Thread by @sapeermayronnz

It's been a month since @wilson_soli exposed that Samoa had been treating 16 people in an isolation unit with suspected measles in early October. But the @samoa_observer had been following the growing measles crisis long before that, as far back as March. #Thread #MeaslesInSamoa

In March, anti-vaxxer Taylor Winterstein wanted to charge Samoans hundreds of tala to attend a "workshop" on "choice." Dr Helen Petousis-Harris told us her advice is a public health threat. Already, NZ was facing more than 50 cases of the disease. bit.ly/33wGHE6

Head of the Ministry of Health was worried too. "One serious, virulent virus can wipe out this population in less than two weeks," he said about Winterstein's anti-vaxx agenda. bit.ly/2NwWcX0

Luckily the backlash was heard, and in April we reported the workshops would be cancelled. I found out later Winterstein managed to hold a coffee club version though. bit.ly/2K13GiH

In August, the Courts closed the books on a case Samoa desperately needed put to bed. It found two nurses responsible for the deaths of two babies, dead after recieving their MMR vaccine. @ARheeney explained why this case mattered so much to public trust. bit.ly/2K1Zyiy

Not long later, in September, @jamesrob reported that NZ's measles outbreak would definitely spread to Samoa. Our shocking immunity rates + frequent travel between Auckland and Samoa meant it was "inevitable". bit.ly/2CspkZm

@WHO expert Dr. Nicola Turner agreed. With public trust in the vaccine program still so low after two babies died in Savaii last year, immunity gaps wouldn't be closed in any hurry. bit.ly/2p0EMIS

Samoa's @WHO representative, Dr. Rasul Baghirov said despite fears, our vaccine program and health services could and should be trusted. “I think Samoa is definitely prepared to perform this function at a very good level," he said. bit.ly/2qDjSjm

He even published this letter explaining vaccinations, to help put everyone's minds at ease on the matter. bit.ly/2NzftY1

"The wrenching irony about vaccinations in Samoa is that parents’ most primal instinct to protect their children’s lives now seems like it could cost them," @jamesrob wrote, in an editorial exploring the state of immunity in Samoa. bit.ly/2p0AFwn

At the end of September, @UNICEF published a regional advisory warning of the risk of importing measles into our countries. "Despite significant efforts," herd immunity would be no help in the Pacific. bit.ly/2K4u6Au

Meanwhile, @wilson_soli learned there are barely anynurses in Samoa to tend to the population's sick. Some 350 nurses are on the hospital's payroll, she said: "not enough." bit.ly/2WYP8Fy

On 9/10, The Ministry of Health called its first press conference to tell Samoa a person from Auckland had landed in the country with measles, but without symptoms. They had one suspected case of measles on their hands, they said. bit.ly/2Cu3hS0

But three days later, we published @wilson_soli's discovery: 16 people were being treated for suspected measles, most of them children. It was the first of many times to come that the Health chief would hang up on @samoa_observer reporters. bit.ly/2Nzgb7D

Just two days after that, on Samoa's Children's Day no less, a 14 month old from that group of 16 died, leaving his two parents completely distraught. Health say they are still waiting for tests to confirm if the boy died of measles or not. bit.ly/2Q1JhxO

Samoa has yet to declare an official outbreak, or spoken publically about the death. We went back to Dr. Petousis Harris. “I am really sorry to hear this has happened,” she said. “We’ve been really worried about exporting cases to the Pacific. bit.ly/2qF4nY9

Finally, days after Samoa lost its first victim to the epidemic, the Government declared an outbreak, and revealed the extent of the crisis: an adult and and three children all confirmed measles cases. bit.ly/2p6Mp0A

Editor @KeniLesa warned the Ministry needed to "elevate its response" to the crisis. We wouldn't see tangible action for another two weeks. bit.ly/33wKnpo

All the while, the Ministry is not responding to interview requests by phone, text, email or in-person. @jamesrob spelled out the issue in his 18/10 editorial: bit.ly/2qxM1Zo

Our reporter Talaia Mika met families vaccinating their children, despite initially being too scared too. It took the death of a child - not Ministry outreach - to get these people to the hospital. bit.ly/2CuhCO5

Now to an isssue: the ministry claims it takes 3 weeks to get lab tests back from Melbourne to confirm measles. We found that should be a week max, and that at some stage, health officials don't need lab confirmations to know there is a problem. bit.ly/36JkeFL

I loved this interview. Former Health Minister, now Community Minister said women and village chiefs should be entrusted to help stem the epidemic. I completely agree. Have not seen anything to suggest that advice was heeded. bit.ly/2NxMdAA

In late October, weeks before anything would be announced, the Catholic schools were already preparing to have to close their doors to battle the disease. Education Minister said at this point: "exams can wait." bit.ly/34HcUsv

Dr. Rasul spoke to our reporter to encourage people to start wearing surgical masks in public places. "Many patients come to the hospital not yet knowing what they might have," he said. #DidYouKnow Measles silently incubates in the body for two weeks? bit.ly/2WVTNIF

Then, outrageously, we learned that a doctor and two nurses also got measles. Pressed for more information, a Health spokesman told @wilson_soli that he is "quite busy."
bit.ly/2JYZ9gX

The Ministry released another "official update" on 22/10, reporting that there have been 169 suspected cases and 7 confirmed ones since September. Now we're starting to wonder why these numbers are coming few and far between.
bit.ly/36Mu5dT

In neighouring American Samoa, border security tightened. Plane and boat passengers are now expected to stay on board and get visually checked for symptoms before disembarking. "We don’t want a repeat of 1918," they told me. bit.ly/2WYT1dC

On 30/10, the Ministry announces three people are suspected measles related mortalities, adding an 8 month old and 37 year old to the child we already knew about, plus 15 confirmed cases and 314 suspected ones. Where was this info when it happened? bit.ly/2WXpUaI

Alongside the announcement, the Ministry of Education closed all preschools "until further notice" to protect the vulnerable under 5s. They did so with a govt. speak official notice we had to translate into normal words, by the way.

@ARheeney implored government: include primary and secondary kids in your closures, please. Remember 12 days ago, the Catholic schools were already making plans for this, but as yet no announcement. bit.ly/32seHjz

The outbreak was completely preventable. Earlier action by both Samoan and NZ authorities would have nipped any possibility of this crisis in the bud, Dr Helen Petousis-Harris told us. bit.ly/2NujvAS

Not surprisingly, the day after the preschool closure was announced, parents travelled from all over to bring their kids to class only to be asked to go home. Excellent communication on the govt. part, I say bit.ly/2Q4AE5J

November begins. Finally @samoatourism issues an advisory to travellers in and out of Samoa to get vaccinated two weeks before flying. Where was this two months ago when the first infected traveller landed on Samoan soil? bit.ly/2K3YomK

3/11, Education and Health agree to close schools. But not right away, they have exams to sit! Primary schools get two more weeks but secondary get until 29/11. Helpful. bit.ly/33v47cR

Remember those anti-vaxxers we were worried about? During this crisis, they are on Facebook, telling people not to vaccinate against the worlds most contagious disease. I ask Dr. Helen how we are supposed to hold these ppl accountable to their words. bit.ly/2p39X6v

THEN. Oh, then. We learned measles wipes out your immunity's memory. Incredibly frightening. Health does not deign to comment. bit.ly/2PWTPOW

Over in Savaii, our reporter found out one of the hospitals doesn't even have a fridge to keep vaccines and keeps running out. Your guess if the Ministry responded to questions from the @samoa_observer on that one? bit.ly/2WXWN7b

This isn't strictly measles coverage, but it's interesting. A few days after issuing the travel advisory, STA reports an unseasonable increase in visitor numbers. Apparently no one minds a wee epidemic in Paradise bit.ly/2K1RhLK

Around town, clinics and pharmacies ask sick customers to stay out. Plus, the Ministry has suspended outpatient services to shuffle resources around. But they told @RNZPacific this, not us. Good for the public but bad for Samoa, I think. bit.ly/2K1Rmz2

A couple weeks after he died, I went to see the parents of the first measles fatality. They agreed to share their story and pain with me, and I am so grateful. The Ministry still hasn't got his blood tests back from Melbourne, by the way bit.ly/33wwBD5

On 6/11, @Adel01518880 learns another child has died after getting measles. His siblings are sick too, and his parents are distraught. No response from the Ministry. bit.ly/2NwSw7R

We finally extract some genuine public health information from the @WHO team in Fiji. Vitamin A is en route and the team has sent another Dr in for support. bit.ly/2K51uH1

Having previously "advised" schools not to have prizegiving, the Ministry of Education made it official on 6/11. No prizegiving, graduations or camps until the epidemic is over, they said. bit.ly/2WZzmus

This week alone, we emailed questions to Health four times. No response. On Thursday, they published their official update, revealing a whopping 48 confirmed and 513 suspected cases. According to them, no new deaths. bit.ly/2WZL4Vz

After all this silence we turned to @ngaire_sc and @skirkell to learn how crisis communication ought to look. No suprises that it's the opposite of how it's been looking. bit.ly/2NwBA16

So exams are apparently very important. The Principals Association told @Adel01518880 that students will be sitting them in "isolation rooms" for kids with measles symptoms. This is out of hand. bit.ly/2CooWuP

@Adel01518880 The family who lost their child earlier in the week lost his sibling, a one year old. On the weekend they buried them both, completely distraught MOH won't confirm whether they had both been treated for measles, but more children in the family are sick. bit.ly/2qPI3v9

On Friday we learned an Australian group of doctors and nurses had arrived to help. They've been touring hospitals to stocktake the situation and helping establish a new critical care ward. MOH didn't tell us this by the way, we got it from Facebook. bit.ly/2KkLO2w

In Lepa district, an entire village packed themselves into a truck to get vaccinated at Lalomanu Hospital. These are the kinds of measures ordinary people are taking to stay safe. bit.ly/2NHK31s

Rumours had begun circulating that unvaccinated people were being turned away from flying. @FlySamoaAirways said nope, not true, but do please get vaccinated. Good to see them on the front foot on this one bit.ly/2KjsPoZ

The communities are being rallied to help, though it's still a little hazy exactly how. But more hands on deck is certainly a good thing bit.ly/3780oED

In accordance with the gov directive, the National Uni has cancelled its December graduation and moved another to next April. The less crowds the better as numbers continue to grow.
bit.ly/2qOMPJu

Not everyone is interested in the directive though, one school (possibly one of many) went ahead with prize giving this week. Principal said it was already organised and that "our hearts were set on doing this for the children bit.ly/2qLCJZL

Our reporter Talaia spoke to the Traditional Healers Assoc to see how they are responding to the outbreak. They won't reveal their methods (fair). The Hospital should always be the first point of contact if sick! bit.ly/2KBoCxk

On 12/11 after several more unanswered emails from MOH we turned to the Minister herself for answers, only to find she was on duty travel, representing Samoa at a UN conference in Brisbane... bit.ly/2O0BAqp

But luckily, Associate Minister picked up the phone and was very eager to help, answering all our questions about the situation on his island of Savaii. In just a week and a half, hospitals gave out 6000 vaccinations! bit.ly/35eJr9u

Pregnant women told Talaia they were skipping regular appointments to avoid the hospital and the threat of measles there. "I exercise in my front yard and go back inside," one expectant mother said. bit.ly/2CWP68g

Devastatingly, another family have lost two sons, a one year old and three month old. “I witnessed with my own eyes how much my boys suffered,” their grandmother told @Adel01518880. bit.ly/2OpjxsT

On 13/11 another weekly update came in, this time with the villages that had measles cases, and a breakdown of the numbers too, an extremely welcomed show of transparency by the Ministry. 6 deaths, 716 suspected and 48 confirmed cases bit.ly/2psQY5m

The inevitable happened, and two children with measles ended up in American Samoa. They were immediately quarantined and their blood test sent to Hawaii for confirmation. bit.ly/2pysiIS

In the main hospital, measles patients were mingling with people seeking vaccination. MOH closed the children's outpatient clinic and asked all sick people to go to Acute Patient ward and the Outpatient ward, a majorly useful move to contain the spread. bit.ly/2OjDjpK

With two cases enough of a scare, American Samoa demands travellers prove they are vaccinated before letting them off the plane or boat they came in on. bit.ly/2NZxBKT

In Savaii, four patients with measles were urgently flown or ferried to Upolu for treatment in the national hospital. They are four of more than 100 cases of the virus on the island, which is larger than Upolu but less densely populated. bit.ly/2OGiy83

Sweet relief - on 15/11 the Ministry of Health called a press conference. The Director General briefed the media for an hour, and told us vaccinations will soon be compulsory in order to start school, a massive and necessary move. bit.ly/2Xv7iz1

Why did Government wait until there were 200+ cases in the country before cranking out a national vaccination campaign? "We don't want to panic the people," Leausa said, blaming the low coverage rates and not the slow response for the spread bit.ly/37liq6j

With the air still not clear on the Health Minister's absence, we learned the senior staffer leading the measles response left for a week in Nairobi to attend the #ICPD25. Leausa said it reflects trust in the system (I say it's poor leadership but okay) bit.ly/33YZyYF

I also pushed Leausa on the diff between suspected and confirmed measles cases, well into an epidemic when it isn't useful (spoiler alert, they stopped number crunching after the state of emergency was declared the following week, wonder why) bit.ly/2KDwcrj

Unfortunately, but not suprisingly, alternative methods to "curing" measles have cropped up. There is no cure, only good treatment of dangerous complications, Leausa - quite correctly - warned. bit.ly/2rcNl3T

And then: a month into the declared epidemic (and nearly seven weeks after the first case was caught) the government declared a State of Emergency. An evening presser was called, with "details to come" the next day bit.ly/35flSxt

A quick interjection here. The government being slow to act is major. They have still not told us why in any meaningful way. But under the State of Emergency, I'm going to wait to press them on it, because there are more important things to talk to them about. Stay tuned though