All schools close for second week as swine flu numbers soar

Lance Polu

, Health

Primary school boy protects against swine flu

APIA: 3 August 2009 – All schools in Samoa have been forced to close for the second week as the Ministry of Health gets into full swing to break the spread of the H1N1 virus. The Ministry says although the number of confirmed cases is 80, the actual number is much higher as only samples were sent for confirmation overseas. The evidence also confirm “sustained local transmission with the virus transmitted locally by people who have no history of travel.” The very first cases were overseas travellers into Samoa. The Ministry now confirms:

  • Recent batches of laboratory confirmed cases show there is now sustained local transmission within Samoa.  i.e. The H1N1 virus is being transmitted locally by people who have no history of travel.
  • The number of laboratory confirmed cases does not accurately reflect the true situation with regards positive cases, as not all suspected cases can be realistically swabbed.  i.e.  it is a certainty that for every positive case laboratory confirmed, there may be from one to a number of other positives.
  • With the evidence of sustained local transmission and the evident high demands for the special flu clinics set up, the Health Sector is giving priority to reducing transmission rates, providing treatment to those in need and especially the early identification and treatment of the potentially vulnerable groups.  (the very young, those with underlying medical conditions including pregnancy, as well as the elderly)

Pharmaceutical/Clinical Interventions

Urban Area

  • A special clinic at Matagialalua has been in operation since Wednesday 22nd July for people with flu like symptoms and concerns.  Opening hours are from  8.30am-4.30pm Monday to Friday.  A pharmacy dispensary unit is also stationed there for the convenience of patients.
  • Once the special clinic at Matagialalua closes, the Tupua Tamasese Meaole Hospital continues with provision of special clinic for flu symptoms, from 5pm-10pm.
  • Opening hours for the TTM Hospital Pharmacy at Motootua have now been extended to 11pm to cater for the anticipated patient demand.

Rural Area

  • All district Hospitals are ready to deal with the influx of patients with flu like symptoms.  People with flu like symptoms in their vicinity should utilise these facilities rather than the urban area clinic.

Non-Pharmaceutical Interventions

  • School Closures – After careful consideration of several factors such as the need to break the transmission rates and protect the potentially vulnerable (of which Samoa has a high proportion of); acknowledging the evidence at hand that transmission in Samoa is highest in the relatively young and mobile age groups (5-14yrs); acknowledging that evidence based research indicates significant reduction in transmission rates if school closures are activated early in a pandemic; the Ministry of Health has used the powers conferred for disease control under the Health Ordinance 1959 and ordered closure of all schools from secondary level down, for the period Monday 27th July – Friday 31st July. The Ministry has reassessed the situation and is extending the school closure by an extra week, to include the week to Friday 7th August 2009.
  • Social Distancing/Restriction of Movement  – Minimising attendance to social gatherings continues to be strongly advised though the Ministry of Health at this stage is not forcing any bans on public gatherings.
  • Primary Prevention / Basic Hygiene – Public application of basic personal hygiene prevention measures are the mainstay of the prevention measures.  Washing of hands often especially before eating, covering the mouth and nose when coughing/sneezing and disposing of any tissues used appropriately.  Not sharing of drinking/eating utensils and keeping a distance of at least 1-2 metres when coming into contact and conversing with others.

Pandemic Development

* Epidemiological profiling of the virus remains that it is mild to moderate in nature, much like the human seasonal flu.

* Ministry of Health Concerns are:

  • effects of virus on our high population of vulnerable groups
  • difficulty (not just locally but globally) to predict with accuracy how much of the population will be affected, and how severely the vulnerable groups will be affected.
  • ensuring that the health sector meets and has the capacity needed to cope given difficulty in prediction
  • the possibility of mutation of the virus to a more virulent and fatal strain, such as the 1918 Spanish Influenza strain
  • Unknown profile for “second wave” of virus as generally expected

* Mainstay of efforts remain at this stage on slowing down transmission rates through non-pharmaceutical interventions especially basic hygiene prevention measures.  Though symptoms are mild the Ministry strongly advises vigilance as deaths are on the rise globally.

* The Ministry of Health and National Health Service has begun a partnership collaboration with the community through the Ministry of Women, Community and Social Development, to mobilise the “readiness” of Community Based Centres in the event that the concerns as mentioned above are realised.

* Vaccine –  a vaccine has been developed worldwide to prevent infection with the current strain.  The Ministry of Health shall advise as further information is known about its availability.

* The Ministry of Health continues to seek assistance in mobilising resources needed.
Assistance or Resources Required

* The Ministry of Health is grateful for the assistance in some instances, continued collaboration from the following governments, agencies and organisations:

  • World Health Organisation
  • Government of the People’s Republic of China
  • Secretariat of the Pacific Community (PRIPP Project –  NZAid / AusAID funded)
  • Pool Partners (World Bank, AusAID, NZAid) of the Samoa Sector Wide Approach Program.  (SWAP)
  • Government of Singapore
  • Airport Authority / Samoa Ports Authority / Shipping Agencies and Airlines / Ministry of Natural Resources and Environment / Electric Power Corporation / Samoa Tourism Authority / Ministry of Education, Sports and Culture / Private Education Sector / Ministry of Women Community & Social Development / Samoa Water Authority / Private Health Sector