JOINT PRESS RELEASE FROM TCI GOVERNMENT AND TCI HOSPITAL

(Providenciales, Turks and Caicos Islands – Thursday 19 March, 2020):

The Turks and Caicos Islands Hospital wishes to advise the general public that activities to reduce non-essential services have commenced in an effort to divert resources to COVID-19 preparedness and response.

This process will take place over the next several days. The medical team is currently conducting a clinical risk assessment of patient lists and prioritization of care. Patients with affected appointments will be contacted and advised of the next steps.

To facilitate continuity of care, team preparedness and response, several activities are underway. These include the utilization of telemedicine applications to maintain communication with our valued patients due to the eventual reduction of non-essential services.

PREPARDNESS, SERVICE CONTINUITY AND RESPONSE ACTIVITIES

The Turks and Caicos Islands Hospital has initiated several mitigation and preparedness activities since December 2019 in response to the emergence of the novel Coronarvirus (COVID-19) disease in Wuhan, China.

Below is an overview of some of the many key activities that have occurred and are in the advance stages of implementation, monitoring and evaluation:

• Monitoring of CDC, WHO and PAHO to track the disease progression, emerging and new best practices such as infection prevention and control, environmental decontamination and clinical management;
• Conducted a review and where indicated, updated our current Infection, Prevention and Control, Emergency and Disaster plans;
• Daily tracking and monitoring of inventory utilization levels related to personal protective equipment and other essential clinical supplies;
• Communications and planning activities commenced with the Ministry of Health Agriculture Sports and Human Services;
• Priority setting related to mitigation and preparedness;
• Refresher training of all health care workers and ancillary staff both within TCI Hospital, Ministry of Health, Agriculture, Sports and Human Services (MOHASH) and other key government agencies. The training is led by MOHASH Infection Prevention and Control National Focal Point, Nurse Jackurlyn Sutton and instructed by TCI Hospital Infection Prevention and Control (IPC) Specialist Nurse Surbrena Pedican and TCI Hospital Clinical Nurse Educator, Lurline Barnett who have also conducted refresher training of all hospital housekeeping and porter staff.
• Review and updated IPC policies, guidelines and procedures where applicable;
• Frequent planning, preparedness and strategic response meetings;
• Development and testing of a COVID-19 Preparedness and Response Hospital plan, guidelines and standard operating procedures;
• Social media platforms have been used to provide public information on respiratory etiquette and hand hygiene, social distancing and COVID-19 screening questions and reference to the Ministry of Health’s hotline;
• Signage have been erected to alert persons of the need for hand hygiene before, during and after accessing the facility;
• Increased environmental surveillance and control measures;
• Waiting room chairs are separated to promote social distancing between patients;
• In-hospital television monitors continuously stream information on COVID-19 for patients and staff;
• Public Health England was engaged and reviewed the hospital’s key policies, laboratory capacity and onsite inspections;
• Infectious disease specialist has been engaged for advice on our IPC programs, personal protective equipment and care pathways;
• Where predictable and permissible, based on activity within the emergency department, privacy screens have been erected and are utilized within the department to facilitate a protected patient pathway used only for persons suspected of COVID-19;
• Telemedicine is utilized to support clinical care and minimize provider exposure consistent with best practices recommended by WHO and PAHO;

Essential health care workers have been instructed to remain on island. TCI Hospital has adopted a work from home strategy along with the use of designated off-hospital work locations for some non-essential employees in anticipation of the advancing pandemic as a component of the hospital’s service continuity plan.

The senior management team wishes to thank the community for their ongoing support and remind the general public of their role in helping the health care team to be successful in the fight against COVID-19. Persons are reminded to execute the following:

• Avoid large social/public gatherings especially groups of more than 10 persons;
• Listen to advice and information from approved sources. TCI Government Ministry of Health, Agriculture, Sports and Human Services, CDC, PAHO and WHO is recommended.
• Wash and Sanitize your hands and work station regularly and practice respiratory etiquette;
• We strongly encourage the utilization of communication mediums such as phone calls, videoconferences on cell phones or other mobile devices in the interim as a means of personal communication as part of social distancing;
• Contact your family physician and TCI Government Ministry of Health hotlines if you are concerned about exposure to COVID-19;

JOINT PRESS RELEASE FROM TCI GOVERNMENT AND TCI HOSPITAL

(Providenciales, Turks and Caicos Islands – Thursday 19 March, 2020):

The Turks and Caicos Islands Hospital wishes to announce further changes to its operations in response to the threat posed by the COVID-19 pandemic and provide information on a suspected COVID-19 inpatient case.

We wish to confirm the admission of a patient to the general ward of Cheshire Hall Medical Centre on the evening of 18th March 2020, who is now classified as a suspected case of COVID-19. The patient is being cared for in a designated isolation and negative pressure room with the relevant infection prevention and control measures.
The 89-year-old female is a Turks and Caicos Islander who departed the country to Jamaica in mid-February 2020 to receive overseas care and returned to the Turks and Caicos Islands on 2nd March 2020. She had no further travel history.

The patient has multiple co-morbidities and was transported to the department by emergency medical services with breathing difficulties on 18th March 2020. She developed symptoms including coughing and shortness of breath four days prior to hospital admission with no fever. The patient is currently on oxygen therapy and does not require ventilation at this time. She has no known contact with a suspected or confirmed case of COVID-19. TCI Hospital is unable to comment further on the details of the patient’s care due to patient confidentiality.

The Minister of Health wishes to advise that the Turks and Caicos Islands Government Ministry of Health, Public Health Team is actively tracing all contacts of this individual in order to provide them with the relevant guidance and action that may be required. A sample has been collected and sent for testing. The Ministry of Health along with the TCI Hospital are following the necessary established protocols as it relates to COVID-19. All key personnel from the Ministry of Health are engaged with the TCI Hospital on this matter and the Ministry of Health remains committed by way of advising the general public of any new developments on this case in a timely manner.

TCI Hospital will continue to provide updates to the Ministry of Health, Agriculture, Sports and Human Services through the Director of Health Services and Public Health Team. Hospital measures have been escalated after a continuous and comprehensive risk assessment and taking into consideration the safety of our patients, hospital staff and the wider community.

Complete visitor restriction from the inpatient wards was immediately initiated and remains in effect until further notice. Persons who need to items delivered to inpatients are required to present the items to the main reception desk and the hospital’s security team will deliver the items to the ward. Please ensure that items are properly labeled and no valuables such as money or jewelry are enclosed.

Members of the general public are asked to refrain from visiting the hospital except for an emergency complaint that requires access to the emergency department. Information related to the reduction of non-essential services at Cheshire Hall Medical Centre and Cockburn Town Medical Centre will be issued in a subsequent press release.

The Ministry of Health would like to advise the public that as at 12pm today.

5 suspected cases of COVID-19: First, tourist visiting the country (1). Second, resident of the TCI who had contact with a confirmed case (1). The other three suspected cases are TCI residents returning from countries with local transmission (3). All 5 persons met the WHO case definition for a suspected case of COVID-19, thus they are experiencing symptoms. Samples have been collected and sent for testing.

Persons under quarantine/observation—The suspected cases (5), relatives/contacts of suspected cases (13), persons travelling from a highly affected country—Italy & Spain (3), TCI residents returning from countries with local transmission (7). Persons under observation/quarantine are all not displaying symptoms.

Please note the following definitions:

• A suspected person is someone who meets the case definition as outlined by WHO and CARPHA - and is experiencing symptoms.
• A person in quarantine is an individual on island who has come from infected country(ies) or may have come in proximity to suspected or confirmed cases - and have not exhibited symptoms.

Let's continue to reduce the risk by:
1. Washing our hands for 20secs or more
2. Practicing social distancing
3. Prepare your home, office and other surroundings by following the advice of the Ministry of Health and other credible health agencies.

For more information, please visit the Ministry of Health website, www.gov.tc/moh/coronavirus; email: This email address is being protected from spambots. You need JavaScript enabled to view it.; or call our hotline numbers, (649) 232-9444 and (649) 333-0911, if you or someone you know has symptoms or signs of COVID-19.

The Ministry of Health would like to advise the public that as at 12pm today, the TCI CONTINUES TO REMAIN COVID-19 FREE.

3 suspected cases of COVID-19: First, tourist visiting the country (1). Second, resident of the TCI who had contact with a confirmed case. The third suspected case is a TCI resident returning from a country with local transmission. All 3 persons met the WHO case definition for a suspected case of COVID-19.

Persons under quarantine/observation—The suspected cases (3), relatives/contacts of the suspected case (7), persons travelling from a highly affected country—Italy & Spain (3), TCI residents returning from countries with local transmission (5). Persons under observation/quarantine are all not displaying symptoms.

Please note the following definitions:

• A suspected person is someone who meets the case definition as outlined by WHO and CARPHA - and is experiencing symptoms.
• A person in quarantine is an individual on island who has come from infected country(ies) or may have come in proximity to suspected or confirmed cases - and have not exhibited symptoms.

Let's continue to reduce the risk by: 1. Washing our hands for 20secs or more 2. Practicing social distancing 3. Prepare your home, office and other surroundings by following the advice of the Ministry of Health and other credible health agencies.

For more information, please visit the Ministry of Health website, www.gov.tc/moh/coronavirus; email: This email address is being protected from spambots. You need JavaScript enabled to view it.; or call our hotline numbers, (649) 232-9444 and (649) 333-0911, if you or someone you know has symptoms or signs of COVID-19.

The Turks and Caicos Islands Government would like to advise that further to the amendment of the Public and Environmental Health Regulations amendments of 11^th March, 2020 that: The list of ‘infected countries’ in Regulation 2 of the Public and Environmental Health (Control Measures)(COVID-19) Regulations 2020 has been amended to include the following additional countries, as of 20^th March, 2020, which are experiencing sustained in country transmission and may pose a risk to the public health of the Turks and Caicos Islands.

This list is based on the CDCs travel advisories which lists the following countries as having widespread ongoing transmission (level 3 warning). The expansion includes the following countries;

Persons in the Islands who have travelled to, from or through infected country may be quarantined

• A Turks and Caicos Islander or resident of the Islands who arrives in the Islands after travel to, from or through an infected country shall be—
  • subjected to screening and passenger tracing at port of entry;
  • subjected to clinical examination at port of entry; and
  • quarantined for a period of fourteen days, as deemed necessary.

As per protocols for ALL travellers entering the TCI are subject to screening at the airport. This includes completely filling out the health declaration card on both sides and presenting to healthcare officials at the airport. Travellers coming from such states will be asked to monitor themselves for symptoms over the subsequent 14 days and if they develop symptoms, then immediately call the Ministry’s Coronavirus hotline: (649) 333-0911 and (649) 232-9444. PLEASE BE AWARE THAT YOU MAY BE SUBJECT TO QUARANTINE. Travelers should contact their travel agent and or airline prior to travel. Also, if persons in the general public feel that they or someone they know are showing symptoms or signs of the virus, they should also call the hotline; please DO NOT go to the hospital or any other health facility, as this will increase the likelihood of spread. The government continues to monitor this fluid situation and will update the general public regularly. For additional information, please visit our website www.gov.tc/moh/coronavirus, or email This email address is being protected from spambots. You need JavaScript enabled to view it..