The National Emergency Operations Centre has been the central organ coordinating Cayman’s COVID-19 response for 108 days.

Last Friday, it was deactivated as the country moved into Level 2 (minimal suppression) of combatting the virus, which saw a relaxation of many of restrictions, including the revoking of the hard curfew and shelter-in-place protocols.

The daily operation of the NEOC, which consisted of 17 cluster teams working in tandem, was deemed to be no longer necessary.

For Hazard Management Cayman Islands Director Danielle Coleman, the deactivation not only spelled success in managing the health crisis, but it was a chance for the teams that have been working around the clock to finally breathe and get back to their regular duties.

“There’s a lot to be proud of,” she told the Cayman Compass. “I think Cayman’s decisions from the get-go… closing the schools, closing the airport, and early activation of the NEOC, [have] led to a fantastic result.”

Chief Medical Officer Dr. John Lee and Hazard Management Cayman Islands Director Danielle Coleman using one of the screens
that displays global COVID-19 stats in realtime which was utilised by the National Emergency Operations Centre. Photo: Reshma Ragoonath

She said Cayman’s “great testing mechanisms from the health services [and] great collaboration between [members of] the health sector, both public and private”, have placed it in a strong position to handle the crisis.

Hazard Management coordinated the NEOC, which was activated on 3 March by Deputy Governor Franz Manderson in his capacity as chairman of the National Hazard Management Council.

“To activate a full NEOC, it’s a massive undertaking,” Coleman explained, adding that this was the first time it had operated continuously for such an extended period.

Usually, the NEOC would be activated for a day to execute Cayman’s annual hurricane exercise.

However, under the cloud of COVID-19, the 17 teams that make up the NEOC were functioning daily for three months.

“We were meeting two times a day under the different groups,” Coleman said. “We have the NEOC meeting every morning. We also have the policy group, which is another part of the NEOC, and the National Hazard Management Executive”, consisting of the premier, the governor, MLAs, the commissioner of police and the attorney general. “So, that’s a massive functioning mechanism,” she added.

COVID-19 spread increased urgency
So far, 2020 has been far from smooth sailing for Coleman and her team, which have faced several challenges this year.

First came the 28 Jan. 7.7-magnitude earthquake, which was quickly following a tsumani-warning scare. Then, a few weeks later, Cayman experienced one of the biggest dump fires in recent history, which burned for several days. Soon after, COVID-19 arrived.

Even before the first case was confirmed here in March, Coleman said work was already going on behind the scenes to develop Cayman’s coronavirus pandemic response plan.
As countries began reporting cases, Coleman said, “we recognised very early on that this wasn’t just a health issue; it was going to be a sort of multi-agency issue.”

Hazard Management had already teamed up with Chief Medical Officer Dr. John Lee and local health officials in January. They had participated in a workshop with Public Health England in Miami to discuss Cayman’s pandemic plan.

Chief Medical Officer Dr. John Lee says COVID-19 is not
over and now is the time that the country needs to be
hyper vigilant and not let its guard down. Photo: Reshma Ragoonath

Lee, speaking to the Compass this week on the NEOC and Cayman’s COVID-19 efforts, said, early on, he too knew this needed to be a joint affair.

“There were lots of aspects that I knew that I couldn’t do on my own, [like] setting up the field hospital. I felt, from the very beginning, that we needed to have that resource set out and so that was clearly not something that the Ministry of Health could do on its own. It needed coordination to find the location and get the supplies and so on and so forth,” he said.

Lee pointed out there were also important issues such as centralising some of the thinking around how to secure supply chains for the most simple things, like drugs and intravenous fluids, to more complicated items, like ventilators and specialised drugs to treat COVID-19.

It also became apparent early on that personal protective equipment was unobtainable from anywhere because there was such a demand worldwide.

“So, [with] all of that, it was much easier to have a team working on it. In fact, the Health Services Authority had been working already in the background on these things,” Lee said.
Activating the NEOC focussed people’s minds on one central issue, he added.

“They realised … it really needed to take primary attention,” he said. “For example, I was asked at one point, ‘Well, should we be focussing all our efforts on COVID-19 and dropping everything else?’ I said, ‘Yes, you should. It’s that important.’”

From that initial assessment of the health crisis, Cayman’s central focus turned to suppression of the spread of the virus, which led to restrictions on travel and movement, and strict health protocols.

Both Coleman and Lee acknowledge that the COVID-19 fight is clearly not over.

However, the Hazard Management director said, “The risk at hand that we’re seeing and the results coming in don’t justify the full [NEOC] mechanism at this time.

“We also really need to think about sustainability … because we know we’re up for a busy hurricane season ahead. Operating an NEOC throughout the year… it’s going to be a very big task”, in terms of human and other resources.

Lee, who has been at the forefront of Cayman’s COVID-19 response, said, “I just felt it was an absolutely essential thing that the Cayman Islands had to produce the goods in order to get the right result for the country. I think we’ve been very lucky and blessed that we’ve, so far, managed to avoid huge amounts of people being sick and people dying.”

He said the NEOC can be activated quickly again, if necessary.

“I don’t think this is over, by no means, but up to this point, we have got all our plans set. The NEOC may need to be reactivated either wholly or partially at some point in the future should we have another COVID-related explosion of work, but for now, the work is largely done,” he said.

While the main NEOC body has been deactivated, groups with assigned responsibilities, like the field hospital at the Family Life Centre, management of the government-run isolation facilities, and government communication continue to function.

Next steps
For Coleman and her team at Hazard Management, the focus will now shift to hurricane season and getting the country ready.

“I think one of the main things right now from a hazard-management perspective is to make sure that people really understand that this year they have to be very, very well prepared,” she said. “They have to know where they’re going to go and we’ll do our very best to ensure social distancing in shelters. But, we’re really trying to advise people to be self-sufficient as much as possible.”

Hazard Management deputy director Simon Boxall points to one of the cluster groups that operate under the NEOC. Photo: Reshma Ragoonath

Hazard Management, she said, has been trying to increase capacity in new and existing shelters. It is also procuring personal protective equipment to be used within the shelters.

Cayman’s COVID-19 screening programme is continuing and, with antibody testing under way, a better picture of the virus’s presence on island will come into focus.

However, Lee said, this is not a time to relax, even though almost all the restrictions locally have been lifted.

Now, he said, is the time to “really to be hyper-vigilant”.

“We need to continue to do our surveillance testing programme. We need to continue to run the flu hotline, flu clinic, to watch to see if there’s any outbreak of disease. One of the absolute core functions of managing any public health emergency of an infectious disease nature is the public-health response,” he said.

Lee explained that the coordinated contact tracing and isolation of people has been a “huge piece” of work involving a lot of staff.

This, he said, was an advantage Cayman and other regional countries had over other nations around the world.

He said every year there are outbreaks of infectious diseases in the Caribbean.

“In the tropics, infectious diseases are far more common, so every year we look for outbreaks of dengue and Zika that we’ve had in the past … and the whole team knows exactly what to do right from identifying the areas to the actions they need to take, to the different organisations they need to involve,” he said.

While the domestic economy emerges from its three-month hibernation, all eyes turn to the resuscitation of the tourism industry through the border reopening.

Premier Alden McLaughlin has said government is working with the Cabinet-appointed date of 1 Sept. for the lifting of international travel restrictions.
Lee said New Zealand’s increase in cases following its decision to partially reopen its borders is a lesson that “you mustn’t let your guard down”.

“Our guard has been up … and we know that each plane has brought in people who have ended up being COVID-positive. Whether they could have actually spread the disease or not, that’s something that time may tell with better understanding about the disease itself.”

However, Lee acknowledged there is an economic imperative to allow businesses to go back to work as normal, or else other public health problems would emerge due to poverty and isolation.

“We need to work on that as hard as we can,” he said. “The government is currently working on plans to try to safely open the borders, but in a more conservative way. We would bear in mind at all times the potential risk of the virus and how we can mitigate that risk, possibly through technology, possibly through more stringent requirements, with visitors coming to Cayman.”

He added, “We’re all hoping to find the right way and I hope Cayman is able to lead in many ways because I feel we have been an example.”

It has been worthwhile to watch every country’s reactions to handling COVID-19, he said.

“There are lessons to be learned, very quite positive lessons to be learned from Cayman’s response,” he added, “and I look forward to the time that I can get on a plane and go on a holiday too.”

The chief medical officer commended McLaughlin and his administration for learning from others when it came to developing strategies to manage the COVID-19 crisis.

“I feel, in Cayman, we have actually paid attention to the historical lessons and I give due credit to the government because I think it has paid attention to historical lessons very well about epidemics and pandemics and how you can make big mistakes by relaxing too early,” he said.

NECO cluster groups

Human concerns

  • Shelter operations
  • Medical relief services
  • Mass fatalities management
  • Voluntary agencies

Emergency response

  • Evacuations
  • Community Emergency Response Team (CERT)
  • Search and Rescue
  • Security and Law enforcement

Support Services

  • Joint Communication Services
  • Continuity of operations
  • Resource Support
  • Economic continuity
  • Relief aid management

Infrastructure

  • Damage & economic impact assessment
  • Initial clearance & debris management
  • Utilities
  • Communications

Some of the key elements of Cayman’s COVID-19 response

Closure of cruise
Closure schools
Closure of border
Clear and Organised Communication
Acquiring tests
Establishing a Flu hotline
Conducting Contact Tracing
Acquiring masks and PPE
Protecting the Brac and Little Cayman
Shutdown between Islands
2 week initial lockdown
Assigning letter days
Slow and very gradual opening of the internal economy (recent challenges w restaurants though)
Securing buy in of the people for the curfew and the lockdown
Ramping up testing capacity and acquiring ventilators and masks
Efficient and timely legislative process (regs written in a timely manner and passed and implemented with efficiency)
Repurposing hotels as quarantine facilities and implanting a two week isolation period
Brokering of evacuation flights and air bridge, UK support including helicopters, ships, regiment, and generally UK knowledge, experience and expertise
Community support and interventions Including: pensions allowance (permission for non gov pensions holders to withdraw up to 10k plus 25 %),
Assistance for those in need to expatriates, PR holders and Caymanians.
Resilience Cayman computer for children who need them (Source: HMCI)

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1 COMMENT

  1. Congrats to CIG / Cabinet / Civil Service, His Excellency and team (& their UK liaisons), HSA and other SACGs involved, HCCI and CTMH Doctors Hosp., no doubt other smaller clinics, disaster management agencies, other supporting agencies, outside NGOs possibly, Church organizations which provided field facilities, Law enforcement and border control departments, private organizations including merchants and other service providers and their frontline staff, Mexican officials and local teams who coordinated acquisition of test kits, benefactors who help pay for them and transport them here, our frontline health care providers who were perhaps most directly at risk, despite the relatively low impact of cases – which was entirely unpredictable and could have been worse for them and everyone, and last but by no means least, the residents of the Cayman Islands for enduring a previously unthinkable event with decency and general respect for circumstances and law and order, despite hardships and impatience in some cases. Thank you all!

    This was/is a true example of a cohesive response, admittedly with no precedent and little time to execute, which so far has seemed to work well. The admission that it is not over is wise, real and comforting and vigilance must continue but at least we know we can do it and prevail if perhaps there is another wave or “flare-up”, and in the interim, continue to fine-tune and implement plans.

    Meanwhile, all the players deserve whatever little respite they can prudently be allowed to take from their corona response functions, for their own well-being and to focus on other significant responsibilities.

    The next challenge is re-opening our borders and I hope that will be handled with no less care and attention as was given to the corona virus response so far.

    We should be proud!