Outbreak of unknown proportions

Papua New Guinea: Officially, Papua New Guinea had recorded 2269 cases of Covid-19 as of Tuesday – a relatively low number for a nation with more than nine million residents. But the country has one of the world’s lowest testing rates and there are growing signs that the actual Covid-19 tally is staggeringly high.

On Monday, Queensland’s premier, Annastacia Palaszczuk, revealed that its state health authorities had conducted testing for PNG and that a single batch of 500 samples from PNG residents had contained 250 positive results.

“That’s quite extraordinary and quite concerning when it’s right on our doorstep,” she said.

Separately, the country’s largest hospital, Port Moresby General Hospital, said this week that 20 per cent of pregnant women being admitted to its labour ward have tested positive for Covid-19.

The virus has been spreading across the country’s mainland and islands, leading to cases being reported in at least 18 of 22 provinces. There have been 26 deaths.

Authorities in PNG have conducted about 55,000 tests; Australia has conducted more than 15 million. Some test results in remote areas of PNG are reportedly taking 30 days to be returned.

And so PNG is now preparing for a severe outbreak.

Michael Kabuni, a politics lecturer from the University of Papua New Guinea, has credited the recent increase in community transmissions to a lack of public concern about the virus and a failure by state authorities to enforce health restrictions. The first infections on the island of Bougainville, for instance, are believed to have occurred after officials from the mainland attended a meeting in February to discuss the province’s move towards independence; the officials reportedly did not wear masks or practise social distancing.

But the current surge in case numbers is also believed to have been exacerbated by the recent two-week mourning period for the so-called “Father of the Nation”, Sir Michael Somare, an independence leader and long-serving prime minister, who died on February 26.

Despite calls by health experts to cancel a state funeral, the event went ahead late last week and was attended by thousands of people. Few wore masks.

Hospitals overwhelmed

Papua New Guinea has a desperately underfunded and poorly resourced health system that is ill-equipped to deal with a serious Covid-19 outbreak. The country has about six doctors per 100,000 people; Australia has about 370.

Hospitals have already been forced to cut services due to the increased demands from the Covid-19 outbreak.

Port Moresby General Hospital has put out calls on Facebook for donations of emergency supplies of face masks, face shields, gowns and gloves, as well as power generators. On Tuesday, the hospital’s chief executive, Paki Molumi, told the ABC’s Natalie Whiting that 114 staff – or about 10 per cent of the workforce – had tested positive for Covid-19.

“Some have recovered and returned to work, most still out,” Whiting said in a tweet. “But no plan to close the hospital. [Molumi] has backed requests for Australia to help with early vaccinations.”

Experts have warned that the worsening Covid-19 outbreak – and the spread of the virus among the country’s health workers – could cause further closures of medical services, leaving the country unable to deal with cases of HIV, tuberculosis and malaria.

But authorities have been reluctant to impose lockdowns due to concerns about the economic impact on a country that already has high poverty and unemployment rates. In some areas, locals have resisted the establishment of testing centres because they fear that the discovery of outbreaks will lead to business closures and the loss of livelihoods.

Vaccination plans

Papua New Guinea has struggled to secure Covid-19 vaccines and has not yet conducted any vaccinations. Last week, the government said Australia and India had helped to source supplies of 200,000 and 70,000 AstraZeneca doses, respectively. The batches are not due to arrive until next month.

On Tuesday, Prime Minister Scott Morrison said Australia will now send 8000 doses from its own stocks in the coming week and will ask AstraZeneca and European authorities to divert another one million doses from Australia’s supply. He said the outbreak in PNG poses “very real risks” to Australia, particularly to Queensland and the Torres Strait, where some islands are a short boat ride from the PNG coast.

“We’ve paid for them and we want to see those vaccines come here so we can support our nearest neighbour,” he said.

Australia also sent a small team of doctors to PNG this week and is helping to set up testing centres, as well as providing 1.2 million masks, 200 ventilators and other protective equipment. Flights from Port Moresby to Cairns have been suspended and passenger capacity on flights to Brisbane has been reduced by 25 per cent.

Australia is the largest aid donor to PNG, its former colony, and has already committed about $205 million to support the Covid-19 response and the securing of vaccines.

But aid groups say further immediate supplies of at least 12,000 doses will be needed to ensure frontline health workers are immunised.

The challenges ahead

The PNG government announced this week that a four-week nationwide isolation will start on Monday, stopping short of imposing a lockdown or the mass closure of businesses. Instead, masks will be mandatory in public and residents will be barred from moving between provinces.

The PNG government plans to start mass vaccinations later this year but faces serious hurdles, including widespread misinformation and scepticism about vaccines.

The Australian Council for International Development this week urged Australia to assist with countering misinformation about the vaccine through churches and trusted community organisations.

“Building trust will be essential to getting testing, protection and vaccines effectively into PNG communities,” said the organisation’s head, Marc Purcell.

PNG will also need to secure further vaccine doses. It is due to receive 588,000 doses of the AstraZeneca vaccine before the end of June from Covax, an international scheme to ensure equitable international access to supplies. But Australia and others will likely need to assist PNG to source additional doses.

Finally, the PNG government faces the monumental logistical task of distributing vaccines to remote regions that can be notoriously difficult to access. For months, health experts and aid groups have been warning that national and state authorities in PNG need to develop a plan for co-ordinating the vaccine rollout. But no such plan has yet emerged.

On Wednesday, Justine McMahon, from Care International, told Sky News: “PNG’s a country of many cultures so the messaging and the logistics in terms of getting the vaccines into people’s arms is quite a huge job.”

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