Queensland fear over Covid threat from PNG
Of white supremacists & the ‘kanakamen’

PNG Covid catastrophe: Australia must act

PNG scientistBRENDAN CRABB & LEANNE ROBINSON
| The Conversation | Edited extracts

MELBOURNE - The COVID epidemic in Papua New Guinea has significantly accelerated, judging by the available reports of case numbers.

Since its first case was diagnosed 12 months ago, PNG has avoided a large number of reported cases and corresponding deaths.

That situation has changed dramatically over the past fortnight. A crisis is now unfolding with alarming speed and the response must quickly match it.

Australia can be proud of its preparations to support PNG and the region in responding to Covid-19, especially its preparations to support vaccination in the region.

As good as they are, these plans are unlikely to be fast enough to stop this current surge before enormous damage is done. There’s simply no time to waste in responding.

Reported Covid-19 testing rates remain critically low, with just 55,000 taken from an estimated population of nine million people. This means we don’t yet have a precise picture of the scale of the epidemic.

The reported numbers are highly concerning. In the first week of March, 17% of all people who were tested throughout the country were positive to Covid-19, with over 350 newly confirmed cases.

This is the highest number of cases in a single week in PNG since the start of the pandemic. Over half of PNG’s 22 provinces reported new Covid-19 cases in that week.

There are other indicators of a potential large scale outbreak, such as reports of increased cases among health-care workers.

What’s more, the total number of documented Covid-19 deaths in PNG has nearly doubled in the past fortnight alone.

Low testing rates, combined with reports of high daily case numbers, means there are likely many thousands of current cases in Port Moresby and widespread seeding and spreading of infections throughout the country.

PNG’s hospitals and front-line health-care workers remain particularly vulnerable.

With limited public health controls in place and an effective vaccination program yet to be initiated, and with last week’s huge commemoration ceremonies for former prime minister Sir Michael Somare, there’s every chance the current outbreak will continue to grow exponentially for some time yet.

The people of PNG now face dual health emergencies: death and disease from Covid-19 itself, and a likely increase in existing major diseases barely held in check by the nation’s already stretched health system.

These indirect effects, such as potential rises in malaria, tuberculosis, HIV, cervical cancer, vaccine-preventable diseases and poor maternal and newborn health, are likely to be even worse than the direct impact of Covid-19.

This health crisis should be reason enough for Australia to respond urgently in support of PNG. But there’s another reason too.

High levels of circulating Covid in the Asia-Pacific region are a recipe for generating mutant coronavirus variants that might spread more readily, evade immunity more easily, and/or cause more serious disease.

A regionally coordinated effort to combat Covid-19 will help ensure protection for everyone, including going a long way to help preserve Australia’s own vaccine program.

PNG already has a coordinated national and provincial Covid-19 response and a vaccine technical working group that has begun planning for deployment of the first allocation of vaccines to front-line health-care workers.

Meanwhile, Australia is also playing a crucial role in supporting this effort, contributing generously to the COVAX vaccine access facility and to a A$500 million fund to support Covid-19 vaccination in PNG and the wider Pacific.

However, these plans were developed on the basis there was substantially more time for planning, deployment and phased rollout than the current case numbers would suggest.

Two considerations are now paramount. First, the response needs to be requested by — and, more importantly, led by — PNG itself. Second, the response needs to reflect the urgency and scale of the unfolding emergency.

Arguably the most important element of this would be immediate vaccination for health-care workers in the most heavily impacted areas of the country.

Ideally, all of PNG’s crucial health-sector workforce should be vaccinated within the next fortnight.

Australia could provide around 20,000 vaccine doses for health-care workers without putting a significant dent in its own vaccine supplies, potentially making a profoundly important intervention in the course of the epidemic in PNG.

This is the moment for dialogue to occur between the two nations, so PNG can ensure Australia’s help with such an immediate and ambitious response.

Brendan Crabb is CEO of the Burnet Institute in Melbourne and Leanne Robinson is Program Director of Health Security and Tropical Public Health at the Institute

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David Vorst

Covid-19 crisis at hospital (19 March 2021, The National )

By LULU MARK

THE Port Moresby General Hospital (PMGH) is facing a Covid-19 crisis with more people testing positive daily and more than 100 workers in isolation, an official says.

Hospital chief executive officer Dr Paki Molumi said six to eight Covid-19 cases were coming to the emergency department daily.

The 18-bed Covid-19 isolation ward was full and two women with Covid-19 were in labour.

He said the hospital saw a surge in cases in the past 15 days with more than 200 cases recorded.

“Of the tests we did, we had a positivity rate of 41 per cent including staff, patients and guardians,” he said. “We have 115 of our staff down with the Covid-19 who have been isolated.”

He said the holding bays in wards were being used to accommodate patients while waiting for beds in the isolation ward.

Last week, a 56-bed ward was also opened.

“There are more than 30 Covid-19 patients at PMGH.

“We were hoping to offload (some) to Rita Flynn but the 43 beds there are full as well.

“So hopefully by the weekend, the Taurama Aquatic Centre will be opened so that PMGH can be freed up.”

He said the hospital needed to take care too of those suffering from other ailments such as tuberculosis and malaria.

“If we don’t treat these diseases we creating another comorbidity for the virus to attack them quickly,” he said.

“When we started our Covid-19 preparedness last year, we set up a lot of processes, different infection protection measures with the support of our development partners.

“We thought we were prepared until the surge. A good number of those staff acquired the infection from their communities and spread to the others in the hospital.

“This indicates that there is already widespread community transmission around the city and country (because) two of our staff came from outside the NCD.”

William Dunlop

The chickens have already come home to roost. Starting with prime minister Marape, the buck stops with him.

Whilst amidst much spruiking about the Richest Black Nation in the World, the virus was taking hold.

In Ireland, 100 years ago, a terrible beauty was born. Today in Papua New Guinea, a terrible tragedy is unleashing itself whilst he and his ilk sit on their arses.

Philip Fitzpatrick

Well said, David and Chris. This is going to be ghastly and I really feel for the people of PNG.

For goodness sake Australia, whatever you do don't give the politicians any money.

David Vorst

Greetings - I am the CEO of the Western Highlands Provincial Health Authority - you didn't mention the K78million cut from the 21 PHAs for 2021, the chronic under reporting from PHAs to the National Control Centre National Department of Health et al and the inevitable closure of hospital and health services as a consequence of this massive budget cut. On top of that the National drug procurement budget has been slashed by >50% when already last year WHPHA spent K6,000/day supplementing what the Central medical supply facility (AMS) couldn't provide. Finally when the AUSMAT team hits Port Moresby - which as we say here is another country - they will be at risk of being fed a load of rubbish as very few people in PoM actually have any idea of what is happening in the Provinces. And yes the COVID genie is out of the bottle and the risk you mention of a mutant strain is here - I think it is called Strain K

Chris Overland

It is little short of astounding that the Australian government has, until now at least, utterly failed to grasp the potential scale of the catastrophe looming on our door step.

Once again, our government has been effectively "asleep at the wheel" when it comes to our "Pacific family".

The seeds of catastrophe were sown when the PNG government decided, whether by design or default, that its response to the pandemic would be to effectively ignore it.

Certainly, ineffectual efforts were made to encourage social distancing and isolation but the basic response was apparently to hope it would go away.

For a long time this strategy appeared to work but now we know that all the while the disease was insidiously working its way into the population.

Experience has shown that the worst effects of the pandemic can only be ameliorated by swift and determined action to prevent its spread. This patently did not happen in PNG. Given the nature of the country and its government's proven inability to deliver even basic health care much beyond the major centres, this was inevitable.

Bitter experience has also shown that there are still no really effective treatments and that severe cases will require massive intervention, including the large scale use of ICU technologies to keep patients alive long enough to beat off the disease.

The demonstrated death rate with this disease is about 1.5% of all cases. This is so where the full array of modern medical technologies can be brought to bear upon those who are most severely effected.

A much larger percentage of patients will require hospitalisation, perhaps as high as 10% of those who contract the disease.

In the absence of this interventional capacity it is reasonable to expect a much higher death rate but no-one currently knows what this may be. PNG seems likely to be about to find out.

The Australian government will need to do much more than send a few container loads of the Astra Zeneca vaccine to PNG.

Specifically, it will need to send a small army of people to help distribute and deliver the vaccine. To do this speedily and efficiently seems likely to require a significant military effort because only the military has the logistical capacity required, e.g. aircraft, helicopters, portable refrigeration and, ultimately, the capacity to put boots on the ground in very remote and inaccessible locations.

The much less severe and threatening Influenza epidemic of 1969/70 required the full scale mobilisation of all the resources available at the time.

I and many other kiaps, together with a small army of Police, Medical Assistants and Aid Post Orderlies, rapidly mounted medical patrols across the country in an effort to find and treat people effected by the disease.

In those days, a shot of procaine penicillin could save people from certain death but this will not be the case with Covid 19.

I sincerely hope that those in Canberra actually understand the sheer scale of the task that confronts PNG if it is to exert effect control over Covid 19 and that they have no hope of doing this without massive and immediate support from us.

If ever more proof were needed, it should be clear to our government that we cannot sit here on our huge island, fat, dumb and happy, while our "Pacific family" suffers the impact of this disease, not to mention climate change and various other modern ills that have been inflicted upon them by our collective actions or inaction.

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