Sunday 20 September, 2020

PAHO changes Cayman's transmission level from 'sporadic' to 'no cases'

The Cayman Islands has something new to celebrate today...

Having recorded no positive cases of COVID-19 since July 13- a month ago today- and no active cases since July 24, Cayman's PAHO/WHO transmission level for the country has been changed to "No cases". The good news came with a report from Chief Medical Officer, Dr John Lee, who confirmed that 111 cases had been carried out since the last report on August 11, all of which came back negative. There are 158 COVID-19 negative cases under government mandated isolation.

While Cayman's suppression level remains at level two, suppression protocols could be relaxed, given that the World Health Organization's advisory for public health methods at this stage are limited to hygiene, sanitary measures, respiratory etiquette and social distancing. WHO does not recommend the wearing of masks for everyone at this transmission level. It awaits to be seen what government will decide with regards to the relaxation of the mask-wearing requirements.

Given that COVID-19 is a new threat without any antiviral therapies or vaccines, current measures to mitigate this crisis depend heavily on the national and regional preparedness and responses; the transmission level approach provides a framework for WHO to provide guidance to countries on their approach to the virus. WHO has defined four transmission scenarios for COVID-19: No cases, sporadic cases, clusters of cases and community transmission.

“No cases” includes both countries that have never had any COVID-19 cases and countries that have had COVID-19 cases, but currently have no active cases.

The World Health Organisation states that the public health measures required for countries with a transmission level of "No cases" should include hand hygiene, respiratory etiquette, social distancing, environmental cleaning. With regards to the use of face masks, the WHO says that the use of medical masks should be enforced for anyone with symptoms suggestive of COVID-19; and those caring for sick patients at home. With regards to testing, the WHO says that countries should test patients with unexpected clinical presentation or an increase in hospital admissions in a specific demographic group that could be COVID-19.

Criteria for COVID-19 transmission classifications as per the World Health Organisation guidelines are as follows:1. No cases: Countries/ territories/ areas with no cases; 2. Sporadic cases: Countries/ territories/ areas with one or more cases, imported or locally detected; 3. Clusters of cases: Countries/ territories/ areas experiencing cases, clustered in time, geographic location, and/or by common exposure; 4. Community transmission: Countries/ territories/areas experiencing larger outbreaks of local transmission, defined through an assessment of factors including, but not limited to: - Large numbers of cases not linkable to transmission chains - Large numbers of cases from sentinel lab surveillance or increasing positive tests through sentinel samples (routine systematic testing of respiratory samples from established laboratories - Multiple unrelated clusters in several areas of the country/ territory / area.


The World Health Organisation says that "Even as transmission dynamics change as the pandemic evolves, every country should continue to take all necessary measures to slow further spread, to avoid their health systems becoming overwhelmed, and to prevent infection among elderly and persons with co-morbidities who are at higher risk of severe outcomes, including death."

Related Article

If there was need of any evidence that Cayman should not be complacent, New Zealand passed 100 days without local transmission of the coronavirus on Sunday and by late Monday, the streak of negative tests was over. Four cases of the coronavirus were confirmed in one Auckland household from an unidentified source. They are the first cases of local transmission in the country in 102 days.

At the time this article was written, COVID-19 has infected more than 20,496,900 people (according to official counts), at least 746,500 people have died, and the virus has been detected in nearly every country.

Cayman has much to be thankful for.

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