Charmaine Gauci grilled on the witness stand in court case challenging COVID restrictions

A priority throughout the COVID-19 pandemic has been to ensure hospital beds remain available for those who need them, Charmaine Gauci has testified in court.

The Public Health Superintendent took the witness stand in a constitutional court case filed by several individuals claiming that COVID restrictions were unconstitutional and breached human rights.

On Friday, Gauci was grilled on the witness stand by three lawyers representing the case – Keith Borg, Edric Micallef Figallo and Rudolf Ragonesi.

Gauci defended the restrictions taken throughout the pandemic, insisting they were an “evidence-based response” to developments.

“One must remember that Malta has a high population density, and we need to make sure we don’t burden the hospital. We only have one hospital, and we need to do what we can to make sure that we are not overwhelmed to be able to treat other patients that need it,” she said. “The priority was to make sure that beds in hospitals remained available for those who needed them.”

She testified that during the third wave of the pandemic earlier this year, the vaccination programme made a difference.

Questioned by Micallef Figallo, she described the process that public health adopted when deciding what measures to take and when.

Gauci said that when it came to evidence-based policy, the information had to first be gathered, analysed and understood.
“We have always taken a national preparedness response plan to combat any threat that comes to Malta,” Gauci said.    

Keith Borg asked Gauci what she meant by “national preparedness response.”

Gauci explained that when there is a threat, the first port of call is to decide how to control it.

“You have to have a mode of attack. In a biological sense, you need to know how the virus is transmitted and once you know that, you can evaluate what measures need to be put into place to control it. You also need to be aware of how it is going to affect your population in order to make sure hospital cases do not shoot up, and people don’t die,” Gauci said.

Micallef Figallo then questioned the surveillance system used by the health authorities to detect COVID-19 cases and asked if this was in place before.

Gauci said the surveillance system was in place before COVID. “This has always been done for infectious diseases,” Gauci said.

She said that the process of PCR tests for COVID had begun before the first cases were detected in March 2020.

Questioned over the reliability of PCR tests, Gauci said they are used all over the world, are reliable and able to pick up the genetic material of the virus to make sure it is a genuine case.

Gauci made recommendations to Health Ministry

Micallef Figallo then asked if Gauci was the person responsible for recommending the restrictive measures.

Technical measures are her domain, she said. However, she gives recommendations that are passed on to the Health Ministry and then discussed in Cabinet, after which a legal notice is issued.

Gauci said that studies used to determine what measures should be taken were conducted abroad but work was done to transpose them to the Maltese context. She said the surveillance system is robust and all information was submitted in court.

Giving an overview of how the pandemic evolved, Gauci said that when the first wave started in March 2020, cases began to rise until measures were put in place. When they were relaxed, the number of cases went up again, she added.

During the second wave, which started in July 2020, the cases went down when measures were put into place and started rising again when they were relaxed.

Vaccinations made difference in third wave

Gauci said that what made a difference during the third wave was the vaccination programme. However, not everyone could be vaccinated at the same time, so certain measures had to remain, she said.

“The well-being of a person is important, and we are taking measures that are very much needed, and when they are no longer needed, are withdrawn,” Gauci said.  

Replying to questions by Rudolph Ragonesi, Gauci said PCR tests were used at Mater Dei Hospital prior to COVID-19.

Ragonesi then asked who conducts the PCR tests with Gauci saying that these are done at Mater Dei Hospital labs and private laboratories. 

Ragonesi then asked if PCR tests could get it wrong. The Public Health Superintendent said PCR tests are highly reliable and studies provided by the ECDC were consulted before they were used to detect COVID. 

COVID deaths

Ragonesi then inquired about COVID-19 deaths and how these were determined.

Gauci said that the health authorities are using the WHO definition of a COVID-19 death. “We are obligated to report the deaths,” she added.

Ragonesi then pressed on how the authorities decide if it is a COVID-19 death or if the person died with COVID-19 in their system.  

“If the person died with no other prior health issues, that would be categorised as a COVD-19 death. Let’s put it this way if someone is run over and dies, and then they test positive for COVID-19, that does not count as a COVID-19 death,” she replied. 

Ragonesi then asked about autopsies and why they weren’t done. “For there to be an autopsy, there has to be a reason the death cannot be declared without one. To my knowledge, that has only occurred once for a COVID-19 death,” she said.  

Asked about the policy on masks worn in school, Gauci said that masks and visors could be used, but masks are recommended because they are more effective.  

Ragonesi questions if the term in the legal notice references “recommendation” rather than citing that masks must be worn instead of visors.  

Gauci confirmed that it was a recommendation. 

The case continues on 26 January 2022. 

Judge Lawrence Mintoff is presiding, while the State Advocate is represented by lawyers Bernice Saliba and Anthony Borg.