Here are some common sense proposals to reduce the risk of infection in the Isle of Man. They should not be controversial, but rather, represent serious and achievable proposals to reduce the risk of the coronavirus reaching the Isle of Man – and reducing the risk when it gets here.
Slow to act
The Isle of Man Government has been slow to act on protecting our island from coronavirus. For example, it took until 25 February before they first asked members of the public who had been to infected regions to self-isolate, regardless of symptoms. Similarly, on 9 March, the Isle of Man Government was displaying very little signage on arrival – and what information it provided was out-of-date! Fortunately, as I write this, there have been no confirmed cases of coronavirus on the Isle of Man yet – but this is despite our Government, rather than because of it.
Concrete Measures to Protect the Isle of Man
- Since the Government has demonstrated that it cannot update paper signage in real-time, clear and prominent digital signage at our ports (airports and ferry ports) should be installed. This can be updated remotely, instantly and centrally.
- The Isle of Man requires people to self-isolate if they have been to a Category 1 region (currently Italy, Iran, China, some parts of Korea, etc.) regardless of whether they currently have symptoms. In addition, the IOM requires that people who have been to a Category 2 region (currently various parts of Asia) if they think they have symptoms. Because infected people do not always have symptoms immediately, or do not realise they have symptoms, we cannot rely on people to make this judgment. All people who have been to any of the affected regions should be required to self-isolate for 14 days.
- Follow the advice of the World Health Organisation China Joint Mission on Coronavirus for uninfected countries – and inform the public that this has been done:
- Prepare to immediately activate the highest level of emergency response mechanisms to trigger the all-of-government and all-of society approach that is essential for early containment of a COVID-19 outbreak;
- Rapidly test national preparedness plans in light of new knowledge on the effectiveness of non-pharmaceutical measures against COVID-19; incorporate rapid detection, largescale case isolation and respiratory support capacities, and rigorous contact tracing and management in national COVID-19 readiness and response plans and capacities;
- Immediately enhance surveillance for COVID-19 as rapid detection is crucial to containing spread; consider testing all patients with atypical pneumonia for the COVID-19 virus, and adding testing for the virus to existing influenza surveillance systems;
- Begin now to enforce rigorous application of infection prevention and control measures in all healthcare facilities, especially in emergency departments and outpatient clinics, as this is where COVID-19 will enter the health system; and
- Rapidly assess the general population’s understanding of COVID-19, adjust national health promotion materials and activities accordingly, and engage clinical champions to communicate with the media.
- Bolster our healthcare system by beginning to recruit retired doctors and nurses as additional staff to fight the escalating viral epidemic. This is important because when the disease spreads to the Isle of Man, some health care workers will be infected, removing them from work. Because these retired medical staff are likely to be senior citizens, these staff should be deployed in posts that do not expose them to undue risks (such as staffing phone advice lines).
- If UK universities close down, recruit any Manx students returning to the Isle of Man to assist in medical roles appropriate to their level of completed study and training. Identify those students now, and let them know that they are wanted back home in the Isle of Man if their university closes.
- Request the contact details on an on-going basis from commercial carriers (airlines and ferry services) of all people who have travelled to the Isle of Man, and contact them to ensure that they are aware of the self-isolation requirements.
- When the first case is detected in the Isle of Man, immediately implement the measures which we already know helped to reduce the impact of the 1918/19 flu pandemic (“Spanish Flu”). Early action is key to saving lives:
- School closures;
- Public gathering bans;
- Mandatory isolation and quarantine for infected people, and voluntary quarantines for as many people as can do it
- Develop our own, local, testing system, rather than rely on sending tests to the United Kingdom. The UK system is already backing up, with longer delays in processing Manx tests.