April 16th update on coronavirus (COVID-19) on Bonaire.
This afternoon, Bonaire’s Lt. Governor, Edison Rijna, and Doctor of Public Health, Dr. Marian Luinstra-Passchi, held a press conference to update the island’s residents about recent developments in the fight against Coronavirus.
Mr. Rijna’s text is related in full below:
Over the past period I have spoken to you more than once, to inform and to call for calmness, togetherness and strength. Today I would like to ask you that again. Bonaire has now entered a different phase, a very special phase. I would like to announce that we have a first positive result. The virus has been found on Bonaire. But I will make a few comments right away.
The positive result is a conclusion of the experts in consultation with the RIVM. A test has been taken several times. Each time the test result came back as not positive, but also not negative. The doctors call that inconclusive, or not conclusive. On the basis of the first test result, Public Health immediately started an investigation into the source. It probably concerns a contact that took place a few weeks ago with someone who has been on Aruba. This contact had mild disease symptoms. After the contact, the person became ill after some time. As a precaution, the person stayed at home voluntarily and was tested recently. There has been little or no contact with other people, but all contacts in the immediate vicinity are being investigated further. In the meantime, the person is doing well. The investigation in addition to the measures already taken, give us good hope that the infection does not further develop. The COVID Drive Thru helps us to investigate the situation further.
So the virus has been found on Bonaire.
In all probability this concerns an import case with a subsequent contamination on Bonaire. The source can be traced. Restrictive and known measures were taken prior to this contamination. Because there is good insight into the origin of the case, and the contacts, it is not necessary to proceed to a lockdown. Nor does it have any consequences for tomorrow’s repatriation flight.
It is important that you continue to comply with the restrictive measures. Keep your distance from each other, but also keep the peace. Do not be tempted into hoarding or panic, that really is not necessary.
Bonaire is resilient. We have already faced so many things. If we work together, we can limit the spread of the virus. I will keep you and my team up to date on the situation. I am counting on you, on your cooperation, and I count on your trust in us and in each other. Together against Corona.
Questions by press.
Were the persons who had contact with the infected person only checked if they had symptoms or have they all undergone a corona test as well? If not, why not?
Symptoms are often not noticeable in the initial phase. During the initial research we determine with whom the sick person has been in contact during the time that he/she was ill and showed symptoms. We also determine with who the person was in contact before he/she was ill. This is to have a complete list of all contacts. The next step is to approach the contacts and examine them: are they healthy? Do they have any symptoms; and if yes, which ones? We ensure to have an overview of all the facts of each person. If there is a valid reason, we will test them, maybe we will test them all.
The challenge is that if you test without symptoms, you actually use sledgehammers to crack nuts because it might already be over. When someone is ill, the virus is only in the throat for a short period. If you start testing without focus, you will often find nothing. However, in this case we look into it very carefully and test if necessary.
The results of tests conducted at the drive thru, return after two days. Are the test still send to the Netherlands after that?
No, the tests are no longer send to the Netherlands. The tests are send to Curaçao and will be analyzed at the laboratory in Curacao. The laboratory has proven to have enough expertise and experience with these tests, which makes it no longer necessary for a second test to be send to the Netherlands.
Was this person tested positive or not?
This is a question we have been struggling with. The test results of this person can be explained as both positive and negative, repeatedly. Because of this, and the fact that the persons shows the symptoms, plus that we are aware that there was a possible contact with Aruba, we assume that we have a positive case. Thus, we assume that because of the combination of those 3 items. We do this in consultation with the experts: the AFC Curaçao, Mr Izzy Gerstenblut (head of the Department of Epidemiology & Social Science), and with the experts from RIVM. We consider this case positive, not only the test but also due to the circumstances.
When was this person tested and what gender does the person have?
We understand that there are a lot of questions regarding the person. We are all aware that Bonaire is a small island and that it is a challenge to keep things private. We are committed to protecting this person’s privacy as much as possible. For this reason, we can only inform that this person is a resident of Bonaire who does not form part of the vulnerable group in terms of age. Unfortunately we cannot give any additional information about this person, nor when this person has been tested. This person was tested recently of course, otherwise we would have come up with it sooner. This is all the information we can provide.
Why has it never been said that there is a doubtful case?
We revealed it as fast as we could. We must be very sure first, prior to informing. Thus, we had to consider very carefully and check again: “is this true”? What we have found, yes, we can now state that this is correct. It is clear and we have interpreted it that way.
Another inconclusive: yes or no?
We do not have another case on Bonaire at this moment. So far all tests have been clearly negative, and we are of course very happy about that. However, we have heard that there is also a case on Curacao that is “inconclusive”; and a decision needs to be taken how it should be interpreted. Because this is our first case, we thought we should decide on it. This is the first test that was not clearly negative.
Is the patient still in isolation, and if so, until when?
There are a lot of smart people on Bonaire who will stay home if they get symptoms as fever, a sore throat or coughing. This is very wise. That is what these people have done. You can also infect someone with another virus like an influenza or something else. So they stay at home as long as there are symptoms. Our advice is to also stay home the few following days. We talk to them regarding the best course of action, and in this case, as long as there are symptoms, please stay at home and wait a few more days until you are sure no one can be infected anymore. Besides, the experts have also assured us that with such an inconclusive test, it is impossible to infect anyone else. You will not be contagious anymore. But just to be sure, we advise you to stay at home and wait a few days before you go outside.
If the now positive tested persons was infected by someone who came from Aruba, did the person return to Aruba or did that person stay on Bonaire?
There was a question about whether the patient had a travel history, the response might not have been clear. This patient had no travel history. A contact of this patient who had minor complaints has a travel history to Aruba. Which we assume is the source of the contamination. We are not sure about that either, but we assume that. And this is the situation we assume in our research. But we keep all other options open. This is the most likely source of infection, not from the patient himself but from a contact person of this patient.
What is a travel history?
Travel history is something we have been using in infectious disease control for a long time. It has become an important term in this epidemic. The case definition, so what we assumed from the beginning, is when someone has this infection and when he/she has to be tested? That is when someone has the typical symptoms of sore throat, cough and fever and the person has been in contact with a high-risk person. We know that it initially came from the at-risk countries. China started the epidemic, via Asia, and later went via Italy to the Netherlands. That is how the virus has spread all over the world and has now reached Bonaire. The virus travels all over the world and with this travel history we now have to do the same for Bonaire.