Could PNG produce the next Covid variant?
13 December 2021
STEFANIE VACCHER
| Burnet Institute | The Age | Edited extracts
MELBOURNE - In South Africa, only one in four people are vaccinated against Covid-19, a key factor behind the spread of the Omicron variant.
But just four kilometres north of Australia, the situation is far more dire. In Papua New Guinea, our closest neighbour, fewer than one in 20 people have had the jab.
High rates of infection and low vaccination coverage significantly increase the risk of Covid not only spreading, but mutating.
Combined with high rates of HIV and multi-drug resistant tuberculosis, also seen in South Africa, the risk of a dangerous new coronavirus variant emerging on Australia’s doorstep becomes very real.
As the world races to understand the implications of Omicron, PNG is still reeling from the latest Delta surge, causing record numbers of cases and deaths. Despite this, vaccination rates remain some of the lowest in the world.
As of last Sunday, just 2.2% of the population was fully vaccinated. By comparison, 75% of the Australian population was fully vaccinated.
In PNG, inadequate community awareness has led to widespread vaccine hesitancy in both urban and remote areas, spurred on by confusion about who can be vaccinated, where and with what vaccine.
PNG’s vaccine rollout has been severely hampered by misinformation and fear, compounded by practical and logistical issues.
Across the country, conspiracy theories spread by word-of-mouth and social media at immense speed. Even healthcare workers are not immune.
Unvaccinated workers discourage others from being vaccinated, while those promoting vaccination have been physically attacked in several provinces.
Many with fervently held religious beliefs have also incited stigma and discrimination, preventing people from being tested for Covid, let alone being vaccinated.
In such a climate of suspicion and distrust, Australia cannot simply send vaccines to PNG and expect to see a dramatic increase in vaccination rates.
Effective public health interventions require meeting people where they are - working with varied levels of understanding and acceptance - and physically visiting people in their communities.
It means empowering and educating local leaders and supporting them to shape discussions with their constituents.
The ‘End-Covid-For-All’ initiative is calling for the Australian government to invest $50 million to address vaccine hesitancy.
Changing minds is particularly challenging when you consider that PNG has no routine adult vaccination programs and some of the lowest childhood vaccination rates in the world.
A coordinated and sustained response is needed. Strategies which are currently underutilised but effective include joining forces with local vaccine champions – doctors, sports stars or community leaders – to share personal stories about people who have had Covid or been vaccinated. Church leaders could use scripture to encourage congregations to get vaccinated.
Western Province, bordering Indonesia and Australia, has ongoing community engagement and the highest vaccination rates outside of Port Moresby thanks to strong partnerships between government, churches, local leaders and international organisations.
Additionally, visits to remote and hard-to-reach villages for vaccine awareness and immunisation have been pivotal in helping overcome fears.
The lack of testing and absence of a national death registry makes it impossible to measure the true toll of Covid in PNG.
Yet, despite recent reports of oxygen shortages and overflowing morgues, most Papua New Guineans remain unconcerned and do not plan to get vaccinated.
Every additional day with lagging vaccination rates leads to preventable deaths. Omicron is a clarion call for Australia to do much more to help vaccinate the people of PNG.
Until we complete the Greek alphabet no doubt! Then what?
Posted by: Harry Topham | 16 December 2021 at 03:22 PM
"Is it possible vaccination could have contributed [to] the recent mutation?"
That's a really interesting question. Does the virus mutate to overcome the resistance afforded by vaccination?
Extrapolating from there, why would a virus have to mutate in an unvaccinated population if it is successfully infecting people there?
________
These may be interesting questions, but they are silly questions – as a quick search of any reputable health website will demonstrate.
Vaccines against Covid-19 cannot cause infection because variants cannot derive or replicate from vaccines as mRNA vaccines do not use live virus. This is explained in the link below to the US Centers for Disease Control and Prevention.
Mutations (changes) in viruses — including the coronavirus that causes Covid-19 — occur when there is a change in the virus’s genes. This is a natural and common process. It is the nature of mRNA viruses like coronavirus to constantly evolve and change. They do not think, ‘oh I’m going OK, I’ll just chill’. They do not think. They just keep mutating, some more than others - KJ
https://www.cdc. /2019-ncovvaccines/different-vaccines/mrna.html
https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/a-new-strain-of-coronavirus-what-you-should-know
Posted by: Philip Fitzpatrick | 15 December 2021 at 07:26 PM
Hi Keith, you are correct with most of the information you provided about me.
However, I have not been absent from PNG all this time.
At one stage from 2014-16 I travelled regularly to POM almost monthly to see medical patients at one of the private hospitals in PNG.
I also spent many months in Kimbe providing medical service almost for free between April 2018 and 20 March 2020.
I returned to Australia, arriving in Cairns at around 7pm on March 2020 just few hours before Australia shut its borders.
I will be returning to PNG soon when international travel is a lot easier.
They are several PNG doctors with Australian and New Zealand Specialist Physician qualification of Fellowship of the Royal Australasian College Physicians (FRACP) along with me.
Only Professor Sir Isi Kevau is the only one who has returned permanently to PNG after obtaining his FRACP.
All the others have taken up Australian permanent residency and have not returned to PNG to contribute professionally over an extended period because the money is great in Australia.
I try in my small way to bridge the huge gap that exists in medical practice between Australia and PNG.
So I am quite aware of the common medical issues in PNG.
_________
Thanks for that clarification Kindin. Happy to learn you're not part of the 'brain drain' - KJ
Posted by: Kindin Ongugo | 15 December 2021 at 03:11 PM
We have in medical practice a phrase 'antibiotic stewardship'.
This is to avoid inappropriate use of antibiotics/antifungals and antiviral to minimise risk of development of resistance by micro-organisms.
COVID is mutating but from the current trend it is hard to blame poor vaccination.
Resistance mostly comes about as a survival means by the organism after exposure to the antibiotic..
Typical examples;
1. Tuberculosis- Drug resistant TB such as MDR-TB, X-DRTB happens after poor compliance with TB treatment
2 MRSA- from frequent inappropriate use of anti-S. aureus antibiotics
3. Carbepenem resistant enterococcus - after prolonged or frequent exposure by the organism to the antibiotics in this class.
4. HIV resistance to anti-retroviral after frequent interruptions
My simple understanding of antibiotic resistant is one of two mechanisms
A- organism must have ongoing exposure to the antibiotic
or
B- the organism has an inherent resistant to the antibiotic
I am confused how unvaccinated populations could create a conducive environment for COVID -19 to mutate.
Is it possible vaccination could have contributed the recent mutation?
_________
This comment - which I have left unedited - is misleading and for the most part non-factual. Usually, it would not be approved for publication, but knowing that similar misinformation is well-entrenched in PNG, I have allowed it to be published for further expert comment if forthcoming and so I am able to point to its wrong premise which leads to a major logical problem.
But first some background. I understand that Dr Ongugo MBBS FRACP is an Australian-based respiratory and sleep medicine physician who has operated as a sole trader since November 2016 based in Currajong, a suburb of Townsville. He has consulted as a locum at Townsville Base Hospital.
Dr Ongugo grew up in Kimbe and graduated with a medical degree from the University of Papua New Guinea. He worked in the PNG health service in rural areas before pursuing further education in respiratory medicine in Australia.
By 2010 he was a medical registrar at the John Hunter Hospital in Newcastle, New South Wales, at which time he stated that he intended to return to practice in PNG, although it seems this did not happen.
In his comment, Dr Ongugo writes that he is “confused how unvaccinated populations could create a conducive environment for Covid -19 to mutate”.
But there is ample evidence from the most reputable scientists that vaccination is one of the best ways to slow the emergence of Covid and new Covid variants.
To quote from one source I have linked to below: “With more than a million new infections occurring every day and billions of people still unvaccinated, susceptible hosts are rarely in short supply. So, natural selection will favour mutations that can exploit all these unvaccinated people and make the coronavirus more transmissible.”
So not only is an unvaccinated population more susceptible to the coronavirus, contradictory to what Dr Ongugo states it makes Covid more transmissible.
For readers who want more information, here are links to relevant articles from reputable sources (there are very many easily found online) - KJ
https://theconversation.com/massive-numbers-of-new-covid-19-infections-not-vaccines-are-the-main-driver-of-new-coronavirus-variants-166882
https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/a-new-strain-of-coronavirus-what-you-should-know
https://www.nature.com/articles/d41586-021-03552-w
https://www.cdc.gov/coronavirus/2019-ncov/variants/about-variants.html
Posted by: Kindin Ongugo | 14 December 2021 at 07:10 PM