The Malta Independent on Sunday
State of public health emergency could be lifted along with travel ban – Charmaine Gauci
100 days since the first case of COVID-19 was found in Malta, the country is now on the verge of opening up again. Superintendent of Public Health was, and still is, at the forefront of the situation in Malta. The Malta Independent on Sunday spoke to Prof
Malta’s state of public health emergency could be lifted along with the travel ban, which will come to an end on 1 July, Public Health Superintendent Charmaine Gauci has told The Malta Independent on Sunday.
“When you remove the travel ban and other measures, then it means that you have done an assessment where you can conclude that the risk is decreasing,” Gauci said in an interview.
She added, however, that this does not mean that all mitigation measures should be removed, seeing that the virus is still circulating. She was also asked whether the re-opening of the airport and bars could lead to another spike in cases.
Gauci replied that the authorities will keep monitoring the situation and certain measures must remain in place. Social distancing and hygiene practice should still be observed, as this helps not only in the Covid-19 pandemic but also in other scenarios, like the influenza season.
“We understand that people want to go out and have fun, especially now that we are in summer, but we must remain careful to keep protecting ourselves from the spread of the virus.”
It has been 100 days since the first COVID-19 case – firstly, how do you feel now, having been on the forefront of this pandemic?
We were faced with a situation – a pandemic – which had an impact everywhere. Our advantage was that we could see what was happening in other countries so we had time to modify our strategy and base it on strong public health principles so we could contain the situation. In fact, if you see from the start to now, we always followed that containment strategy – identifying the cases, isolating them, finding their contacts, and isolating them as well. Even though we are now at the stage where the number of cases spreading in the community is low, we are still following this same strategy with all the new cases.
Looking back with hindsight, if there is something you would change from Malta’s response to the pandemic, what would it be?
As a superintendence, we have a unit which is dedicated to infectious diseases. At the beginning of this pandemic, when we were preparing our systems and when we were dealing with the early cases, we worked with the people in that unit. However, we saw that this small team could not keep up – and what’s nice is that all the people in public health and a number of volunteers came onboard. So, looking back, I’d wish that those people were onboard from the very beginning as it would have made it much easier to respond to the pandemic and split the work between everyone. Something else which, looking back, we’d have liked to have had was for the information management and IT system to have been in place straight away. We already had a system, but we then had to adapt a WHO system which had been used for Ebola for the situation we had. The fact that we were trying to adapt this system in the early days of the pandemic made things a bit more difficult; had it been there beforehand it would have been much more helpful for us.
We almost at a point that we can say that we are totally open, what with the airport opening on 1 July – is it reasonable to expect case numbers to increase, even by a little bit, because we have opened up?
Yes, you can see that we have a situation where the final solution is not close – that solution being the vaccine. Clinical trials are ongoing but there are still several months before the vaccine will be made available. Therefore, we definitely could not remain in a situation where shops were closed, people weren’t going to work, and events weren’t happening, which is why we started opening slowly and evaluating at each step to see what the impact was. Now that we know that the level of community transmission is still low, we need to continue monitoring the situation – which is what we are doing – so to see that if there is a higher number of community cases, maybe even from imported cases, we continue to identify them and control them.
If there is a significant increase in the number of cases, is there a contingency plan in place on what will happen in that cases? Will we go back to having certain restrictions in place?
Like our initial strategy was with imported cases, we would be in a situation where there is a mix of community transmission and imported cases. As time passes, we have our alerting systems which are based on how many cases we have, whether they are sporadic or related to clusters, and people going into hospital and needing intensive care. Those are the parameters we use to evaluate the best means of controlling the situation.
With bars opening, we have already seen pictures of a certain level of overcrowding in such areas – does this worry you?
It’s important for us to keep in mind that the virus is still in the community. We are still seeing some sporadic cases, so the principles of social distancing and mitigation measures have to remain there. Our advice was, and still is, that a person should, especially if they are with strangers, keep their distance. We understand that people want to go out and have fun, especially now that we are in summer, but we must remain careful to keep protecting ourselves from the spread of the virus.
The same thing with the airport – we will have the risk of cases being imported from abroad – how worried are you about this happening?
What we’ve done against this is to follow the concept of safe corridors – seeing which countries have a virus epidemiology which is similar to Malta’s or better. This means that people coming from abroad, are coming from countries which are in a situation like our better than ours. What we have also requested is the installation of thermal screenings at the airport again – this won’t catch every case, but it is only one of the instruments we have in place to catch cases. We are going to continue our prevention campaigns and see that the same message gets to tourists as well. This being said, we have to remember that since the pandemic was of course Europewide, every country was already teaching its people how to prevent the virus – something which will no doubt help other countries when people start to travel from one place to another.
Even though we have a low number of cases, we are still in a state of public health emergency – why?
So far, we are still in that state because we still have restrictive measures, like the travel ban, in place. While that is in place, it is good for us to retain that state of public health emergency. Once we see that we will start relaxing that, then we can move on from this state of emergency as well.
So, once the travel ban will be lifted, we will be at a point where we can come out of this state of public health emergency…
Because there is an evaluation of the whole situation. When you remove the travel ban and other measures, then it means that you have done an assessment where you can conclude that the risk is decreasing. That does not mean that the mitigation measures should be removed – while the virus is still circulating, it is important that they continue to be followed.
In terms of numbers, Malta obviously has a much lower number of cases compared to other countries owing to its size – however Malta also has a very low percentage of positive cases when compared to the number of tests carried out when compared to other countries – why is this?
We had a very broad testing strategy. We were one of the countries which had a high testing rate; we were carrying out tests on people who were both symptomatic and asymptomatic and in fact we were among the first countries to realise the percentage of people in the population – around 1% - who tested positive while having no symptoms. We know that even if you have a