Health Minister Chris Fearne is at the centre of the worst health crisis of a generation. He says the authorities are determined to treat every single case.
Are you scared the coronavirus epidemic will spiral out of control?
We know how this particular virus is behaving so we’re prepared for it. Things are going as we anticipated they would up to this point.
In short, our strategy is twofold. We need to decrease as much as possible the demand on our healthcare services and increase as much as humanly possible the supply of our healthcare services in case they are needed.
So can we actually say we are in control at the moment?
It’s nothing we haven’t planned for. We’ve now had over two months of intensive planning, and things are going as we expected. We need every single person on the island to cooperate 100%. If even one person doesn’t follow what we’re asking the public to do, we have problems. But if everybody sticks to what we’re telling them to do, then we will remain in control. The virus will only spread from one person to another or if you touch a contaminated surface and then touch your face. If you wash your hands frequently, even if you touch contaminated surfaces, you won’t contract the virus.
The second thing is what we’re calling social distancing. If you don’t come in contact with somebody who has the virus, you won’t get it. So, all our advice has been geared towards closing down schools, restaurants and bars, asking people to avoid crowds, asking elderly people to stay at home, urging people to only go out when they really need to.
As health authorities, we are identifying people who have the virus, isolating them and telling those who have been in contact with them to go into quarantine. We’re getting infected persons away from everyone else.
It seems people are cooperating. And even though we expect the numbers to keep going up, they’re increasing in a controlled way.
There is talk among the medical profession that the peak will be in about five weeks’ time. Do you agree with this forecast?
This is conjecture at this point. We know what’s happening in other countries, we know what happens with pandemics. But we can’t say exactly what will happen in this particular case in our country because it depends on the success or otherwise of the measures we take. In other words, we rely on the cooperation of the public.
Left unchecked, the epidemic will spike and practically four out of five of us will get the infection, a lot of us will need hospital, some of us will need intensive care. A few will not make it.
But with the measures and with the cooperation we’re getting from the general public, we’re flattening the curve or as I like to put it, changing the tsunami into a steady stream.
What is the maximum number of cases our hospitals can deal with?
We have increased to a large extent the ITU beds and COVID-19 beds and we can step up even more. We are determined to treat every single case that needs our help. We have set the bar extremely high. We will care for anybody who needs care, this is what we want to do. So, we will look after everyone. Of course, the bigger the numbers, the more stretched we become and the more our healthcare workers have to work long hours.
Does this mean we could be forced to call every single doctor on the island to try to give a hand, irrespective of their speciality?
It’s not a question of bringing standards down. At the moment we’re well covered with our staff. We’re training as many people as possible and we’ve recruited final year medical students who would anyway have graduated in a few weeks’ time.
We’re recruiting as many nurses and medical staff on the island as possible, because we’ve had a number of nurses who have been working on the island as ‘carers’ because of bureaucratic shenanigans. And we’re also working very well with the private sector.
Left unchecked, the epidemic will spike and practically four out of five of us will get the infection
For instance, St Thomas Hospital has been fantastic as it’s been taking a lot of our positive cases. Community pharmacies have been brilliant. We even have dentists who have actually volunteered to go on to the frontline and swab patients. The whole nation has come together.
Our healthcare system relies to a certain extent on third country nationals. Yet, your colleague Silvio Schembri said people who are out of a job should be sent back to their country.
He wasn’t referring to healthcare professionals, let’s make that clear. The provision of healthcare comes irrelevant of any nationality…
… Exactly, so you’re probably going to need to recruit more of them…
… If we can find them. This is not something which is happening only in Malta. In most countries, it’s happening to a larger extent. Our resources are what we have. We have to make the best use of them.
This crisis is quite unprecedented. In the beginning of the year, we didn’t even think we were going to be talking about the subject now. Are you and Prime Minister Robert Abela on the same page?
Yes, we are.
News reports said you were in disagreement over closing the northern Italy flights in the beginning, for example.
Don’t always believe everything you read in the newspapers. Once the extent of the epidemic and the gravity of the situation was evident to politicians, then everybody was on the same page. Robert Abela is very receptive to the advice that medical authorities are giving us. We are on the same page.
Clearly your priorities cannot be on the same page. The prime minister must also be looking at the issues from an economic perspective. You need to take care of the nation’s health.
It’s not a question of days. It’s certainly weeks, it might even be months. But we will get through this. Yes, health is a priority, but it’s not the only issue.
The Imperial College of London told the UK government it will probably take 18 months before the virus is completely under control. Is that the same type of timeframe you envisage?
The longer this takes, paradoxically, the better, because the more the healthcare systems can cope. The lower the demand, the longer we stretch it out, the less the load on what we can supply as health carers…
… But also the more devastating for the economy.
Well, leaving a lot of people badly off because of this epidemic with casualties is also bad for the economy.
So, it’s not just a question of getting this over with as soon as possible and then get on with our lives. We need to control this as much as we can. Timeframes will depend on our success, but also on how fast we can get the vaccine onto the market. Realistically, it will take nine months to a year, optimistically it can take up to six months to get a vaccine which works.
You are an expert in the health field. When the world is faced with such a crisis, by when do you envisage a return to our ‘normal’ way of life?
‘Normal’ will change. Things will never be the same. The way this pandemic has affected the whole world’s society means that things will change.
In what way?
The way we do business will change, the way we travel will change, our interactions with each other will change, our interactions with neighbouring countries will change, the way we allocate resources, the way we make sure that our healthcare systems are resilient. All of this will change.
We have a new normal.
It sounds quite alarmist.
It’s not that alarmist, it might be for the better. When things change, they don’t always change for the worse. Often, they change for the better.
We have to make sure that changes we are forced to make, are direct towards making things better. A minor example: every minister goes to Brussels, probably two or three times a month for two-hour meetings. Because of the coronavirus situation, we’ve been having teleconferences now. They work perfectly. If we continue to do this afterwards, we will save time, money, travel, carbon dioxide pollution. Things like this will accumulate and our life will be different.
So, at this stage you can’t envisage we could back to so-called normality within six months?
The longer it takes, health-wise, the better. Ideally, we control this until we have a vaccine, and then we can vaccinate as many people as possible.
I walked through Valletta this morning. There were hardly any people in the streets, so people appear to be really taking note of what the authorities are saying. Do you envisage a situation where there are no tourists in the streets in summer?
It’s too early to say and hopefully, things will settle down enough so that we get that part of our normality back. Having things starting to come back to what you are calling ‘normal’, like social gatherings might not necessarily mean the end of the epidemic.
So, there will be a point when the epidemic is still present and the virus is infecting people that we might decide we can relax some of the measures we are taking. We get what is called the ‘herd immunity’, in other words, we will have enough immune people because they’ve already contracted the virus.
So, in that case, you can start relaxing the social distancing policies. In that case we might start getting tourists back, we might start re-opening bars and restaurants. We need to take all decisions based on evidence, not based on what you’ve read on Facebook or based because people are fed up because they haven’t been going to their favourite bar for two or three weeks.
On social media a lot of people are saying we should resort to a lockdown.
This lockdown phrase has been bandied about and it’s almost become a political football. The situation can’t be dictated by party politics. It depends on what the science is telling us.
The longer it takes, health-wise, the better
Lockdown means that you stay indoors until further notice. If you impose it at an early stage people will start disobeying it when you really need them to stay inside. So, we need to time everything according to how disciplined we are at the moment.
Are you happy with the level of public discipline?
I’m very happy with the level of cooperation that we get from the public. Yes, it’s been fantastic I have to say.
So you don’t envisage the lockdown will happen over the next few days.
We have to follow the evidence. If the evidence changes, we will have to change.
We now have cases of people who have been infected locally. That means we don’t know where their infection is coming from. Do you plan to test randomly now within the community?
We’ve started doing this. We started testing about 20 cases in the beginning, now we do about 300. Today, we’ve increased the capacity of our laboratories. This week, we opened a second lab at Mater Dei specifically for COVID-19 testing. And we have a drive-through testing hub on the outskirts of Luqa where you will get the result in about six hours. This is exceptional.
Because if you have a virus, then we need to isolate you. We need to look at all the contacts you’ve had since you could possibly have become infectious. And we need to quarantine. There are a lot of countries which aren’t doing any testing at all. In the US it takes you a week to get the result back.
Do you think there is unnecessary panic out there? There are people who almost believe they can contract the virus if they speak to an infected person over the phone. Maybe the information isn’t getting through to the people.
It’s important that we keep educating people. This week, people should start receiving leaflets at home with basic information of how to wash your hands and also on what to avoid and what you could do.
You’re at the heart of a crisis of a lifetime in a way and many people are saying it’s a good thing we have a surgeon and a health expert to lead us through this. Does this put a lid on your clear disappointment of not winning the leadership contest?
I am surrounded by very competent people. So, this is not just about me as a health minister and a surgeon. I’m surrounded by very competent people. I mention a few, Walter Busuttil at Mater Dei, Rosanne Camilleri primary health, Charmaine Gauci… and others.
You’re not answering my question. Do you feel that at this stage your role has become almost more important than the prime minister’s?
No, we’re a whole team, the whole government is working very well together. One of the things we’ve done, for instance, over the last few weeks is to look at each and every department, especially those that provide essential services to make sure that essential services keep going even in a worst-case scenario. And this is just something that I’ve done as minister or as deputy prime minister.
The interview was carried out on Friday morning.
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