Dr. Lynda Sisson:

I will take that question. We have had an opportunity to look back at the possible causes of transmission for some 2,000 cases. There is no doubt that in the very early stages, undetected cases in the hospitals contributed to huge numbers of infection in healthcare workers. The other thing we have noticed was the inability to practice social distancing, or a lack of awareness around it, in hospitals at the very beginning. Some of our hospitals do not lend themselves to physical distancing.

The decision on masks was made by NPHET and we did not recommend mask-wearing at the very beginning. However, as PPE became more available, mask-wearing was commenced. The differences between the earliest stages and later stages were largely due to the Covid and non-Covid pathways in the hospitals, the earlier detection of cases, the implementation of social distancing and the closing of the canteens. The other issue, to which we alluded earlier, is the change in the culture of healthcare workers coming to work when they were sick. That was one of the big challenges for us because healthcare workers traditionally show up to work with symptoms.