Planning that had been undertaken for the end point to the ‘stay at home’ order

2020.04.21

9 Deputy R.J. Ward of the Chief Minister regarding the planning that had been

undertaken for the end point to the stay at home' order: (OQ.93/2020)

What planning is being undertaken to put in place an end point to the stay at home order and what modelling and key indicators will be used within this planning to allow a return to normality?

Senator J.A.N. Le Fondré (The Chief Minister):

The strategy is always to delay the spread of the virus, contain it where cases arise and to shield the most vulnerable from it. The primary goal is to suppress the spread of coronavirus, to flatten the curve of cases in order to protect the health system and shield the most vulnerable Islanders. Our second vital task is to exit the pandemic safely, as the Deputy is alluding to, and I will be making an announcement on Jersey's safe-to-exit strategy hopefully by the end of April or shortly thereafter. That will set out a phased approach to get us all back to normal life. The monitoring evidence and indicators we will be drawing upon to inform each phase of the exit strategy will be set out in detail. The Deputy will be aware, hopefully, of the health survey that Islanders are completing at present. That will be one of the indicators and the other, subject to all the caveats we have said previously, will be the antibody testing regime, I believe. But at present we are monitoring closely how the virus is developing on Island and I very much want to reassure Members that we will only begin to dial down the current public health measures when we are confident that transmissions are under control.

1. Deputy R.J. Ward :

Can the Minister confirm that he is confident that modelling is taking place and there are specific key indicators that will be used so that the people of Jersey can have confidence that we will come out of this lockdown at the right time?

Senator J.A.N. Le Fondré:

I am very confident that there is a lot of statistical modelling being either used or being generated. I think I have alluded to that previously in briefings to States Members. I have certainly referred briefly to the last update we had for Scrutiny and I think we have offered them a briefing on the subject as well as to what is being done. What the intention at present is, and I might be mixing messages here, is that we have the antibody testing. Provided that the evaluation comes back on that, which I am expecting, I think, from the Minister for Health and Social Services in the next, I will say, 2 to 3 days, that means we can then go on a sample basis to probably 1,000 or 2,000 samples, which will then give us an indication as to how far the virus has spread throughout the community. We are hopefully expecting that to come back in the middle of next week, the analysis thereof, and that will give us a variety of indications, including whether the data gathering structures that we have put in place or are being put in place are working. When we have got those initial results back, I think that will be the time when we will be able to give Members a full and proper briefing, firstly on the outcome, hopefully whether that outcome has matched our expectations, but also around the other modelling that we are doing. Because by that point we will have a lot more information from the health survey and that will also be able to be presented to Members, at the very least, in some form of meaningful manner.

2. Deputy M. Tadier :

Trying to follow the curve on the Government website, it seems to me that there is a bit of time delay, perhaps by a week, of the actual where we are on the curve graph. Certainly, I think, as of 12th April it seems that we are not following the normal distribution curve that has been put out in the model but in fact we seem to have one peak back in March and then a lesser peak earlier in April, and the number of daily cases is on a downward trajectory. Could the Minister talk to this and how it informs an exit strategy?

Senator J.A.N. Le Fondré:

The recording of the testing statistics against the curve will not be the only measure that is used in the testing strategy. If the Deputy recalls, and as Members hopefully recall, at the presentation last week there were some elements of caution stated about the results that came out last week, partially because of a delay in some of the testing. I believe we are now back up to 120 tests a day but we also want to try and expand that. Obviously, as one increases the tests that one takes, that potentially skews the result the other way. I think there are 2 other bits to talk to at the request of the Deputy . Number one is to re-emphasise the fact that at present we are still dealing with low numbers in terms of the positive cases. Two, which I have certainly alluded to publicly, I do not know if it was at the time to States Members or not because it depends when we were given the information relative to when the last briefing was with States Members. Some of the anecdotal remarks that are coming out, an issue from some of the work that the G.P.s (general practitioners) are doing - I do emphasise anecdotal at this stage as opposed to evidence based - is that there is an indication that they may be seeing what they believe to be more corona cases in the community than are being identified through the positive testing regime. That raises the question as to whether our rule of thumb, that for every one positive test we have there are 10 out there in the community, is absolutely valid for Jersey. That is where the antibody testing will be important. As soon as we get that initial outcome from the sample tests as I said, the last update we had earlier this week was that there was an intention to do testing towards the end of this week and early next week and then for us to get the results, which will take 2 or 3 days thereafter. That will give us the first of, let us call it, a statistical evidence base, and I emphasise hopefully, that will then start giving us some better information as to what we think the spread of the virus is through the community. At that point, we can then start taking account of the health survey, bring all that together and that will then inform us towards the exit strategy. Sorry for the long answer there but it is quite a complicated subject.

3. Senator S.C. Ferguson:

It seems to me, and perhaps the Minister would confirm this, the problem at the moment is that many people are relying on the data and the models. Given that we have incomplete data, what sort of margin of error are we working on? How reliable can we say the models are at the moment?

Senator J.A.N. Le Fondré:

On the issue around the model in terms of, let us call it, the curve, I think we are fairly comfortable on how it is being applied to Jersey. The issue we do have, which is what we are aware of, is around collecting and getting the testing done of people who have had and tested positive for the virus. We are very much alive to that. That is effectively what I was referring to in my response to Deputy Tadier and what was alluded to in the presentation to Members last week. We will get a better position again towards the end of this week. We are updating that particular work on a weekly basis. We are also trying to increase the capacity to get more testing done, whether on-Island or off- Island, which will give us an overall better picture. However, I go back to the earlier point I made that the modelling against the curve is not the only tool in the toolbox. The other 2 bits are being worked on and when they are in a better state they will be presented to Members. One is the health survey and the results from that and the second one is the use of the initial samples from the antibody tests that have recently arrived on Island, of which we now have 50,000 kits on Island. The evaluation is just being completed in these next few days and then the expectation is we will move to an initial sample test of probably between 1,000 and 2,000 people.

4. Senator S.C. Ferguson:

How sure can you be that the antibody tests that you are going to be using are reliable, given that they are from China and given the Chinese unreliability?

Senator J.A.N. Le Fondré:

There are 2 sets of tests. That is why a lot of my answers at the moment are caveated because it depends on the outcome of our own evaluation, which is being done on Island. As Dr. Muscat has referred to in previous presentations to Members, we have been looking at antibody testing for quite some time and I think he said at the time it came up in meetings and discussions probably 4 times each day. One of the first ones that was certainly brought to my attention, which had an element of credibility attached to it, when it was evaluated there were some cross-contamination issues and in the end that was not a route we went down. The 2 lines we are receiving, both ultimately do come from China. One is through the media contact and a Jersey contact through an American supplier who has sent us the 50,000. The other one is through an existing contact that we use for I think it is blood and drug testing, which is a British supplier but they are using their own Chinese producer of the kits. Therefore, the ultimate source of the kits is a known supplier, but we are also evaluating those on a sample basis essentially as we speak. We will know the outcomes of that testing, I am informed at this stage, some time this week.

5. Deputy I. Gardiner :

We can see now different exit strategies adopted by different countries. I understand that we need first to get our numbers right. Would the Chief Minister indicate what measures are being considered in the short and medium term plans for Jersey's exit strategy when we will have these numbers?

Senator J.A.N. Le Fondré:

The exit strategy has not yet been discussed at the Council of Ministers but there are discussions starting to take place, if that makes sense. As I said, the expectation is that that will be finalised by the end of April and then we will put all the details together on that. In the short term - and in my terminology the short term is the next week or so in our present scenario that we are going through -there will not be any changes. I also made the point that in certain instances, without identifying the jurisdictions, where certain jurisdictions are looking at release out of lockdown they are possibly moving to where we are. For example, it might allow window cleaners to go back because they can still socially distance. We have never stopped window cleaners from operating because the social distancing could be applied. So one needs to be quite careful as to what jurisdictions mean when they are talking about coming out of lockdown. We have never gone into complete lockdown, I emphasise "as yet", because it always depends on the medical advice and everything we do is based on the medical advice.

6. Deputy J.H. Perchard of St. Saviour :

The Chief Minister has mentioned the exit strategy a couple of times in his responses so far. Does he anticipate further waves of the virus in Jersey over the next 12 to 18 months as we await a vaccine? Therefore, does he anticipate the stay at home order to be implemented on a rolling basis over this time?

Senator J.A.N. Le Fondré:

I think that is too early to comment on because the suggestion around the recurring waves as I have understood it, and my understanding on this is not perfect - as I said, we are advised by the medical professionals - is where there has been a suspicion of a second wave, it has come from countries that have effectively tried to lock down completely and prevent the spread of the virus through their society and then when a lockdown has been eased, particularly from people coming back into the country, that has caused new infections. What we have said is that we are trying to slow the speed of the transmission of the virus through the community so as not to overwhelm our health services, but that is not to stop that spread. To date, that advice remains the same and, therefore, we have to be quite careful.

[11:15]

I think we may be looking at different jurisdictions having followed slightly different strategies.

7. Deputy J.H. Perchard:

Does the Chief Minister anticipate that the stay at home order will need to be implemented again, even if just for particular groups of people, over the next 12 to 18 months?

Senator J.A.N. Le Fondré:

I reiterate the point that I think we are in too early a state to say. As I have always said, the medical advice on this updates frequently. When we have come out through the exit strategy and we are in September, October time, if the medical advice then came that we do need to do greater social distancing or some form of stay at home, if that is the medical advice of the day, then I rather assume that Ministers at that point in time would go with that medical advice. At the moment I need to focus on, and as Ministers and as politicians we all need to focus on, what the medical advice is going to be basically for between now and, I would say, September and how we can ease the stay at home policy and the social distancing. The exit strategy will identify the measures that we need to take into account before that easing commences.

8. Deputy G.P. Southern :

The Minister has made much of the testing regime and indicated what we will derive from that. What role, if any, does contact tracing play in his determination to get back to normal?

Senator J.A.N. Le Fondré:

Contact tracing is part of the strategy and at the last meeting - I was trying to remember whether it was Competent Authorities or Council of Ministers, I think it was the Competent Authorities - members received a briefing on the various parts of the overall strategy that is being pursued and the contact tracing team is being doubled in its capacity so that we can put greater resource into that. We are also looking at whether there can be an automation of more tracing. That has a whole range of issues attached to it. Once we identify some of those issues they will come back to Ministers and then we will be briefing Members on them should we consider that to be the right way to go.

9. Deputy G.P. Southern :

Doubling of the team means what in terms of contact made or established?

Senator J.A.N. Le Fondré:

We are increasing the team from 24 to 48 people.

Deputy G.P. Southern :

What would be the result of that? Senator J.A.N. Le Fondré:

What that means is that as hopefully the testing regime increases, we can then apply greater rigour or even more greater rigour, because there has been quite a lot of contact tracing going on, to the whole contact tracing process.

10. Deputy R.J. Ward :

I note the quality of the questions that have been asked by States Members. Therefore, I would like to ask the Chief Minister would he commit to including and being absolutely transparent with States Members, and indeed the public of Jersey, as we plan for coming out of lockdown? We are reliant on people taking the actions that they are asked to now and we will be just as reliant on people following instructions that they must be confident in.

Senator J.A.N. Le Fondré:

I would also emphasise I am not aware that I have not been transparent or that Ministers have not been transparent to date. We have tried to give the best information we receive to members of the public at the right time and in the appropriate manner. But the Deputy is right in that once that exit strategy has been, firstly, agreed but, secondly, when we need to come round to starting to implement it, the public will need to understand how that is going to work, because that is the way we make it most effective.

The Bailiff :

Before we move on to question 10, we are just over the halfway point but we have only approximately a quarter of the time allocated available to us to get through it. In part, that is as a result of a large number of people, very understandably, wishing to ask questions. In part, it is a result of the length of the answers, which, as I say, normally should be one minute and 30 seconds. If I could ask Members to bear that in mind. I will, within my discretion as Presiding Officer, be allowing an additional 10 minutes to the normal time to allow for injury time, as it were, because of the technical difficulties that we have had, but in any event it may be necessary to disallow supplementaries if we cannot pick up the pace a little bit.