Monday 23 March 2020
I write to you as the Chair of the Civil Contingencies Authority, overseeing this emergency for the entire Bailiwick, not just as an elected politician for Guernsey alone.
I am sure that the last 10 days have been the most extraordinary in all our lives, with the possible exception of those who lived through the Occupation.
We have all had to adapt at great speed to the loss of personal rights which would have been inconceivable only 2 weeks ago, imposing mandatory self-isolation if you arrive from outside of the Bailiwick and granting the government the powers to deal with anyone who does not comply. Businesses have been closed at great personal loss to many; some of which, sadly, may never reopen. And we are just at the beginning.
The whole community is anxious; fearful even. That is completely understandable. I regard it as part of my job to calm nerves. We all have people we love whom we are worried about. And sadly, before this pandemic has run its course, we will all know someone who has been touched by grief. So it is to be expected that some islanders will have been spooked by the apparent rapid increase in the number of positive test results in the last few days. I want to explain to you, what the strategy is, why the number of positives has increased, why those results are actually good news and where we go from here.
Firstly, let me remind you of our strategy to manage Covid-19. We cannot permanently disconnect entirely from the outside world. This is a global pandemic and there is no prospect of keeping it out of the islands. So the objective is to contain the disease, so that we can manage the caseload through our healthcare system - this is sometimes referred to as 'flattening the curve,' which means spreading the course of the disease out and lowering the number of people who have it at any given time. This strategy requires an ability to process a large number of tests quickly. For this reason, weeks ago, we ordered the equipment that enables us to test on island. We are very nearly in a position to start that local testing, but not quite yet, as we wait for the final piece of kit to arrive very soon from Australia. In the meantime, we are reliant on the UK's testing resources, which are self-evidently under considerable pressure at the moment. This gap, before we have our own facility is a vulnerability, which we are managing by greater controls than the number of positive cases justifies. In other words, we are being very prudent and conservative.
Secondly, the number of positives has rapidly increased for one reason only. The testing centre we were using in the UK became overwhelmed which introduced significant delays to tests being processed and even threatened them continuing. For a few days, we had no new information and we were, in a sense, 'flying blind' so we decided to tighten our controls even further and earlier than others around us by, for example, introducing mandatory self-isolation for those travelling to the Bailiwick. Deputy Soulsby and I made extremely robust representations at Ministerial level to the UK Government regarding this situation and thankfully a new testing centre was identified for the Bailiwick to use, which has been working very well for us since.
Thirdly, we all need to learn to interpret the 'positives'. The ones reported since Friday, contain, in fact, very good news. Why? Because none of the cases provide any evidence of community transmission or 'seeding' - in other words, all the cases involve those who have returned from travel outside the island. Also the positives prove that the system works because of the earlier decisions to extend testing to detect those at higher risk of acquiring the infection. These cases were identified following a local analysis of the global situation on the 15th March, which resulted in a broadening of our requirements for returning travellers to self-isolate on the 16th March. The 19 new cases were identified as a result of the enhanced self-isolation requirements, introduced locally to detect imported cases. Contact tracing for the 19 cases was initiated over the weekend and the next seven days will be crucial as we try and ascertain if there has been any onward transmission. Results from patients with respiratory symptoms who are in-patients at the PEH, who are all tested irrespective of their travel history, are all negative to date. This mean, that the evidence we have, indicates that we still remain in the 'contain' phase of our plan, which is to isolate cases, undertake contact tracing, and quarantine the close contacts
Finally, where do we go from here? The next few days are particularly critical. Although community transmission is inevitable, it is the rate of community transmission that will dictate the measures we need to take. If we get evidence of community seeding before we have our full testing programme up and running — for example if we detect a case of the virus in a hospital patient who has not recently travelled and has not been in contact with another known case— we will almost certainly need to tighten further controls on the community.
The public are on a spectrum of opinion. At one end, there are those who wanted the island shut down on 1 January, only allowing out those in full Hazmat suits, until a vaccine is produced in 18 months time; at the other end, there are still those who think this is an over-reaction to a bad case of the flu. Neither group is right. Although, as the small number in the latter group ignore official public health advice, the former group are more likely to get their way - and I will return to this later.
We have seen full 'lockdowns' in a number of countries including France, Spain and Italy. As people see this happening elsewhere, a number have inevitably taken to social media, email or 'phone to demand that we do the same in Guernsey - and that we do it now, particularly following the increase in the number of reported positives in the last 48 hours or so.
Let me explain why that is not the right step - at least, not at the moment. If we did so, we have absolutely no idea how long it will be for. A couple of weeks would probably be fine. But we cannot hope to shut down our entire community for, say, the next 3 months - and it could easily be at least that long, given we are only at the beginning of this. Seeking to self-isolate the entire community for that period of time, would present a huge enforcement issue with limited resources - unlike other jurisdictions, we have no troops to deploy on the streets to keep people in their homes under curfew; it will also present a real challenge to the mental health and welfare of the entire community. We have already, understandably, seen an increase in mental health issues in the last few weeks. I dread our first Covid-19 related death, which I know will happen; but right now, I fear that the risk is far greater that it will come from someone taking their own life. Perversely, social distancing risks substantial social isolation and all that follows in terms of increased alcohol and drug dependency, depression, and anxiety, resulting in more suicide, self-harming, domestic violence and divorce. Social isolation will damage us all and potentially create a longer term social problem to add to our more immediate public health and economic problems. The population would, literally, go stir crazy. And the longer we are in lockdown the more permanent damage will be done to our economic base, creating further mental health and social pressures, as well as making our recovery in due course that much harder and slower.
Let me be very clear, we may still need to lockdown - and we might need to do it soon. But we are not going to do it just because today's popular opinion says we should - now really is the time to listen to our own on island experts, who have done such a good job so far, and not take the easy option of pandering to a few arm chair opinions. Neither will we do so just because other countries deem it necessary for managing their stage of the disease. We will do it - and we will have no hesitation in doing it very quickly - if, and when, the evidence of infection in our local community shows that it is the right thing to do.
There are some of you who think none of the restrictions apply to you - the group who think it is just a bad case of the flu. You are ignoring advice in relation to social distancing. We have witnessed some of that poor and selfish behaviour at the weekend. Consequently, the majority can be reassured that we are actively reviewing what further steps we need to take to ensure you do comply in the wider interests of the community. Further steps may be announced later this week.
We know that economic well-being is integral to health and community well-being. The Bailiwick, like everywhere else, is facing an economic shock. We are going to do all we can to support our Bailiwick's employers, their employees and their families. A first set of support measures was announced last week. Further measures will follow. It's not going to be easy for many of our businesses, but we will not forget that we are all in this together - and now is the time to support each other.
In the meantime, I have this advice for you: until it changes again, our 'new normal' life goes on; all economic and social life does not need to stop; if you can, get out, enjoy the spring and get some air; it's OK to smile, laugh and play; be kind to yourself as much as others; I know you will, but support each other; ignore rumours; ignore the FaceBook and Twitter experts; ignore what is happening outside the Bailiwick; trust gov.gg as your source of facts; trust our experts in Public Health; and trust us - we've got this; don't panic; keep calm; stay strong; wash your hands; and observe good social distancing.
As we prepare to head into this dark, scary tunnel, it may be hard to believe right now, but I promise you that we will get through this, together. We are one step ahead and intend to stay one step ahead. Many more people than you will ever know, are working every waking hour, to do everything we can to protect you and your family. I promise you that we will not compromise and risk that objective - not least because we have skin in the game, we want to protect our own families too; we will continue to act quickly. I promise you that we will keep you informed of what we are doing and why; I will level with you and I tell it to you straight - good news or bad. I promise those of you in Alderney and Sark, that you can be reassured that you are every much a part of our planning as Guernsey. In return, I ask that you make me just one promise: that you will seek out, understand and then diligently follow local public health advice.
Gavin St Pier