Issue link: https://maltatoday.uberflip.com/i/1354201
6 maltatoday | SUNDAY • 21 MARCH 2021 NEWS 'Three weeks need to elapse between one stage and another' CONTINUED FROM PAGE 1 "High risk is associated with exposure to persons recently returning from abroad from countries with high prevalence of cases. The risk of importa- tion of COVID infected indi- viduals is still very high and the experience of countries who have started relaxing their borders has shown this is one most likely source of a second epidemic wave," the Superin- tendence warned. Malta reopened its airport fully to international travel from 'safe countries' on 1 Ju- ly – six weeks after this report was distributed to the govern- ment. The Superintendence had ad- vised that any withdrawal of measures had to be taken in a "cautious, stepwise approach" to allow sufficient time to eval- uate the response on transmis- sion rates. "It is important to note that to effectively assess the effect of population mix- ing, planners need to wait for a period of three weeks (the incubation period of the COV- ID-19 is 14 days) to evaluate the effect of the down-scaling transition measures on the in- fection progression from one stage to another," the report stated. EU decision informed travel ban lifting Phase 2 reflected a partial lockdown, which was the start- ing point for the transition plan, while phase 3 was the in- itial opening of low-risk activ- ities at a low rate of infections with no growth in daily cases. But in between each phase, the Superintendence advised "a window of three weeks be- tween Transition Phases… as this will allow for adequate as- sessment of the effects of pre- vious phase changes and will also permit a review to guide decisions on whether to pro- ceed to the next phase or not." The report stated that iden- tifying the time when public health measures were to be suspended at each stage, was "a key strategic decision": the main choice was whether to speed it up, or scale it down gradually on a longer time- frame. "The main choice is between shorter time frames involv- ing fewer steps with more measures being scaled down or completely suspended, or the converse, i.e. longer time frames with more steps and a lower number of measures re- scinded at every stage. Three weeks need to elapse between one stage and another in the easing and withdrawal strate- gies to be implemented." In a reply to MaltaToday over the 1 July decision to lift the travel ban, the health minis- try said this was made in ac- cordance with the European Council Recommendation on the temporary restriction on non-essential travel into the EU, with several red zones re- maining banned for travel. On 22 August, an amber list was introduced for incoming trav- ellers who required a PCR test 72 hrs prior to arrival. The health ministry told Mal- taToday that it treated the doc- ument as a "baseline" recom- mendation, which was adapted according to the "successful mitigation of the risk for the various activities in each phase. For all measures which were lifted, there was never a com- plete lift of measures as stand- ards were put in place for each measure for mitigation." The health ministry also said it was encouraged by ITU oc- cupancy as one of the critical variables as to whether it could relax public health measures. "Pressure on the ITU was be- low the established thresholds when gradually measures were being withdrawn last year. On the other hand, the ITU situa- tion was also one of the consid- erations that led to more strin- gent measures in March 2021." Prior conditions before easing of restrictions The 15 May plan also stated the conditions that had to be in place prior to the relaxation of any public health measures which, in the words of the Su- perintendence, would be "akin to walking a tight-rope". "A significantly decreased level of community spread of disease for a significant amount of time needs to be registered. A starting threshold is a Rt value below the self-sus- taining value of 1, that is sus- tained for at least 14 days," the report stated, a condition that was respected at the time of the May easing. The Superintendence warned that Malta's public health sys- tems would be "too slow" to manage a resurgence of COV- ID-19 from an easing of physi- cal distancing measures. It said it would need "resilient moni- toring tools" and technology for a "certain level of digital surveillance of cases and their contact" in order to obtain • Superintendence warned of high risk of importation of COVID on 15 May 2020 • Travel abroad was categorised as high- risk, to be allowed at a ninth step of the relaxation of health measures, sometime in early September according to th 16 May transition plan • On 19 August, new health measured had to bre reintroduced for clubs, bars and public gatherings