The decision on whether face masks should be worn in public will be determined by a national study that seeks to identify the number of infected people in the community, Deputy Prime Minister Chris Fearne said.

Fearne was speaking during the latest edition of Indepth, which centred on the Covid-19 situation in Malta and the measures that were implemented in this regard.

During the interview, Fearne was also asked about what other measures the health authorities are considering, including the much-debated use of masks in public spaces.

He pointed out that there are two situations where masks can be used; to protect oneself from those who are contaminated – as medical personnel are already doing with Covid-19 patients – or to protect others from contracting the virus.

Like all other measures, the Maltese authorities are following the advice of the three main health organisations in the world; World Health Organisation (WHO), the Centres for Disease Control and Prevention (CDC) and the European Centre for Disease Prevention and Control (ECDC).

However, Fearne said that these entities are not agreeing on the answer on the debate on whether the public needs to wear masks or not.

“Everything has its pros and cons. WHO is saying to not wear masks except for those protecting themselves since the mask may

annoy you, causing you to touch your face. The CDC says that you should wear a mask not to transmit it to others but only when there are a lot of people in the community that have the virus – the pros outweigh the cons in this situation,” he explained.

Therefore, the health authorities need to base any directives in this regard on evidence that they are gathering through a national survey, Fearne said.

A national survey is underway at the moment which is being used to gather more data on the actual number of infected individuals in Malta.

This is being done because there has been an increase in the number of cases where people who have the virus do not show any symptoms, which would mean that there might be more Covid-19 cases that are simply going unnoticed.

“This is what the survey will help with, as it will give us a clear indication of how many people might be spreading the virus within the community,” he said.

He added: “If the results show that a percentage of the population is spreading the virus without symptoms, then the government will take the decision to have the public wear masks, not to protect themselves but to prevent people transmitting it to others. However, we will take such decisions when we have scientific proof.”

The use of masks in public spaces has been debated on a global scale, especially since certain countries, such as the Czech Republic, are favouring this measure.

Last Thursday, the Civil Society Network appealed for the government to distribute masks to the general public free of charge, and for it to be mandatory for people to wear masks when in public places, or at least in urban areas.

“This measure is being proposed after the new state of affairs, wherein local transmission is becoming more prevalent,” they said, arguing that now is the moment where the risk of passing on the virus is highest in the street and in shops.

During a press briefing, Superintendent for Public Health Charmaine Gauci was already asked if the health authorities will consider making face masks obligatory to wear in public. She said that the health authorities are abiding by the WHO recommendations, but they are also following the Coronavirus situation in other countries to see which measures are most effective in reducing the spread of the virus.

 

Fearne pointed out that WHO has invited health ministers from across the world for a meeting in the coming weeks in order to discuss the Covid-19 situation within their respective countries and think of a way forward.

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Earlier story

The Health Ministry has put together a transition team that will be in charge of handling all medical appointments which have been postponed due to the COVID-19 outbreak in Malta and provide a contingency plan for a way forward, Health Minister Chris Fearne said on this week's edition of INDEPTH.

The interview, carried out by media consultant Rachel Attard, centred on the COVID-19 situation in Malta, the measures that the health authorities have introduced and the impact this pandemic has had on other medical services, especially at Mater Dei Hospital.

Fearne said that the ministry has been working on this pandemic since January in order to have a solid vision of how to face it. This meant that it had to sacrifice some resources in order to have more space for COVID-19 patients and more capable hands to take care of them.

"We were able to do this because we have a lot of appointments that are precautionary check-ups and nine out of ten of these typically turn out fine as they are dealing with minor issues," he explained. However, these appointments cannot be postponed for too long because of that smaller percentage of people who might be having severe issues.

Therefore, the ministry is planning for a transition wherein there will be an increase in the usual medical services without reducing the attention to COVID-19. This might require certain appointments to be transferred to other medical branches and the authorities are investigating this possibility.

"We plan to gradually restart these missed appointments. We have formed a transition team which will handle how we will give out those services that we had to put on hold because of the virus," he revealed.

The team is meeting with the minister on a regular basis and it will be presenting a preliminary report by the middle of next week.

 

Till today, the number of people above the age of 60 is lower than other age groups. Does this mean that we will have fewer chances of deaths in Malta?

Fearne explained that at the moment the number of cases in Malta is too low to accurately state if people of a certain age will be affected more than other age groups. What is known is that people with chronic illnesses or previous medical complications are more vulnerable than others.

"I said it clearly when the first COVID-19 victim in Malta was announced that this will not be the last death. In fact, we announced another death a few hours later," he said.

"We are anticipating that the death toll will rise but our job is to make sure we keep this statistic as low as possible and that victims of the virus die because of the virus itself not because we do not have adequate medical help."

He explained that other countries with globally renowned hospitals, such as New York, are not keeping up with the demand and the Maltese health authorities are doing whatever they can to ensure that this does not happen on our islands.

 

The first thing that the authorities did in this regard was to increase the capacity of beds to cater for COVID-19 patients. Fearne explained that there is no other country that increased its Intensive Therapy Unit (ITU) bed count by ten-fold like Malta did by increasing the amount from 20 to 200.

Having said this, he believes that the most important thing will always be the prevention of transmission through social distancing regulations and staying at home.

 

Lately, during the daily press briefings, the Public Health Superintendent Charmaine Gauci has announced positive cases that did not show any symptoms beforehand. Does this mean that the virus is present in more people than we think?

"We knew from the beginning that a large percentage of the people who get infected will not get severe symptoms," Fearne said.

He explained that other countries have seen this phenomenon happen wherein the figures that are being published are not accurate as the number of cases is probably twice or three times as much due to cases that show no symptoms.

He made reference to the statistics that came out from the first country hit by the virus, China. These show that 80% of patients do not need to be admitted to hospital. The percentage of people who might need to be hospitalised is 15% while only 5% might need intensive care.

"Most of the people belonging to that 80% will not even realise that they have symptoms since they are really minute. Physically they might heal in a day but the virus will still be present in their bodies for a number of days," he explained.

Now that Malta is seeing a rise in local transmission, such cases will become more common and the ministry has a national survey underway that is testing groups of people who do not have symptoms.

This survey will give the health authorities a clearer percentage of people that are actually infected on our islands. Such sampling is being done not only among the general public but also with healthcare workers and patients in hospital.

In turn, the results of this survey will help the ministry take more informed measures.

 

A lot of measures have been introduced for places where there is crowding of people. There are around 750 prisoners at Corradino Correctional Facility in Paola so social distancing is almost impossible. What measures will be put in place here?

Fearne said that he is working in close quarters with Law Enforcement Minister Byron Camilleri on this subject.

"We have introduced a number of strict measures, so much so that guards are living at the prison so that they do not have to continuously leave and enter the prison which would increase the chances of introducing the virus into the establishment," he explained.

Fearne added that there are also discussions underway regarding those prisoners who fit in the vulnerable category which are at higher risk of experiencing complications if they contract the virus.

"As we have done at the Ħal Far open centre, we are planning to have vulnerable individuals transferred from the prison to a more segregated area which will reduce their chance of contracting the virus." 

It was pointed out to him that Caritas has offered to help with social distancing measures in prison.

Fearne said that he is thankful for the Archdiocese of Malta and all entities and NGOs who are offering to help them, not only in this regard but also in other affected sectors.

He explained that he will be opening a call for volunteers to help health authorities during this time who do not necessarily need to come from a medical background.

With the amount of testing increasing on a daily basis, Fearne said that they will need more human resources to call people about their test results or to book their place for a test. They also need people to help transfer food to those working in the frontline.

However, he emphasised that this all needs to be done in an organised manner which is why they will be formulating a database which keeps track of each applicant's skillset.

 

Do you anticipate a lockdown?

"We are basing the measures we take on scientific evidence and we are trying to be as quick as we can in collecting this evidence," he explained. "There is something that is called the reproductive rate - how much a person can infect other people - which tells us if we need to increase or reduce our measures."

Fearne said that there could come a time where further steps need to be taken, in the same way that there will be a time when measures will need to be reduced, which is something the aforementioned transition team is working on.

The team will not only be taking care of appointment backlog but also investigating whether it would be safe of people who overcame the virus to go out in the community and work as usual.

Malta is one of the very first countries which are implementing this system.

Fearne explained that the three main health entities in the world - WHO, Centres for Disease Control and Prevention (CBC) and the European Centre for Disease Prevention and Control (ECDC) - are recognising the steps that Maltese health authorities are taking with regard to COVID-19, so much so that they are turning to Malta for advice.

"Something which is beautiful yet scary is the fact that we usually call them for advice, but now they are contacting us to get pointers on what to do. This is great as it validates the decisions we are taking but it is scary because we are used to asking them for advice but they are not able to provide it," he said.