UEMO, the union of European General Practitioners, held its general assembly on a virtual platform recently. Despite the distances that now stretch between us, it is still possible to talk to friends and to learn from them. The Maltese delegation were talking about their experiences with the covid-19 pandemic and reported that they had faithfully followed the UK’s public health advice as set out in their documents and handbook. Malta, of course, has close links with the UK. For a long time the British Medical Association represented Malta’s doctors through its BMA Malta branch. Maltese medical graduates have the opportunity to complete their post graduate training in the UK and in times of trouble, for example, during the Second World War and later, Malta based its medical training in the UK. Malta organised its training schedule for its general practitioners on the Royal College of General Practitioners curriculum and the speciality of general practice/family medicine has been recognised in Malta and endorsed by the European Commission.
It has always fostered its relationship with the UK so it was natural that the Maltese response to covid-19 should be based on what they saw as UK expertise.
They adopted, immediately, a policy of test, trace, and isolate.
The warning of the pandemic was taken very seriously, and very early on. The Director of Public Health acquired funding to put in place a countrywide testing programme, creating three hubs of “drive-in” testing at different strategic and easily accessible sites. Charmaine Gauci, Superintendent of Public Health within the Ministry of Health, has been active in public health and epidemiology for many years serving on health commissions in the EU and for WHO. She was assiduous in making sure that communications with the population were clear and comprehensive. Malta shut down early in the pandemic with rigorous adherence to the regulations that the government instituted. Testing started when only a few cases were known about and a “trace and isolate” policy was put in place. When a patient was found to be infectious, the patient and his or her contacts were immediately traced and instructed to isolate. Failure to do this would attract a €1000 fine for each day when the person was found absent from their home and the police were instructed to check that infected people were staying indoors. Gauci was on television almost every day explaining the policy and encouraging people to follow the advice they were publicising. Remember this was advice from the UK Public Health Handbook
The results showed the efficacy of this policy. The testing revealed a pick-up rate of between 11-15 infections per 1,000 people tested. The total infections, on the islands were 630 with 9 deaths. The rate per 100,000 population was 130.3 infections and 1.9 deaths as opposed to the UK figures which are 432.3 infections per 100,000 population and 61.1 deaths per 100,000 population. Death rate is low by European standards, as is the infection rate.
Malta was following UK public health advice which raises the question—why didn’t the UK do the same?
Joseph Portelli-Demajo, Malta Delegation to UEMO.
Mary McCarthy, UEMO Vice President, BMA Council.
Competing interests: None declared.