News

On Wednesday, 31 August 2022 the Ministry of Health & Wellness, hosted the first “State of Health and Wellness” media event to share key Ministry developments and to broaden the dialogue on health beyond COVID-19.

“The COVID-19 pandemic has dominated our thoughts, conversations, as well as the airways and social media channels over the past two years.  While the pandemic is by no means over, these past few months we have been transitioning our efforts towards equipping our population to living safely and mindfully with COVID,” stated Minister for Health & Wellness, Hon. Sabrina Turner.

“While the demands created by COVID-19 have been many, the holistic work of the Ministry of Health and Wellness and the numerous departments and statutory authorities that fall within my Ministry has not stopped, and as such today marks a change in the way that we share that information with our community,” she added.

Minister Turner identified the need to strengthen public health nationally as one of the key lessons learned from the COVID-19 pandemic.  Public health is the science of protecting, promoting and improving the lives, health and wellness of individuals, families and communities via prevention, education, access and personal empowerment.

“Public health extends far beyond preventing the spread of communicable diseases, like COVID-19, the flu and even monkeypox,” Minister Turner explained.  “Public health is also concerned with being proactive about the prevention of non-communicable diseases, such as heart disease, cancer and diabetes.  These diseases have also consistently had a significant impact in our community, to which many of us can attest based on personal experience or those of close family and friends.”

Minister Turner announced that Cabinet has approved, in principle, for the Ministry of Health & Wellness to develop a business case to reform public health at the national level.  “This business case is the first in what will become a series of tangible steps that will engage our stakeholders in the process of achieving this goal,” she added.

Following on from the Minister’s remarks, Interim Chief Medical Officer, Dr. Autilia Newton, outlined the forthcoming changes in COVID-19 surveillance and reporting.  “When COVID-19 was first identified in 2020 it was a completely new virus, no one had had any exposure to it before, which is why it spread as fast as it did, claimed so many lives and eventually became a pandemic” Dr. Newton explained.  “Our efforts at that time rightly focused on suppression.  Now, however, we have had exposure to this virus for the last two years.  We have developed immunity based on either access to the vaccine, contracting the virus itself, or both.  Thus, the focus has changed from suppression to living with this virus,” she added.

COVID-19 will now be monitored as part of winter respiratory infections, via sentinel surveillance sites notifications, sub-set testing of samples taken from patients presenting at the surveillance sites and genome sequencing of positive samples.  Sentinel surveillance is the monitoring of the occurrence of respiratory infections (such as influenza, COVID, Respiratory Syncytial Virus) through clinical diagnosis from selected sites of health care providers, aimed at assessing the presence respiratory viruses in the country.  Genome sequencing will then provide additional data on the variants of the identified virus in circulation in the community.

The surveillance, testing and sequencing work will be undertaken as part of the greater epidemiological data collection, and will be shared as such.  Moving forward, key COVID data that will be reported regularly to the community will be limited to hospital admissions and mortality.  “COVID in 2022 is not the same as COVID in 2020. Our key messages will remain for fall booster vaccinations for the over 50 population and the immune-compromised,” she added.

Dr Newton also touched upon the other communicable disease of interest globally and locally: monkeypox.  “I have received questions from the community about monkeypox becoming the next COVID, and I want to explain the difference between the two viruses,” she began.

Unlike COVID-19, monkeypox is not a new virus, it has been around for some time and there has been human exposure to it, Dr Newton explained.  Furthermore, the respiratory transmission of monkeypox is less effective. “Transmission of monkeypox is primarily through skin to skin contact,” she elaborated.  “It is important to remember that transmission of this virus can impact anyone, not just specific sectors of our population,” she added.

While there is no vaccine for monkeypox, because the monkeypox virus is so closely related to the smallpox virus the smallpox vaccine has proven effective in protecting people from contracting monkeypox.  As such, work is being undertaken by the Ministry to procure smallpox vaccines to have on hand.  There are still no confirmed cases of monkeypox in the Cayman Islands.

While both COVID-19 and monkeypox were a part of the conversation, communicable diseases were by no means the entire discussion. Minister Turner highlighted mental health as an important public health issue, and one which the country as a whole had agreed warranted more attention, especially as it relates to the nation’s youth.

To underscore this point, Minister Turner shared preliminary information from the National Drug Council’s (NDC) Cayman Islands Student Drug Use Survey (CISDUS) 2022 focusing on key Adverse Childhood Experiences (ACEs) among Cayman’s youth.  Among them:

Almost 8 in 10 students (79.7%) reported they had witnessed violence and aggression

43% of students reported experiencing any abuse (of those 50% girls, 36% boys)

ACEs are directly linked to health and wellness as research has shown that such experiences can change brain development, affect how the body responds to stress, and are directly linked to chronic health problems, mental illness, and substance misuse in adulthood.

“I highlight this information to emphasise the importance of data and how we, as a Ministry, have started working to ensure that future programmes, services and interventions are data driven,” Minister Turner added.

This data driven approach was reinforced in the Consultant Epidemiologist’s, Rachel Corbett, presentation. “Surveillance of infectious diseases, like COVID-19, and non-infectious disease is essential to understand the health needs in the population and to determine the best approach for both prevention and treatment, “Ms. Corbett stated. “We need to gather, analyse and report public health data to make evidence-based decisions because, at its core, surveillance is about gathering information for action” she added.

Ms. Corbett highlighted, by way of an example, the recent 2021 Census, which she described as an important information source to help provide context to health information.  However, she cautioned of the limitations to interpreting the report as a stand-alone indicator of the state of health and illness in the nation. “Last year’s Census data identified diabetes, arthritis and cataracts as the highest occurrence disabilities or medically diagnosed illnesses reported in the population,” Ms. Corbett explained.  “While this data is both necessary and useful, we need to be mindful that the census is self-reported, there may have been varying willingness to report illness among different demographics, it would not have captured any individuals in health care facilities for a period over six (6) months, and focuses on disability rather than chronic non-communicable illness” she adds. “It is for that reason that it is important to collate different data sources, including medical data, to understand the complete picture.”

To achieve this goal, the Ministry is working to repeat the World Health Organisation’s STEPS survey- first undertaken in the Cayman Islands in 2012- to collect, analyse and disseminate data on the prevalence of risk factors for non-communicable diseases in the country in 2023. The Ministry is also undertaking work to generate a non-communicable disease database that will determine the prevalence of non-communicable diseases in the population, as well as understand the epidemiology of which groups within the population are most affected.