Hantavirus Update- Wednesday 13th May - Dr Jake and Minister Martin Henry

Welcome and Overview of Hantavirus Update Discussion Good day to all our listeners. This is Anita Robertson on Sam's Radio One. In the studio with me to give the listening public an update on the situation regarding the hantavirus globally. And here on Saint Selena is Doctor Jake Asplan and Minister for Health and Social Care Martin Henry. Welcome to both of you. And I will First off hand over to you. Do just give us an update and then if there's any questions, we will deal with those afterwards, Yeah. Speaker 2 Sure. Speaker 3 Oh, so well, thank you for having us again. And as you've just said, we're here again to give another update, which we have done consistently over the last week or so. Now Jack's been our past and that's that's the one that that sort of comes every week. He's the one that that's picking up all of the data and, and also speaking to our teams in, in, in the UK and of course directly with our teams here. So he brings with him the, the latest we have and dare I say again, the latest confirmed information we have. I have to keep repeating this because we have to ensure that that, you know, we, we qualify, we, we fat chat before we come and bring out our data. Of course, last night press release went out. We have promised to keep the public informed with the latest informed data of the situation as it happened and last night we we also did that. So I think today is quite important that we update behind some of the information that went out last night. I noticed this quite a bit of questions around today. I've had questions today about, you know, what about, about testing, what about isolation? What about high risk groups etcetera, etcetera and they are still coming in. So I think it's a good opportunity for us today to discuss some of those things in in more detail so that at least the public understands that you know there is a method behind all of these things. And and I think I'm also some some very good news around the testing etcetera as well. So I'll hand over to Jake in just in case I say something I shouldn't when it comes to the technical terms to be able to just update on a few of those bits. OK. Hantavirus Global Status and Ascension Island Developments Yeah. Thank you, Minister. I think as I've done with every session so far on this topic, I'll provide a quick update from the global picture and then we can talk a little bit about Saint Helena as well. So in terms of the global picture, we have no movement in terms of the cases reported and verified by the World Health Organization. So that is 8 cases, that's 6 confirmed with antivirus and two probable cases. However, there are media reports and and local reporting from three other nations, that is USA, France and Spain who are reporting possible cases there as well. Again, we will wait until they have been fully verified by the World Health Organization to to include those in our numbers that we're updating. So that is just to reiterate, we have 8 cases and a possible three more down the track once that you know the full verification has happened here locally, absolutely stable. So really reassuring picture. Again, we have 0 suspected cases of antivirus. We have nobody with symptoms suggestive of antivirus that we are monitoring. We have 22 people in isolation. So there's no movement on that figure And all of those 22 continue to have their daily check insurance and remain well, OK. And, and just to confirm as well, from the global picture, we have 3 deaths in amongst those 8. So that's no further deaths reported, which is which is great news. Speaker 1 Good news, yes. Speaker 2 Overnight, as the ministers, as mentioned, there have been some developments in Ascension with some implications for us here in Saint Helena. So one of the high risk contacts that was being monitored over in Ascension has developed symptoms. These symptoms are consistent with hantavirus. But as the public will know from my previous messages, that symptom list is quite long. So there are lots of people who may develop symptoms and it, you know, that can include both breathing problems and, and in sort of gastrointestinal problems, nausea, vomiting, diarrhoea, those types of things. I'm not going to speak specifically about that case because that would be breaking, you know, confidentiality. But that person is being monitored by the team and there is a plan in accordance with the plans that we've had in place all along that we are, you know, we're working in lockstep with our sister territories that that person will now be evacuated back to the UK just to ensure that they're in the absolute safest place with access to the highest level of medical care possible. Speaker 1 But I believe that the press release also said that the initial testing was negative. Speaker 2 For yeah. So the situation in in, in essentially is slightly different to what we have here because they have direct access through flights back straight back to the UK. They've been able to monitor their high risk contacts with testing. So the testing is taken in in Ascension and then that test is flown back to the. Speaker 1 UK so it's a little bit quicker the turn around time. Speaker 2 Well, yes, so there's obviously a delay in getting that sample all the way back to the UK. But what they have been doing is testing their high risk contacts regularly, whether they have symptoms or not, just to see if they can get the earliest sign that there may be a problem and so they can act as quickly as possible. It's worth saying for that for this case, they were that that routine testing was taken on Friday and their test for antivirus was negative. OK, so between Friday and yesterday, that person's fallen unwell and it's being followed up and there's further testing ongoing to try and confirm exactly what that diagnosis is. Speaker 1 OK. But the plan is to repatriate to the UK. Speaker 2 Yes. And that's in accordance with the precautionary measures that that Ascension and we here have had all along. Obviously, there is a delay in getting that testing. Ideally they'd be able to do the test there and then and figure it out for themselves. But because that they're relying on that air bridge to take the samples to the UK for testing, the safest thing to do, and that's what we've been doing all the way through this, is taking the safest option every time that that that person is now being relayed back to the UK. Exploring Local Hantavirus Testing and Its Complexities Just a technical question, How long does the testing take? How long does it take to have a result? Speaker 2 Yeah. So, so in terms of in the laboratory, once that sample has made it to the laboratory, that can be done in a matter of hours. Oh, OK. So. Speaker 1 If you have the facilities, you can really quickly. Speaker 2 Exactly. Yeah. So I mean the, the, the obvious challenge for for the folks over in Ascension is getting that sample to the laboratory. It's worth saying that again, and I've said this and I'll repeat it, that testing for Hantavirus is a very, very specialist skill. For example, in the UK with all the facilities that are all over the UK, there is only one laboratory in the UK that performs that so. Speaker 1 It's not like something we can ship out here and do on Saint Helena. It's not anything like that, so. Speaker 3 Reconfirm that this morning. It's just like just one laboratory. Speaker 2 So I mean so, so you, you mentioned that that there there obviously as as the minister's alluded to, there is some good news regarding testing here and the public will be aware that we have been supported by a few medical personnel over from the UK. Two of those people are laboratory scientists and something that they've been working on in the background is looking at the feasibility of whether we can perform the testing OK that which would. Speaker 1 Be very reassuring for the public, yeah. Speaker 2 Absolutely, Yeah. So that feasibility study or or work is still ongoing and hopefully we will be able to update with a with a confirmation of whether we're able to do local testing or not. But just to reiterate again that how specialist that testing is, it's no guarantee that we'll be able to do it at this point, but we're looking to see whether we can perform it within within the kit that the the guys have brought over with them and then obviously in this environment. So we're looking and the team are trying really hard to make sure that that can happen. But it's worth saying again that we need to make sure that the facilities here and the environment can support proper testing. We want to rely on reliable tests. Speaker 1 Yeah, you also don't want to create any false results. Speaker 2 Or anything like that. And there's also just to consider as well the safety of our laboratory technicians as well. So there's, there's the technical aspect of running the test, but there's then having the environment that keeps them safe if they are potentially handling specimens that have antivirus that they are not then infecting themselves. So there's all of that to be worked out and the the team are working long, long hours to make sure that we can get that result as soon as possible and to see whether we're able to support testing here on Saint Helena. Speaker 3 I think probably at this stage, Jacob, it's it's important to point out as well because there's there's a lot of noise and I think members are picking up from the fact that countries are declaring that they're testing people etcetera. I think it's important to, to pick off, you know, testing in terms of reliability, et cetera, of, of some of these more, more mobile testing versus what we are trying to do here as well. Because you know, now that I've sort of, you know, we, we knew the kid arrived. We, we wanted to ensure that it was set up and functioning prior to us coming to say that we could test because that's important as well. It's it's much better to say that we can test. I know the kid is now set up. I know test. We pretests are being ran to, to, to, to, to go through the stuff that that Jacob's already talked about. But I think it's it's, it would be good at this point to sort of distinguish the difference, would I say, because it, it's starting to sound like, and I think in the back of people's heads is that this is now a curve. We can stick a stick. Speaker 1 Something in your. Speaker 3 Mouth and and and two lines are going to show up on the screen and and I think that's an important. Speaker 2 Yeah. So I think a lot of people will be familiar with the little test kits that you got, the little rectangle plastic white thing that you, you know, you, you performed your sample and you dropped a little bit of fluid in there. That's something that got various names that you can call it a rapid diagnostic test. This is the the testing for antivirus is not that it is not that straightforward unfortunately. So it needs highly specialist equipment to be brought in to make sure that it's functioning, to make sure all of the things are there, to make sure that the reagents and the chemicals and things that are used to. Speaker 1 Do and then the safety of the staff. Speaker 2 As well and then the safety of the staff as well. So unfortunately it is not as straightforward as ordering a box of, of rapid test. It's not that certain. So that's and that's why we're taking our time to to to issue this information because there's lots of things that can go wrong in between packing that kit up, shipping it out here, getting it off the plane, getting it here, setting it up, all the rest of it. So we're looking, it's so far so good, but we can't say for definitely we'll be able to do it until the team and the laboratory scientists have full confidence in the results that it's going to produce. What we don't want to do is test people and it to throw up spurious results that are giving us false information. So it it unfortunately takes this time to make sure that we can use these tests appropriately. Speaker 1 Which is understandable. Understanding Hantavirus Risk Categories and Medical Exposure This leads me into the next question. Now in the press release, it stated that that it has shown symptoms on Ascension, was part of the medical team that treated the person that got off on Ascension. What I want to ask is did any of our medical personnel have exposure to the hantavirus and are they being isolated? Are they high risk? Do we have any of that high risk cases here that they have on Ascension just to you? Speaker 2 Know, OK, yeah, I think that's a really good question. So we've we've spoken a little bit about higher risk and and high risk and lower risk. There's lots of different things yeah. So what we have is there's probably two things occurring in parallel here. There's one which is where the evidence and the guidance coming from the UK Health Security Agency allows us to categorise people's level of exposure. That's in three tiers. The people who we are talking about being high risk or and those are the folks who will enter isolation are those in category 3, the highest risk. But what you've got is within that category is the is the, you know, that's, that's a relatively arbitrary categorisation. Within each category you've got a spectrum of risk. So if you think about the people who have contracted the Hantavirus or even those that have sadly died that are associated with the ship, that is because they are passengers who have spent multiple days if not weeks aboard the ship in this environment where there has been. Speaker 1 Cases, and that's the only confirmed cases is from the ship. Speaker 2 All of the cases that have been identified so far have had direct contact with the ship, IE they have been passengers. Yes, obviously there's lots of people on the island who visited the ship. Speaker 1 Yes, there's something different. Speaker 2 It's not the same. And so, you know, that's one category within a category of particularly high risk. Of course we have a number of people here who were passengers on the ship for a small period of time. So we can think of those people as within that higher risk, within the high risk. Speaker 1 And these are the ones typically isolated now. Speaker 2 Yes, so, so all of our high risk in the category three are isolating, but within that we do have a number of people who were passengers on the ship who we are monitoring with our utmost attention. The other element that you might think within that broader group who are at a particularly high risk or medical personnel. Now none of our medical personnel have had any interaction here on Saint Helena with a case of antivirus. We have not had a case of antivirus on St. Speaker 1 Helena so the lady that left here on the Airlink flight, she had not been to the medical. Speaker 2 She had not interacted. Speaker 1 And she wasn't symptomatic when she left here. Speaker 2 So we believe that she was showing early signs and that's why we are taking all the precautions we have because she would have been able to, you know, in theory, able to spread this infection to other people here. So that's why all of this precautionary activity is going on. So that's our situation in Saint Helena is due to a couple of people who were showing early signs interacting with our community in Ascension. Their risk is again, slightly different because that's the medical personnel who were treating one of the cases who was then Med evacuated from Ascension to South Africa. At that point in time when they received that patient, there was no indication that this was hantavirus. You know, there was very, very limited information about exactly what was, what was going on with these patients. And of course, the medical team stepped in and supported and saved that person's life. Speaker 1 As they would anyone coming. Speaker 2 Sure. And that included doing some quite invasive procedures. And obviously when you do invasive procedures on somebody with an infection of this kind, that puts people at risk who were there in very close proximity and doing, you know, all of the procedures that they need to do to support that person. So I'm saying all of this because those folks who are on Ascension even within that broader high risk category are probably even, you know, they're at an even more elevated risk as opposed to, and I'll give an example of some of our folks who are in isolation here who meets the definition of being in the high risk category 3. But actually their level of exposure may have been a 10 minute conversation with one of these. Speaker 1 People, even though they spent time on the ship with them travelling, they might not have had that intensive contact, yeah. Speaker 2 Yeah. Or we've had or we've had those two cases who have come off the ship with those mild symptoms and interacted with our community. You know, for example, one of the the the lady was grieving the death of her husband. It's absolutely natural that people here would have offered her some support, consoling and things like that. And so those are some of the people that here in Saint Helena that we've asked to go into isolation. But you would appreciate that giving somebody a hug is. Speaker 1 There a different to spending days on one ship. Speaker 2 Or providing in depth invasive medical intervention. So there's a the the whole reason I'm explaining all of this is because you have a category three. Those are the people who are placing. Speaker 1 But different tiers of that. Speaker 2 But within that, there's a real spectrum of risk. Speaker 3 And I think it's also pruned to include the fact that we, we have a, a sort of double case on the ship with the ship's doctor as, as one being on the ship, but also treating patients who had who, you know, we now know had had the virus. So if you look at it from, from that spectrum, it places both those categories, you know, in terms of what we have here as high risk people travelling and also medical procedure, which happened on the ship above, not the full procedure, but a medical intervention. So, so we can compare them as as a almost like for like when we're looking at that whole spectrum. Speaker 1 OK. Speaker 2 That's correct, yeah. Yeah. High-Risk Repatriation Logistics and Funding Discussions So the, so the the other thing I can say is regarding that person who is showing symptoms in Ascension did have a family member who has travelled to Saint Helena and I know there'll be questions. Speaker 1 That's also mentioned in the press release, yes. Speaker 2 Exactly. So it's worth clarifying the and we, I think we said in the press release that we were going to figure out exactly what the details of that was. And I'm happy to say that we are able to exclude that family member as a contact of Hantavirus, so. Speaker 1 Yeah, that's really reassuring. Speaker 2 Yeah, absolutely. And so just as a precautionary measure overnight whilst we were, you know, retrieving that information, you know, between my colleagues in Ascension and we asked that person just to remain in isolation until we could say safely that they were not in contact with any case of antivirus. OK. So the team in in Ascension had done a really good job around managing their interactions with their high risk contact. And so that person who's developed symptoms did so after the last known contact with this person. So there's absolutely no opportunity if this turns out to. Speaker 1 Have transmitted. Speaker 2 Us, which we don't know it is, there's no opportunity that they could have passed that to the person who was flown here. So there are absolutely no public health restrictions on that person having arrived here in Saint Louis. So that's good news. Speaker 1 Brilliant. OK. So we talked a little bit about the repatriation. So we've obviously had reports that people are being repatriated and still to be repatriated. Can you give us some more information about that? How many have been and how many still has to be repatriated? And then also how and when this will then take place. Speaker 2 Yeah, that's a good question. OK, So the, the entire international community who are involved in managing this incident have and are continuing to attempt to find the people who are at the highest level of risk, as I've just gone to pains to explain. Amongst those are the people, the primarily the passengers who are on the ship. So the from a from Auk perspective, what I can say is that there were 20 British nationals on that ship as it approached to the Canary Islands. They have now been repatriated to the UK and in accordance with that the same level of precaution is being afforded to the UK overseas territories. OK, So what we have on island are a small group of people who did transit on the vessel for a small number of days. Speaker 1 That's mainly from Trust them. Speaker 2 That's correct. And we are looking to, you know, they are absolutely included in that operation to get them back to the UK, OK, Just as a precaution that if they do end up developing symptoms, they are in the best possible place to be treated, to be treated promptly and they can be monitored and supported through that period of isolation. And of course, the same thing applies to those contacts in Ascension that I've explained are at an even more elevated risk. And I am aware as well that in Ascension there have been a number of personnel already relocated to their countries of origin, which is not the UK. So, you know, all of the international community is working on the same principles here. Speaker 1 To relocate all of their citizens to their countries of yeah. Speaker 2 So those that are so those that are the highest risk within the high risk category are, are being supported to do that. And I think that's entirely appropriate. Yeah. In terms of timelines, you'd asked again, think, think the position is that we're in advanced stages of planning for that for our folks who are here on Saint Helena, exactly when that will happen. I think your listeners will appreciate that. Flights coming in and out of this island can can slip one way or the other. And so I'm not going to make promises at the moment, but I will reassure everybody that those plans are in advanced stage. Speaker 1 To say that they will be repatriated. This now does not go on the Airlink flight. This will not be on the commercial flight. Would it be on a chartered flight? Speaker 2 That's exactly right, yes. So this is a specific flight that has been supported by the UK government to support us as the overseas territories. This will not be an Airlink flight. This will be a a managed situation where any potential risk to anybody else will be minimised to it's it's lowest possible degree. And so yes, the answer to your question is that this will be a chartered flight specific for this reason. Speaker 1 So we all know that those flights always come at very high costs. So what I would like to know is with all of the things being said that the risk is quite low or spread of infection. I know you guys are trying to do the safest route, the cost of that flight. Would that be supported by the UK as well or that's going to be a St. Elenium thing to carry? Speaker 3 Let's just say that I am keeping a separate balance, but I, I am, you know, I, I, I would be, let's say disappointed if something like this heads head to come back as an entire, you know, for the Saint Helena government to support. Given that this is an international emergency, given that it was Saint Helena and Ascension that that flagged it. And you know that I, I think it would be a, a smaller amount in terms of value compared to parachuting people after interested, which I totally support that. And I and I don't think there's a scene at the I don't think in, in terms of cost calculation where we're at that point. We were starting to really worry about that. We're OK, fast and foremost. We're worried about, of course. Speaker 1 Lives matter first, but I was just, you know, with the budget and everything's looming ahead and, and I totally. Speaker 3 Understand that as well because even making that statement lives do manifest, but I also have to try rent a yes, very difficult health system on a tiny island, the health budget. So, so there is a cost, yes, as I've learned over the last five years. So no, I think that's important. St. Helena's Readiness and Answering Public Concerns I also think Jacob, it's, it's worth speaking a bit of about what we're doing here as well, because we have had logistics support now and we do have support, but but you know, setting up our our unarmed facility for that that very low, but just in case emergency. And I think that, you know, again, as I said on the previous show, just because I sit and listen in, in, in these meetings, the new members of the team have now joined our, our daily catch up. So, you know, that type of information would be good. I I would say going out to the public because just to know that there's, there's multiple layers here. You know, if, if a flight can't come, if there's a difficulty with repatriating a person who potentially is ill at a given time, given some of these symptoms kicking really quickly, some of them take a longer period of time depending on the individual that that people know that we're set up for that as well. And, and, and we're in advanced planning stages as well. So I think, yeah, that's a that's probably a good deal in as well. Yeah, absolutely. Speaker 2 So I think we've spoken on the radio before when I was on with Peter Moss the other day, our Chief Medical officer that we are. I've already mentioned the laboratory scientists, so I won't repeat myself there. But we are also being supported by a infection prevention and control specialist who's deployed to the island. And that is to offer us the absolute best advice on how we can safely manage any potential patients that develop signs that are consistent with antivirus through our hospital system without exposing anybody else to any risk, increasing the risk. Speaker 1 So. Speaker 2 Anybody who's visited the hospital in recent days may have seen some additional doors being erected and that's to provide again a specialist pathway through that hospital to ensure that the risk of infection is is minimised. There's all types of different sort of technical procedures and things that you can do in order to minimise the risk of infection passing from one person to another person. That and that is of course our staff as well who will be having refreshed on all the the maximum level of personal protection. So that's the kit that they wear and the procedures that they take to put that on and take it off, how they manage any clinical waste or even the bed sheets of the potential patient and the pathways that. So there's lots of little, little bit technical things that have been improved and supported by the deployment of that person. So we're absolutely hugely grateful for the support that we've received from that. It's really reassuring. Speaker 1 To have that in place, isn't it? I think it's a it's. Speaker 3 A more sort of nervous type of question, because we are asked all types of questions and I can't. Speaker 1 Actually pop up. Speaker 3 And that was one about whether if Hantavirus had to come here with a person, could it then go back and mature in the rat population here as as a reservoir? Oh my, I haven't. Speaker 1 Even thought of that and that's what. Speaker 3 I mean, that's why it's important that that information comes in. And the answer is definitely no 'cause it comes on the back of looking at what do we do with the weights and how do we make sure that that is so. So, you know, believe me, this this questions about almost everything we can possibly think about. And it's important that that although sometimes it may seem like it's just a that if a member of the public has a random question, we falter it through. And I and I do actually like the idea because we do in these updates that those questions come to yourself as well. So we can, Yeah, that's really. Speaker 1 Interesting and and. Speaker 3 The other radio show if necessary so that we can we can come and answer them as we are doing now, rather than trying to put little bites of information all over the place, which then can actually as a get lost in the system and and be used sometimes to just to out of. Speaker 1 Context. Yeah, so I. Speaker 3 I think sort of what we are doing now and how we are trying to manage this, I think is is in the best possible. But please do continue to ask those questions whether you feel that they are, you know, something which may be a bit silly or something, but if it comes to your mind, why not us to be able to look at it? And and I thought that was a really good question. Yeah, I think, I think. Speaker 2 It's really important that people continue asking and that's all we're here for to support people to understand exactly what the situation involves. And I think hopefully by today talking through some of the level of detail that we're going through in preparation that people find some reassurance from that, that we are working in painstaking levels of detail In the very, very rare event that we do have somebody who who is suspected of having antivirus and thankfully we haven't had that yet, but it might just be a point now to just re emphasise. I've spoken a little bit about risk and high risk and higher risk and those are relative terms. So if we actually think about what the absolute risk is to somebody, even our folks who've been on that passage, even the higher risk. Speaker 1 One exactly that. Speaker 2 Risk in if you were trying to quantify it would be really, really small. And I'll reiterate again, we've had lots of people, you know, over 150 people on that vessel for a number of weeks literally stuck and contained within this situation where this thing is passing around. And we've only had a couple of handfuls really cases. And so the opportunity for somebody to be infected on this island in the minimal levels of contact that they may have had with a couple of these people is is really, really small. So even though you know, we're asking you to to maybe enter isolation based off that interaction, the absolute risk remains small, remains very. Speaker 1 Small and as I've said, the. Speaker 2 Whole way through the reason we're taking these this level of precaution is not because of the likelihood that this might happen, it's because of if it does this is a nasty infection yes, but you. Speaker 1 Have taken all of the precautions we have to be absolutely. Hantavirus Transmission, Incubation, and Public Reassurance Ready to deal with that and and and I. Speaker 3 Think, you know, just to put that in some sort of contacts and perspective, we know that it just takes one plane to arrive here with the flu on over Christmas and the whole island is to give contacts on and in terms of of our influencer spread, yeah. So, so it just takes, you know, two or three people on on their flight. And I think, you know, that, that, and we were discussing this, you know, just before we, we, we came on, which, you know, while it's much better that for us definitely that, that this has a low transmission base, it, it gives us the ability to be able to try to step ahead. It does have a very long incubation period, which means that it, it will go on for a bit. So there's these two elements, you know, and if there is a, a, a new contact or if there's someone who is, then you know, if this does become something which is a sedentary, then that whole period is long. So while I'm absolutely grateful I would say for its low transmission, we also have to be aware that if if there is, you have to. Speaker 1 Monitor it for longer. Yeah, it it. Speaker 3 It will take that particular time, yeah. And and. Speaker 2 It's a good point to make because people will remember potentially from the COVID days about itself, the the isolation period, you know, quite short. As the evidence developed, it came down I think from 14 days down to 10 to a week and A5 eventually. And that's because as the as the evidence developed, the evidence for this infection is different. Thankfully, this is not flu. This is not COVID. It passes. Speaker 1 Around really easily. Speaker 2 However, it has this really long, as the minister says, incubation time, so the period between you having been potentially exposed to then first developing symptoms can be a long time. And that's why we're having to unfortunately ask those people who we think are in that higher risk to isolate for such a. Speaker 1 Long time to isolate for up to. Speaker 2 4, 45 days So and I, and again, I reiterate my thanks to the people that are complying with that public health advice. And I understand that the sacrifice they're making, it's, it's, it's a hard thing to do. It is and and we and the island is grateful for that, I I think. Speaker 1 The public is really grateful that they know that their safety is paramount in this whole procedure. The one thing that I want to ask is, and I know you have said this many times, but just to reiterate this, you cannot spread the virus until you start showing symptoms. Yeah, so. Speaker 2 The the the the key point in time where you become maximally able to pass this around is when is in the actually the early bit of the infection, so right in the. Speaker 1 Beginning, yeah. And so that's. Speaker 2 Why, when we're thinking about what's occurred on Saint Helena, is the 2 cases who came ashore were in that, We're in that. Speaker 1 Phase of their. Speaker 2 Illness and so This is why we're having to take all these precautions because we call it the prodrome. That's like the kind of the initial first symptoms that start to show just a little bit of a scratchy. Speaker 1 Throat. Well, it might be. Speaker 2 That yeah, I think with this it's it's kind of, you know, people will start to develop a fever, might have a headache, muscle pains, those kind of things. So we call that a non specific. So it's not really telling us exactly what's wrong with you. Could be flu. Speaker 1 Anyway, exactly and and. Speaker 2 Actually, and I've said this before, if somebody who is in one of these risk categories on the island develops a fever, likely thing is it ain't antivirus, OK? But we of of course have all these pathways in price so that we can, we can make sure that that is safely assessed and then and then, you know, full expectation that we'll get to the end of this without having seen any cases of antivirus. So there's no. Speaker 1 Research showing that before you have any symptoms that you can actually pass this on so so there's. Speaker 2 The evidence as I've said is is limited. I think what is known is that once you do have symptoms, you're able to pass it on. And, and so one of the things that is offering us some reassurance, which is if we can get our testing up and up and running, which it isn't yet, and we hope that it will be, is that that test should be able to pick up whether you have the antivirus before you start showing symptoms. So that's one of the key things that we'll be looking to do. As soon as our laboratory team have said, yes, this is good to go, we can run these tests in Saint Helena. We really, really hope that they'll get that online soon. We hope it will work for us. That will enable us to potentially pick up anybody that's become infected at an even earlier stage than we would have done by relying on our daily check insurance to see when symptoms develop, I think. Speaker 3 It's also important as well and again this is just from listening to to progressive conversation that while we may not be able to use test kit to rule if it is antivirus, what we can do and what we've always done is we actually can detect other viruses so we can rule back. So we can you know and say, okay. Speaker 1 This is definitely the flu. Yes, this is. Speaker 3 You know, one of the viruses which spreads around the island constantly and we do know that there are a few girls about right now. And I think we know that personally for some of us, but but there's also medical evidence to show that as well. So there's a couple of ways to sort of, if I put it in the broadest detail to skin this cat if we want to and if we can't get the primary goal, we can do screen for. Speaker 1 Others from others. Speaker 3 And that's part of. Speaker 2 The additional supplies that have already arrived on the island, we've had extra test kits which are able to detect a wide range of viruses that would also present in a similar way to antivirus and they're easier. Speaker 1 To detect and we. Speaker 2 Already have that testing capacity set up and ready to go on the island, OK. Speaker 1 So anything else you want to tell us? So you. Speaker 3 Know crop summary. Yes, there has been a movement in information. There has been a movement in an event. You know, again, as I've said from the beginning, we have to work through this when information becomes available and when it's confirmed last night, I hope it does show the public that when we do have confirmation, we will we will not just gonna come here and say good stuff. If this stuff which which could potentially move in the other direction, we we will say it up front and early. I think that's really important. There is nothing there is nothing that we would want to hide from the public in a potential virus outbreak. The most important thing is to get out information, information at the earliest possible time. So I do hope the public take on board that that that is the goal. That is the goal of this update. That is the goal of the press releases and that that will go out. So yes, I'll hand over to Jake to sum up. Yeah. Speaker 2 Just to summarise, what the position is, again, here in, in Saint Helena is we have 0 suspected cases of antivirus. We have 0 symptomatic people within those risk groups that we're following up. We have obviously a number of people in isolation who we are continuing to support. But again, our overall assessment is the likelihood of having a case of antivirus here on Saint Helena is really low. But all of our actions so far is to is in is in precaution for in the rare event that somebody begins to show symptoms. And we are absolutely maximally prepared as we can be to support them if they do. Speaker 1 So what I read from this is just reassuring the public there's nothing to be worried about. Even though things have changed a little bit possibly that potentially there's still the same low risk on Saint Selena and people just need to stay calm and just rely on information coming from you guys as and when it is available. That's correct. Speaker 2 Yes, thank you very. Speaker 3 Much. Thank you very much. Speaker 1 For coming in and for this update.