Office of the Chief Minister 29Th March 2021 Dear Mr
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Office of The Chief Minister Oik yn Ard-Shirveishagh Hon Howard Quayle MHK Chief Minister DOUGLAS Isle of Man IM1 3PG British Isles Telephone: +44 (0) 1624 685706 Email: [email protected] 29th March 2021 Dear Mr President, Mr Speaker, Honourable Members During the March 2021 Sitting of Tynwald I made a series of commitments. Firstly, in relation to Urgent Question from the Hon. Member for Arbory, Castletown and Malew, Mr Moorhouse. Mr Moorhouse asked a supplementary question on the testing of the Isle of Man Steam Packet Company (‘IOMSPC’) Crew members and if I knew how many crew members had refused a COVID test (Hansard Ref. 330). As I explained in my response to the supplementary question, this is not a about a refusal at the point of test. The Exemption Certificate, issued to non-resident crew members, includes a condition that the IOMSPC crew members must undertake surveillance testing at the beginning and end of their rostered shift cycle. This is a condition of their entry to the Island and failure to comply is an offence. The Direction Notice issued to IOM resident crew members, requires them to undertake surveillance testing so as to be excluded from self-isolation requirements. If a crew member does not agree to the surveillance testing then they would be required to self-isolate for 21 consecutive days from the date of their arrival back to the Island. Failure to comply is an offence. Secondly, I was asked by Honourable Member for Douglas Central, Mr Thomas, how many COVID cases has the IOMSPC has had over the course of the Pandemic. At the time, I was aware of six positive results, but committed to providing an update on this (Hansard Ref. 460). The answer of six was in respect of positive results received by the IOMSPC crew members who had undertaken surveillance testing. The IOMSPC has confirmed that between 1st April 2020 and 17th March 2021 a total of 27 crew members had tested positive for COVID- 19. This included UK crew members who had tested positive in the UK. Office of The Chief Minister Oik yn Ard-Shirveishagh Thirdly, during my supplementary questions, the Honourable Member for Ramsey, Mr Hooper asked why the symptoms of COVID on the ECDC website in an infographic published on 25th February are different to those on the IOM Government Website (Hansard Ref.955). I requested more information on this from the Director of Public Health. The ECDC infographic referenced by Mr Hooper listed the ‘symptoms of COVID’ as ‘fever, cough, difficulty breathing, muscle pain and tiredness’. This is different to the symptoms listed in the ECDC clinical case definition for COVID which are: ‘cough, fever, shortness of breath, sudden onset of anosmia, ageusia or dysgeusia’. Therefore, the infographic does not list a symptom which studies have shown to be a good positive predictor of actual COVID infection. Why the authors of the infographic did this is not known. The two symptoms they have included (muscle pain and tiredness) are included in the ‘additional symptoms’ listed in the case definition. Responses to previous questions have indicated how these additional symptoms are assessed by 111 clinicians. The evidence on the positive predictive value of these symptoms is weak. The fact that they are observed in patients who go on to test positive for COVID does not validate them as good predictors of infection – as always, association does not equal evidence of causation. The two symptoms listed on the infographic are two from a list of six additional symptoms in the case definition. Headache, chills, vomiting and diarrhoea are not mentioned in the infographic and no information has been given as to why they are excluded. In summary, the infographic varies significantly from the case definition which would seem to indicate an issue around consistency of messaging in ECDC. It also indicates the lack of a robust evidence base to quantify the positive predictive value of an array of non-specific symptoms that have been associated with subsequent diagnosis of COVID. In the same question, Mr Moorhouse asked if an IOMSPC worker who was awaiting their test results had to avoid certain places, such as areas with large gatherings, until their test results are available (Hansard Ref. 980). The Direction Notice states: The Biological Sample Test will be carried out in a designated area within the Sea Terminal, Douglas Isle of Man as directed by the Department of Health and Social Care (Community Health Team). In accordance with paragraph 2b) you do not need to self-isolate whilst awaiting the results of a Biological Sample Test, or between the start and end of Duty Periods. Office of The Chief Minister Oik yn Ard-Shirveishagh Under the Direction Notice, IOM resident crew members do not have to self-isolate, there are no requirements to restrict their movements and there is no legal requirement to remain at a specific location whilst awaiting results of surveillance testing. For UK crew members the surveillance test and any subsequent result, does not impact on the requirement to self- isolate whilst on the Island. In response to my answer for Question three as part of a supplementary answer, I told Honourable Members that I would ascertain as to whether the information on how many single parents are in isolation at the current time was available (Hansard Ref.1085). Unfortunately I am unable to provide this as we do not hold the information required to provide an accurate figure on total single parent households in isolation. During my COVID Statement on Supplementary Order Paper Number two, I was asked if I would look to publish the positive cases who had already been vaccinated as Gibraltar have published this data (Hansard Ref 1255). At the current time, we do not feel it is appropriate to provide this information. The data is not robust enough to give a sufficiently accurate answer and the results could be subject to error for a number of reasons. Data on infection and immunisation status should not be published on individuals until they are three weeks post first vaccination. This is because it is possible for someone to be infected and not know it at the time they are vaccinated. Furthermore, it takes up to three weeks for immunity to develop post vaccination. Due to our small population on Island, it would be possible that we could either appear to be getting exceptionally good or bad effectiveness from the vaccine as measured by infection rates purely be chance. I have been advised it would be possible for them to rapidly swing from one extreme to the other. Reliable data on real world effectiveness needs much larger populations. Public Health and DHSC will keep this under review, and if the situation changes, Honourable Members will be informed. Yours sincerely [Signature redacted] Hon Howard Quayle MHK Chief Minister .