The authorities should be prepared to reverse or slow down the lifting of coronavirus containment measures if case numbers continue to increase, a former chief medical officer has warned.

Nastaha Azzopardi Muscat, who was recently appointed the World Health Organisation’s Europe Director of Country Health Policies and Systems, praised Malta’s control of the spread of the virus.

But in an interview with Times of Malta she also advised the government to keep a careful watch on the rising numbers of people testing positive for COVID-19.

She said: “The rise in cases over the past few days needs to be carefully monitored. The easing timeline should not be set in stone. The government has to keep a watchful eye on the numbers and be willing to slow down or reverse transition if numbers continue to increase.”

Azzopardi Muscat held a series of senior management positions in the health sector in Malta between 2001 and 2013, including being the first woman appointed as chief medical officer.

“It is known that the process of getting out of lockdown is very difficult politically,” she said. “You need to control the virus while keeping in mind economic and social issues… Malta is doing a good job so far.”

Malta was very well prepared for the pandemic

Non-essential shops were recently opened, after Malta started registering a consistent drop in new coronavirus cases.

However, in the last week the number of active cases have increased, reaching 125. Restaurants and hairdressers have also been reopened as more restrictions are eased.

Time to make change

Azzopardi Muscat took on the new role within the WHO on Monday, a decision she described as “difficult”.

“This is a challenging period for the WHO, not only because we are fighting the COVID-19 pandemic but also politically and financially.

“But it is also the time to make change. So, once the airports re-open, I will be moving to Copenhagen alone while my family remain in Malta”.

Her role will consist of assisting countries in Europe to design, establish and implement appropriate health policies and systems to strengthen universal health coverage in the region.

“One of my priorities will be access to vaccines – how to improve access to high cost medicines and ensure there are the right incentives to promote innovation and make it accessible to those who need it,” she said.

She will also be looking at lessons learnt from the coronavirus pandemic that includes how the vulnerable and the socially marginalised bore the brunt of the impact of the illness globally.

Azzopardi Muscat said Malta was very well prepared for the pandemic due to several factors that meant the country never had to fully lockdown.

“It had a very strong public health workforce, the result of 15 years of investment in the sector that resulted in a young and motivated workforce.

“Decisions to expand the capacity of beds and ventilators were taken early, and as soon as the first case of coronavirus in Malta was found in March, incisive measures were taken,” she said.

Azzopardi Muscat has a PhD from Maastricht University in the area of European Public Health and is a senior lecturer at the Department of Health Services Management at the University of Malta. In recent years, she worked as a consultant with EU and WHO expert groups.

WHO policy considerations for transitioning:

Public health and epidemiological considerations must drive the decision-making to ensure the country has the capacity to test and isolate.

There should be available capacity for a dual-track health system management that allows for the reinstating of regular health services while at the same time continuing to address COVID-19.

Authorities should work with the public to leverage social and behavioural perspectives as tools for responsive engagement with populations.

Social and economic support is needed to mitigate the devastating effects of COVID-19 on individuals, families and communities.

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