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On Monday 16 November a low-level positive COVID-19 test result were returned following routine testing of individuals currently subject to compulsory isolation measures. As a consequence of these two positive test results occurring for people within Ascension, the Ascension COVID-19 Response Level was escalated on Monday afternoon to Level 2 RED. This escalation was in line with the Response Level Protocol and is a precautionary measure which alerts authorities and the public to an increase in the potential level of COVID-19 risk.
As per the Georgetown Hospital protocols, subsequent tests were conducted on the individual on Wednesday 18 November. The result of this test indicated significantly reduced levels of virus, to the point of non-infectious amounts, and the individual was therefore deemed to be negative.
As a result, the individual will continue their 14 day quarantine period whilst they remain under observation, and will be tested along with the rest of their arrival cohort prior to their release at the end of their isolation period.
Due to this subsequent negative test result, the Ascension COVID-19 Response Level has been reduced to Level 1 AMBER as of this afternoon.
As with the previous escalation of the Response Level in September, AIG will review the Response Level Protocol in light of this escalation and will report any changes to the protocol that result from this.
As ever, anyone who develops a new persistent dry cough, a fever or experiences unexpected shortness of breath should go home, self-isolate and telephone Georgetown Hospital on 66252 for further advice.
Background
The individual in question had arrived at Ascension on Friday 13 November. They had previously returned a negative COVID-19 test result 72 hours prior to their departure for the island. Following the low-level COVID-19 positive test result on Monday 16 November, the individual was isolated from their quarantine group and further tests were scheduled.
The results of test conducted on Wednesday 18 November indicated a significant reduction in the levels of the virus, to the point of non-infectious amounts. This suggests that the earlier positive results occurred due to a previously acquired infection, or prior exposure to the virus, which has now decreased to the point where the individual can no longer be infectious to others.
Although the levels of virus detected in the first tests were low, these met the threshold of a positive result for COVID-19. Therefore the response level was escalated to Level 2 RED to reflect the increased level of COVID-19 risk to the community whilst further tests were scheduled to establish whether the induvial was recovering from a previous exposure to the virus or was developing a new COVID-19 illness.
This is a scenario that AIG had planned and prepared for. Robust measures for effectively managing arrivals to Ascension have been in place throughout the COVID-19 pandemic. These protocols have been developed in liaison with experts from Public Health England and are designed to ensure that any person arriving at the island is kept separate from the general public until the Senior Medical Officer is assured that they do not pose a risk of introducing COVID-19 into the community.
Even though the individual who tested positive had not had any contact with the wider public, and therefore any potential COVID-19 was contained, the level of risk to Ascension from COVID-19 had increased and as a result the response level was raised. Following the negative test result and confirmation that the threat from COVID-19 had reduced, the response level was returned to Level 1 AMBER.
Why did tests only three days apart give different results?
The COVID-19 test performed by Georgetown Hospital looks for the presence of COVID-19 virus within a swab of cells taken from a person. The original result showed low-levels of virus in the individual in question. As they were not displaying symptoms of COVID-19 this could have indicated the remnants of virus from an infection acquired sometime in the past, or the beginning of a new infection.
The response level was raised to Level 2 RED following confirmation of COVID-19 virus in that individual, with further testing scheduled several days later to confirm whether the level of virus in the individual was getting worse or improving. As the levels of virus had decreased to non-significant levels, the individual was confirmed as having tested negative for continued presence of COVID-19.
Is it safe for these individuals to be released at the end of their quarantine?
The test result has been analysed by the Senior Medical Officer and experts within Public Health England. Both are satisfied that the decreased levels of virus mean that the person in question has non-infectious weakening virus. As a result, they do not pose a risk to the public.
The protocols in place in Ascension have been designed in liaison with experts in Public Health England to ensure that any person arriving at the island is kept separate from the general public until the Senior Medical Officer can be assured that they do not pose a risk of introducing COVID-19 into the community. Along with other members of their arrival cohort, the individual will be tested again prior to the end of their quarantine.
Why is the response level changing after only a few days?
The Ascension Island COVID-19 Response Levels indicate to the public what level of risk the island is at from COVID-19. As a test result indicated positive presence of COVID-19 within a person on the island, even at a low-level, the response level was raised to Level 2 RED.
If the subsequent test result had showed that the individual was still being affected by the virus, or that the virus was getting worse, the response level would have remained at Level 2 RED. However, as the subsequent test result demonstrated significant reduction in the levels of the virus, to the point of non-infectious amounts, the response level was reduced to Level 1 AMBER in recognition of the reduced level of risk to the island.
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