Since the start of the COVID-19 crisis in early 2020, the small yet resilient Cayman Islands has leveraged its community, private sector and global relationships to protect its citizens and residents from the global COVID-19 pandemic.
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First Case Confirmed
On 12 March, the Public Health Department confirmed the first positive case of novel coronavirus SARS-CoV-2 in the jurisdiction. The patient was a visitor transferred from a cruise ship to the Health City Cayman Islands private hospital for a critical cardiac issue. During treatment the patient developed breathing difficulties, and a sample sent to the Caribbean Public Health Agency (CARPHA) returned a positive result for COVID-19.
On 14 March, Health City Cayman Islands announced the passing of the patient, the 68-year old cruise ship passenger and the Islands’ first confirmed case of COVID-19. The Islands’ leaders offered their condolences to the patient’s family. To date, this first case remains the only COVID-19 death in the Cayman Islands.
Border Closure & Travel
Efforts to prevent widespread community transmission have been led by Premier Hon. Alden McLaughlin and his Government of National Unity. One of Government’s first decisions was to close the sea borders to all cruise and private yacht traffic from 16 March and to restrict land entry to all countries in the Schengen area, China, Iran, Japan and South Korea, in line with global standards.
Travel restrictions culminated in the announcement of a full border closure from 22 March - excepting cargo, air ambulances and repatriation flights.
During the early days of the outbreak, activities were curtailed and returning travellers or anyone displaying symptoms were required to self-isolate for 14 days. This later evolved into mandated quarantine at a government-run facility run by the National Emergency Operations Council (NEOC), in order that the most vulnerable in the population could be properly protected from persons returning home from COVID-19 hotspots.
Repatriation flights were operated by CAL to the US and other countries depending on what borders were open. An Air bridge to the UK using BA was also arranged.
An Emergency Travel Helpline became operational from the end of March, providing advice and assistance to those with urgent and compassionate need to travel for medical reasons or t return to their home countries. Initially operated by the Governor’s Office, this role was transitioned to the Ministry of International Trade, Investment, Aviation and Maritime Affairs (MITIAMA) from 1 July. The transition recognised the importance of providing continued travel support to residents of the Cayman Islands while the borders remain closed to tourists.
The first repatriation flight to the UK was organised for 7 April; it also brought into the Islands essential medical equipment from the UK, as well as Caymanians who wished to return home and some freight for supermarkets. Regular airbridge and repatriation flights followed to the UK, and other destinations, including: the US, Canada, India, the Philippines, Jamaica, Honduras, Mexico, Costa Rica, and the Dominican Republic.
Testing & Medical Provisions
On 17 March, the Chief Medical Officer announced the preliminary results from the first tests for COVID-19 to be carried out in the Cayman Islands, the first British Overseas Territory to conduct its own domestic testing. This system was set up at the Health Services Authority (HSA) in partnership with a small team from Public Health England. These results were sent to CARPHA for confirmation in a sampling process which continues to operate presently.
Thus began a comprehensive testing and tracing regime, focusing on frontline and essential workers. A digital dashboard was also developed on 23 March, to provide the public with a detailed tracking resource of positive cases. Testing capacity was further expanded with laboratories coming online at the private Doctors’ Hospital on 24 April.
In mid-April, the purchase of 200,000 COVID-19 test kits from a South Korean company was made possible by the Cayman Islands Government with logistical and financial support provided by local philanthropists and other members of the community. Acquiring these kits enabled the Cayman Islands to rapidly scale up its testing efforts for COVID-19, while also supplying much needed supplies to other nations in the Caribbean. Leadership by the Premier’s Government has continually positioned the Cayman Islands as a regional example in tackling a global threat of this scale.
The complex and challenging arrangements for the procurement and consignment were led by the Governor’s Office in collaboration with the Cayman Regiment, MITIAMA, the private sector and the British Embassy in Seoul who undertook due diligence to assure the quality of the testing kits and helped with local logistics. Locally, it was heralded as an example of “CaymanKind,” a grassroots spirit of community-minded generosity for which the Islands are famed.
Furthermore, this CaymanKindness was paid forward to the Government of Barbados on 10 April, when the Cayman Islands Government provided them with 20,000 polymerase chain reaction (PCR) test kits for COVID-19, at cost.
The nation’s ability to sustain significant COVID 19 testing was boosted further on 30 April with the arrival of 52,000 nasopharyngeal swabs (globally in short supply) to collect samples. A further 100,000 swabs arrived shortly thereafter. The Governor's Office worked with Dart and the British Consulate General in Guangzhou to help facilitate the shipping of the consignment from China.
Two drive-through testing facilities became operational after 11 May, ensuring widespread and thorough testing capacity across Grand Cayman. The UK Foreign and Commonwealth Office provided new testing equipment - a gene expert machine capable of returning results in 30 – 45 minutes - on 29 May. This was sent to Cayman Brac to enhance the testing capability there. The regimen was further enhanced at the end of June with the arrival of Roche antibody testing technology, operational at both HSA and Health City Cayman Islands.
To further support COVID-19 prevention efforts and the existing provisions in place, including the Flu Clinic and 24-hour Flu Hotline, the Ministry of Health announced the launch of an online self-assessment tool open to the public on 30 March 2020. As of 15 July, this online symptom checker has been used 43,599 times.
The Medical Officer of Health announced on 8 May that two field hospitals had been set up, to provide facilities for the treatment of general patients and milder COVID-19 cases, in the eventcase the number of cases were to increase and overwhelm existing healthcare facilities. They will also prove an invaluable resource that can be stood up in the event of a hurricane or other disaster.
Partnership with the UK
On 18 March, Premier McLaughlin joined a conference call with Baroness Suggs, the UK Overseas Territories Minister, along with representatives from the other Overseas Territories (OTs) to discuss sourcing additional essential equipment and supplies to assist the OTs. This was a sign of early collaboration between the UK and the Cayman Islands during this crisis and a testament to the infrastructure developed in the Cayman Islands, which stood well prepared to help its brothers and sisters in the Caribbean region.
Support and partnership with the UK has been a hallmark of the COVID-19 crisis in the Cayman Islands. Further examples include the deployment of twelve specialists from the UK at the end of April. The team was tasked with providing support in the coordination of essential medical supplies and personnel, offering a liaison function with UK naval assets in the region, working with Hazard Management Cayman Islands (HMCI) on Hurricane Preparedness and providing advice on any security threats that might occur in these exceptional circumstances.
All educational institutions were closed on 16 March, with the Ministry of Education, Youth, Sports, Agriculture and Lands (MEYSAL) putting provisions in place for home and online learning. On 24 April, it was confirmed these facilities would remain shut until the end of the academic year.
By early July, Cabinet had approved funding for the provision of laptops to all government school students, as well as additional wireless equipment, increased helpdesk support, software licensing for additional devices, additional bandwidth and/or upgraded internet connections. By 3 July, almost 2000 computers had already been donated in partnership with the private sector and Government funding was approved to finance the remainder of computers for approximately 5000 students (at an expected cost of $3 million).
From 5 July, all educational institutions, including Early Childhood Care Education (ECCE) centres, were permitted to reopen physical facilities in compliance with existing and established COVID-19 safety protocols and procedures. Seasonal youth programmes such as vacation Bible schools and summer camps were also permitted. Schools remain closed as scheduled for the summer holidays and are currently set to reopen for the start of the 2020/2021 academic year.
His Excellency, the Governor Martyn Roper announced the imposition of a curfew throughout all three islands, beginning on 24 March, under Section 49 of the Police Law (2017 Revision), authorised after consultation with the National Hazard Management Executive. This followed the confirmation that we had community spread at the time and the measures were necessary to stop the spread as well as to enable public health to determine the extent of the spread.
This first announcement required a nightly curfew, running from 7 p.m. until 5 a.m. On 25 March, an extended curfew was announced for a 58-hour period. After this the curfew reverted to being a nightly "hard" curfew, accompanied by a new "soft" curfew during the daytime. Alterations and extensions to the hard curfew were made (see here for a full history) until the Commissioner of Police Derek Byrne announced the hard curfew order would be revoked across the Cayman Islands from 21 June.
On 3 April, the Commissioner of Police reported the first prosecution for breach of curfew order had been completed. The man pleaded guilty and was sentenced to four months imprisonment.
Also referred to as "Shelter in Place", the "soft curfew" was first provided for in Regulations under the Public Health Law on 27 March. This allowed for essential movement during the day, when the "hard" curfew was not in effect. In addition to designated essential workers carrying out their duties, people were able to move only for reasons of health, emergencies, daily exercise and essential tasks. Surname-based restrictions also applied to certain tasks at certain times (see here for a full history). As of 21 June, all "hard" curfew orders have been revoked and the "soft curfew" or "Shelter in Place" provisions have been lifted and no longer apply to any of the Islands.
Financial assistance provisions were put in place on 30 March for seamen and veterans, along with families currently receiving food vouchers and certain employees of the tourism industry (31 March). This support was further extended by means of a one-time food voucher to non-Caymanians in need by April.
The Cayman Islands Centre for Business Development, which had been under development, was fast tracked and began providing services on 23 March, including training to cover areas such as: Smart Measures for Business Continuity, Best Practices for Handling a Cash Flow Crisis, Conducting a Business Impact Analysis, Business Model Innovation, Social Media Marketing and Online Freelancing Opportunities.
On 11 April, the Governor and Premier met with Ken Dart, to begin the process of creating a new National Recovery Fund: R3 Cayman Foundation. Mr. Dart pledged $1 million to that fund; additional commitments of $2 million from individual and corporate donors followed. The fund has four purposes: support for personal protection equipment and testing, support for individuals in distress or needing financial assistance, immediate economic needs and a longer term economic development focus.
On 27 May, the Minister for Finance and Economic Development, Hon. Roy McTaggart delivered his projections, based on assumed resumption of the domestic economy by July and the resumption of tourism by October. Under these scenarios, he projected GDP would contract by 11.4% with the unemployment rate rising to 11.6%. The scenarios were conditioned on the gradual return of visitors (less than 20% of normal visitor levels that usually prevails at the high tourist season) beginning in the last quarter of 2020.
To mitigate these projections and support the Cayman Islands, the following measures have been implemented: $3 million from the disaster relief fund to finance the initial costs associated with COVID-19; a loan fund valued at $5 million for micro and small businesses (100% Caymanian owned), provided through the Cayman Islands Development Bank; a grant fund valued at $9 million for small and micro business; funding of $500,000 for technical assistance to Caymanian-owned businesses to assist with strategy and balance sheet planning; waived tourist accommodation taxes and trade and business licence fees. Since launch until 17 July, 1,085 applications have been received from micro and small businesses. So far, $1,592,000 has been paid to applicants, with a further $386,000 approved for payment.
In early April, the Ministry of Health provided the first of its clear and consistent advice to the public regarding the wearing of face masks, which many supermarkets and banks had started to mandate with the commencement of the “shelter-in-place” rules. Directions were provided to those persons wishing to make their own reusable face mask, along with a discussion of the limitations of such coverings and important primary precautions of staying home as much as possible, practicing physical distancing, respiratory etiquette and frequently washing hands.
By the end of April, island-wide distribution of reusable cloth masks had begun, in a programme assisted by constituency Members of the Legislative Assembly (MLAs), the Cayman Islands Red Cross and the Royal Cayman Islands Police Service (RCIPS). By 21 May, nearly 24,000 reusable cloth masks had been distributed across the Cayman Islands by the Community Policing Branch of the Royal Cayman Islands Police Service. These included 21,500 on Grand Cayman, 2,300 on Cayman Brac and 87 on Little Cayman. A further 41,000 were later distributed. By the end of June, mask distribution had been completed.
The Support Services sub-committee of the National Emergency Operations Centre ultimately procured a total of 100,000 masks, half from Jamaica and half from American corporation Hanes, at a total cost of $150,000. The DART Group helped procure the masks from the US, which had not originally been intended to be sold outside the country. Masks remain compulsory in all enclosed public spaces in the Cayman Islands.
During this time of global crisis, the jurisdiction’s Legislative Assembly met on 23 April, with some MLAs participating virtually. The historic sitting was necessitated by public health restrictions and allowed for the passing of several pieces of legislation to support the Cayman Islands’ response to the COVID-19 challenge, including: changes to the National Pensions Law to allow for persons in need to access their contributions to pension plans and to the Immigration Law to permit persons to continue working and living in the Cayman Islands while work permit applications could not be submitted, processed or renewed.
“Unlocking” the Cayman Islands: Suppression Levels
Buoyed by a successful and comprehensive testing regime and continuing low/declining rates of infection, low levels of calls to the Flu Hotline and low hospital admittance, Government began looking towards plans for a phased easing of restrictions from early May. Prescribed protocols including physical distancing, frequent hand washing and proper respiratory etiquette were continually reinforced by the leadership during this strategic “unlocking” of the domestic economy.
Level 4 (High Suppression)
From 4 May, the Cayman Islands moved from Level 5 (Maximum Suppression) to Level 4 (High Suppression) based on an evaluation of risk in the community. For the first phase of loosened restrictions, hard curfew hours were relaxed by one hour and exercise windows increased, although beach access remained prohibited. Under the new changes to the “shelter-in-place’ provisions, money remittance facilities and post offices were opened to the public and banks, building societies and credit unions given longer opening hours, although the surname-based rules for essential tasks remained in place. Certain activities and operations were allowed, but usually with a caveat that the service must be mobile or delivery based, for example pet grooming was permitted, provided the animal was collected from and delivered back to the client. Similarly, retail operations were opened up, but goods could only be provided via delivery. This phase also meant the category of essential service personnel was widened to include employees involved in the newly permitted activities.
Level 3 (Moderate Suppression) – Sister Islands
A “major milestone” was reached on 5 May, when restrictions pertaining to Little Cayman were lifted, after 94% of the island's population had been tested for COVID-19 and returned negative results. Inter-island travel remained restricted to essential personnel only and physical distancing and the wearing of masks in enclosed, public spaces continued to be mandated. A similar easing of restrictions on Cayman Brac occurred on 7 May, with fishing and boating (limited to two persons per boat) re-introduced to widespread celebration. These developments placed both Sister Islands into Level 3 (Moderate Suppression).
On 19 May, further changes came into effect for the easing of restrictions on Grand Cayman. Highlights included allowing beach access for exercise Monday to Saturday by last name protocols, the dropping of the 24-hour hard curfew on Sunday and the extension of the exercise window from one and a half hours to two hours each day.
The re-opening of the construction and development sector, in a phased manner, also marked a significant development in the Cayman Islands’ COVID-19 response and began with comprehensive testing sampling, followed by the opening of supporting businesses such as hardware stores and home depots from 19 May. Estimates put the size of this sector at 8,000 employees and the testing strategy involved sampling 3,200 people within 2 weeks starting the week of 18 May. Once 40% of the construction population was tested, the results continued to show low community spread and the rest of the construction industry began work again, culminating in the entire sector returning to work from 1 June.
Level 3 (Moderate Suppression) – Grand Cayman
Restrictions were further eased in two tranches on 1 June and 7 June, permitting an expansion of allowed activities within the Level 3 (Moderate Suppression) phase. The first stage allowed for more outdoor recreational opportunities, such as exercise in any public place and open-air non-contact sports, like tennis and golfing (limited to two persons). All retail and real estate businesses were able to fully operate, with physical distancing requirements and the wearing of masks by customers and staff.
By 7 June, gatherings of up to six persons, including for the purposes of non-contact exercise, became permissible. Additionally, restaurants and bars were able to serve customers in outdoor areas, subject to size and physical distancing stipulations. Exercising on the beach, swimming in the sea and fishing from the shoreline were all allowed. Restrictions on boating were similarly relaxed, subject to size and location criteria. Certain Wildlife Interaction Zones (WIZ), including the world-renowned Stingray City and Sandbar, remained off-limits to vessels.
Level 2 (Minimal Suppression)
On 21 June, Grand Cayman moved to Level 2 (Minimal Suppression), which saw a further easing of restrictions and continued expanded provisions under the guidance of the Level 3 mission and the advice of medical experts. At this stage, the risk of the virus was judged to be low enough to permit lifting the hard curfew order and Shelter in Place regulations as well as the unlocking of high-touch businesses and services (e.g. beauty salons), a gradual increase in public gatherings to 25 and, perhaps most significantly, the return of external childcare in the home. Other well received developments in this phase were supporting the domestic tourism industry with staycations and reopening of churches for congregants to physically attend services.
Additionally, exercise in gyms was permitted, although contact sports remained off-limits, along with travel to the Sister Islands without the express permission of the Medical Officer of Health and a negative test for COVID-19.
By 19 July, the expected further relaxation of restrictions began on schedule. This included an increase of the public gathering limit from 25 to 50; dancing, karaoke and nightclubs reopening, with some restrictions such as physical distancing and contact sports were also permitted to start back up. In addition, inter-island travel required that the person(s) travelling should have been on the islands for over two weeks (i.e. testing prior to travel was no longer necessary).
Rules on commercial boating were also relaxed, to allow for: the carrying of 50% of licensed capacity (not exceeding 50 people); travel between the Cayman Islands for pleasure; and operators with a Wildlife Interaction Zone (WIZ) licence to access Stingray City and the Sandbar.