitor the demand and deploy additional buses where possible on individual routes.
Please note that before boarding, it is important that you do not board a bus if you are unwell, or displaying flu-like symptoms such as the fever, coughing, or sneezing. Please reduce conversations with bus operators and if you must converse, do so at the door. All passengers must wear a face mask and anyone without a face mask will not be permitted to ride. Customers must sanitize their hands upon entry, adhere to the physical distancing signage when choosing your seat, and it is important also that healthcare workers do not wear their medical uniforms on the bus.
Remember to travel only for essential purposes and never if you have cold or flu-like symptoms, sneezing or coughing. Now is not the time for leisurely bus or ferry rides, so please continue to stay home as much as possible. The Department of Public Transportation would like to thank the public for their patience and cooperation as they help in keeping Bermuda safe from the spread of COVID-19.
Bermuda, as we enter what we hope to be the last weekend of phase one, we must remain vigilant and continue to push forward with solutions that protect the health and safety of our community while we get our people back to work safely. With the right tools and with your cooperation, we can have the courage to give our people the opportunity to once again earn a living and provide for their families.
On Monday, we will provide the full details on the next phase, how that will work, and what that will mean for you and your families. This is a big step that we will take. A step into the future. And a step in moving us back to the new normal in this pandemic era. Yet I cannot express enough how important it is that we remain vigilant and keep discipline in the behaviours that have helped to achieve our success to date. As a country, we have done tremendously well. But it only takes a few of us not observing the rules, which will make us fall back very quickly. As you heard the Minister of Health say earlier, our real time R number moved very quickly from 0.47 to 0.99. That is a reminder to all of us that we are far from being out of the woods and it is important that we continue to wear our masks in public and to do what is necessary to reduce the transmission of this particular virus.
It is important that we move together as one people with one vision, and one common cause and that is to keep our country safe as we move back to work.
Thank you, and I’m happy to take any questions from members of the media at this time.