Handling COVID-19 as a public health issue in Galapagos

How does a remote archipelago, a province within the borders of a developing nation, handle COVID-19?  Quality medical care is a 1,000km / 600 mile flight away.  Normal transportation between the islands is severely disrupted.   The country has imposed restrictions on travel between provinces.  The social safety net is not as robust as those of the countries most readers of this article are from.   The country has very little leeway in terms of economic support to displaced workers.  

This (Google-translated - with some edits) summary of an interview with the senior political person of Galapagos yesterday (30 March) gives us a glimpse of the situation.   Norman Wray is the appointed head of the Galapagos Regional Governing Council – a “governor” so-to-speak.   He reports directly to the president of the nation.    I have had the opportunity to meet him on a one-on-one basis a couple of times.   He first comes across a little bit as a “surfer dude” – but quickly, one realizes the depth of his engagement and commitment to public service.   


This is the summary of the interview with the Governor Norman Wray this morning on Radio Santa Cruz about the actions that have been carried out due to the #coronavirusgalapagos emergency.

On the return to Galapagos

- I underwent a COVID-19 test, because contagion situations occurred at the National COE level. It is a test that we have made several officials for our responsibilities in the National COE.  (Editor:  Norman was on the mainland in the past weeks and increasingly criticized for not returning to the islands). 

- Once the test was negative, I decided that my presence was important in the territory.

- The Provincial COE (Emergency Operations Committee) approved the protocol out of necessity for public officials who have to enter: health, police, army, there are people who have to respond to their responsibilities urgently and be in the province, it is not a privilege and we are the first to comply with the rigor the Ministry of Public Heath's established protocols.

Situation in Galapagos

- Regarding the subject of the new COVID-19 test samples, a total of 8 were sent (to the mainland for analysis).

The Ministry of Public Health must release the results as required by law. These samples are under analysis, we are awaiting results. The delays in the results respond to the congestion that exists in the sampling of the entire country, but we have asked that they be a priority.

- This moment we continue with 4 confirmed cases and continue establishing epidemiological fences

- Yesterday we were in Isabela Island carrying kits for the work of authorities and public officials. We were able to verify that the local population is respecting the "stay home" directive.  People are clearly committed to the measure. They are maintaining isolation.

- You can always improve the work, there are no perfect situations, but what we have taken as a strategy is the one that PAHO (Pan American Health Organization) and WHO (World Health Organization) dictate: and that is to gather clear information to make epidemiological fences.

- People who are under observation at this time have to give us information about where they have been.

- I send my greetings to entire population which is acting as a team.

- We know that Floreana island residents are also taking this seriously (home isolation).

- You always have to work from home, keep your distance, go out only if strictly necessary.

- The Municipality's work is exemplary, giving support with food supply issues.  This is being done by Mayor Yánez and his team, and that is key.

- All the capacity we have to reduce the movement of people to the maximum will allow us to reduce risks

- It is important (for the media) to speak to Ministry of Public Health officials so that they can give more details. We are welcoming suggestions from the health sector.


Economic resources

- We have mobilized our own resources; the municipalities are doing the same along with initiatives from the private sector.

- Today I just spoke with Councilwoman Castillo who is organizing a private initiative designed to collect resources in a transparent way, so that these can be provided to various support groups. 

- I welcome constructive initiatives from those who are interested in supporting, building and not destroying. Support for, and not criticism of Councilwoman Castillo's example must be replicated by the rest of the province's authorities.

- I reject the attitude of Assemblyman Washington Paredes who is dedicated to creating castles out of thin air, uses his immunity to insult people and what he is doing is generating anxiety.

- We are not going to allow them to want to fish in a rough river (Editor: expression meaning taking personal advantage of difficult times), if they are not going to help, then they should not interfere. Let's all work and get ahead. To Washington Paredes I say: irresponsible and a liar.

- In the course of today, we already have a legal analysis to be able to manage resources to strengthen the emergency with territorial equity funds.

- There are things that had been planned with our budgets (prior to the COVID-19 outbreak) but  we are going to have to redirect the funds.  This must be done within the framework of the Law – if not, the auditors will declare that things were not done in accordance with what the Law and regulations require. 

- We will proceed once we have this report with the Plenary of the Governing Council that we are going to convene this week. It is part of the objectives that we have and in this way we can take important measures.

- In any case, the Provincial COE is also carrying out work, but regarding certain decisions it is necessary for the Council to meet and that is also one of the reasons why I am here.


About the Laboratory donated by the private sector

- We have arranged for it to be the ABG (Biosecurity Agency of Galapagos – usually focused on control of introduced species) laboratory where the equipment is installed and we hope to be able to provide this service, which can be generated even for people who do not have symptoms.

- About the equipment donated by the private sector for the laboratory, as loading and transport sectors around the world know, conditions make it hard to move as fast as we would like, but we are making all the efforts to do it urgently, but we depend on the a reduced transportation system.

- It is important to tell the population that the fact that they do not have symptoms does not imply that they do not have the virus, you may feel in perfect health, but you do not know if you are with COVID or not and these people can be a risk to others. That is why isolation is important, that happens throughout the world, that is why staying at home is essential, because there are asymptomatic populations. The social distance is to deal with those cases that do not look sick but that can be carriers of the virus.


About Galapagos residents who are on the mainland

- We send information to people who are on the mainland (we have collected the detail of the places where they are located) and based on that we have prepared a registry and we are in contact issues of concern (and we know important information about them).

- There are three options on how to handle repatriation back to Galapagos:

1) uncontrolled return to Galapagos, establishing the test and quarantine on arrival only.

2) Restricting access to specific cases only, establishing priorities, and

3) Not allowing admission due to contagion levels depending on the contagion risk levels on the continent

- Clear policies must be established with the Ministry of Public Health and a clear position regarding what the National COE says on the issue of restriction of mobilization in the provinces. It is part of what the Provincial COE must discuss to decide how to proceed in the case of Galapagos residents who are on the continent but wish to return.

- This is a decision that we must take in common with all the authorities of the province, it cannot be a return to uninformed decision-making.  We must evaluate what is happening at the continental level before deciding how to proceed.

- Let's also wait for the issue of access to tests and request for rapid tests to be able to support citizens.

- The protocol must be strictly rigorous in any case. It is not my decision exclusively but of the set of authorities for an analysis of the risk that implies and to close to the maximum the levels of contagion.

- Allow us to have those answers in a concrete way this week to establish a criterion assuming this decision in the whole authorities.

- In order for us to have a Galapagueño doctor here, we had to carry out very complex administrative and logistical procedures.  There are no regularly scheduled flights – even supply shipments are not allowing for the transport of people at this time.

- There are strict protocols, we have to establish clear criteria. It is not that there are primary and secondary priorities.  If doctors need to be mobilized due to the nature of the work, we have a responsibility do mobilize them.

- This is not a political campaign, it is a national emergency. I welcome all those who want to join the fight.

- We have supported a local family who lost a family member on the continent.  That is the risk and it is one of the reasons why we have put restrictions on entering the province. To try to curb vulnerability in the province.

- What we ask for is co-responsibility, do not generate disinformation, allow the Ministry of Public Health to do its job.

On the identity of the patients

- We have not lied to people and we will continue to support their work, it is an emergency that is happening in the world, not only in Galapagos.

- We have to protect the identity of the patients – it’s a legal requirement, it is an issue that is handled by the Ministry of Public Health risk management system, I have been very clear. I cannot put patient tests into the public eye. We cannot do it, it is part of the protocols that the WHO clearly establishes.

- Isabela's patient has recovered very well, but he must follow the protocols of the Ministry of Public Health and maintain his quarantine, after which a new test needs to be done to show that he no longer has the active virus.