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Wilson ‘skirted’ issue of second infected home

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David Burt said last night that he directed health officials to test everyone at the island's largest nursing home as soon as the first case of Covid-19 was found there, but that “regrettably” it didn't happen.

The Premier was responding to questions from The Royal Gazette about why screening for all residents and staff at Westmeath Residential and Nursing Home didn't take place immediately after the first case was confirmed.

He said: “This government's policy has been clear and undiluted — any affected rest home, their residents and staff, should be tested and in the case of Westmeath, our aim was to ensure that testing occur as swiftly as possible.

“My directive on that point was equally as clear, but regrettably that did not occur.

“The Ministry of Health has performed a tremendous service to our country, but in this scenario, we all recognise that there have been lessons learnt; I am satisfied that the testing regime and criteria is now reflective of the nature of this pandemic.”

Mr Burt's comments came as he confirmed a report on the website TNN Bermuda, which revealed that a Westmeath resident had died from complications related to the coronavirus.

The death marks the sixth in Bermuda from Covid-19.

His remarks followed earlier statements by the Chief Medical Officer and the Minister of Health, both of whom had insisted the first case at Westmeath did not warrant testing everyone straight away.

The Royal Gazette asked the Premier to comment on an e-mail sent to him by the chairwoman of Westmeath's board of trustees on April 11, a day after a senior nurse at the home tested positive for Covid-19.

The message from Barbara Lee revealed that the nurse was at work on the day she developed symptoms. Mrs Lee explained to Mr Burt why she believed all staff and residents needing testing as a matter of urgency.

“I am writing with concern about Westmeath nursing home and an incident that happened last week, and has been brought to light only now, when a staff member has tested positive for Covid-19,” she wrote.

“[The nurse] left the facility on Wednesday, April 8, to go to the doctor, as she was not feeling well. She saw her doctor and was provided with a note that she could not return to work until April 23, as a precautionary measure. Apparently she was tested at that time and now has tested positive.”

Mrs Lee wrote that she was aware of the situation at Matilda Smith Williams Seniors Residence, where there was a coronavirus outbreak, and aware that the Premier said publicly on April 9 he had told the Ministry of Health to test all residents and staff at “affected” homes.

Mrs Lee wrote: “Our executive director has spoken with the BHC [Bermuda Health Council] who doesn't seem to see the urgency as I do. They said we need a resident/patient to show symptoms. This is a key member of staff wandering throughout the facility and interacting with residents/patients and staff while having symptoms. She now tests positive.”

Mrs Lee added: “We are the largest rest home on the island. We have 55 residents/patients and 40-50 staff.

“I think it is wrong to be told we need to wait till later next week and they will get to us. I do not call this aggressive testing. We have a confirmed positive Covid-19 staff member who has mixed with staff and residents/patients. Homes abroad are examples of what can happen.”

The e-mail got a response from Major Marc Telemaque, the Cabinet secretary.

He told Mrs Lee that the Premier shared her concern and had told the Ministry of Health to “investigate and attend to this issue directly”.

Mrs Lee e-mailed back on April 12 to say Westmeath had not heard from the ministry.

The chairwoman noted that health minister Kim Wilson had just confirmed at a press conference there were four cases at Matilda Smith Williams but had “skirted over it” when asked about a second home.

Mrs Lee wrote: “We have a positive testing of [the senior nurse]. She was in contact with four key management people/nurses and now the [Government's] epidemiologist has recommended they do not come to work. They run the facility.

“Tomorrow morning our staff will be told that a senior staff member has tested positive. You know as well as I do, it will be out on the street in no time and The Royal Gazette will want the information. What has happened to the aggressive testing?”

Major Telemaque replied that the Ministry of Health had confirmed it was in regular contact with the home's administrator and he had seen correspondence to that effect. “There was lengthy contact by phone and on e-mail with the nursing home, including contact tracing which began on Friday, April 11,” wrote the Cabinet secretary.

The Royal Gazette is also aware of a letter from the nurse epidemiologist to Westmeath, dated April 12.

She told the home there was “potential high-risk exposure” to the virus for four managers.

The Ministry of Health revealed on Tuesday that Westmeath had three cases: two staff and a resident.

The second staff member was a casual nurse who also worked at Matilda Smith Williams and tested positive on April 14.

By the weekend, Westmeath had ten more positive cases, all residents. There are 27 cases linked to Matilda Smith Williams.

Chief Medical Officer Cheryl Peek-Ball told a press conference last week that when the first nurse at Westmeath tested positive, the “details of the case did not warrant testing ... the entire population of residents and staff”.

Ms Wilson added in a statement on Saturday: “That case did not involve a resident, was appropriately contained and, in fact, as it turned out, this case was not linked to the second or third cases.

“We do not want to create unfounded fear among or stigma towards any facility. Investigations were carried out and risk was appropriately contained after the first case.”

Ricky Brathwaite, chief executive officer of Bermuda Health Council, said today: “All case management of a confirmed or suspected case is handled by the [Government's] Epidemiology and Surveillance Unit.

“While the health council has advised and supported [Westmeath's] executive director about the disinfectant cleaning of the facility, and resolving issues around workforce shortages, and wholly supports the country's strategy for the fulfilment of public health action, there was not a conversation that took place from members of the council to advise or marginalise the urgency of reporting and following protocols in regards to a suspected Covid case.”

Dr Brathwaite added: “As public health professionals ourselves, we are in agreement that every detail must be considered when mobilising public health services to cope with a pandemic.

“We cannot look at each action in isolation or critique the outcome associated with a particular course that is chosen based on the most current and sound scientific evidence. “On the converse, we must remember that we are all collectively part of the solution and must remain steadfast in understanding that this is not anyone's fault, but truly an opportunity to keep becoming more effective in our multipronged attack on this virus.”

• Note: this article has been updated to include a statement from Ricky Brathwaite, chief executive officer of Bermuda Health Council

Kim Wilson, the Minister of Health (File photograph by Akil Simmons)
Desperate plea: the nurse identified as the first positive Covid-19 case at Westmeath Residential and Nursing Care Home, the island's largest home for seniors, was at work on the day she developed symptoms (Photograph by Akil Simmons)

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Published April 27, 2020 at 9:00 am (Updated April 27, 2020 at 2:37 pm)

Wilson ‘skirted’ issue of second infected home

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