The emergency rooms are full, health professionals are getting sick and misinformation about the coronavirus is spreading. All of this left Papua New Guinea, an island nation in northern Australia, in the grip of a deadly crisis, while a tripling of infections last month flooded an already fragile health system.
The wave of cases, which the authorities described as a “major epidemic”, probably started in February. About 70% of symptomatic patients have positive results – one of the highest rates in the world. Of the 39 deaths caused by the virus in the country, 30 happened in the last six weeks, and the number is expected to increase. The confirmed infections exceeded 4,100, after having remained at zero until June, although the real number of cases is believed to be much higher.
The impact on health professionals was severe. About 10% of workers tested positive at the country’s main hospital in Port Moresby, a city of 380,000 people that was hardest hit. In field hospitals, workers, sweating under protective equipment, run between the beds to care for the dying.
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“We fear that we will fill all of these beds and we will have nowhere else to continue caring for COVID patients,” said Mangu Kendino, emergency physician and chairman of the COVID-19 committee at Port Moresby General Hospital. “We are tired, we are exhausted, we are tired.”
One year after the start of the pandemic, countries around the world are entering a new phase, as they vaccinate growing portions of their populations and reopen schools, restaurants and offices. But the crisis in Papua New Guinea is another reminder that the global emergency is far from over – that the virus will continue to wreak havoc and sow death until everyone is vaccinated, a prospect that could take years.
The situation in the island nation is exactly what public health experts have warned, as wealthy countries buy the world’s vaccine stocks and leave the pandemic behind, while smaller and poorer nations keep the roof in hand. Having largely avoided serious outbreaks for many months, Papua New Guinea is now experiencing distressing scenes, not unlike those in Italy at the beginning of the pandemic. This month, a patient, suffering from an asthma attack, died in the parking lot of a hospital.
“They have challenges in accessing health care at the best of times,” said Rob Mitchell, an emergency physician specializing in Pacific screening. “I’m afraid the current case numbers are just the tip of the iceberg.”
It is not clear why Papua New Guinea is only now being hit by a serious outbreak. It has an especially young population, and some experts speculate that the virus could have circulated more widely all the time, but that many cases were asymptomatic or mild and were undetected. Others say it may be the result of public apathy over rules such as wearing masks and practicing social detachment.
“When the pandemic was first announced by WHO and we went into blockade, the government reacted very quickly,” said Dr. William Pomat, director of the PNG Medical Research Institute. But at the end of last year, he added, “many of us have become very accommodating. Many of the things we were supposed to do, we didn’t do anymore. “
As infections increase, doctors are working overtime, trying to meet a demand that they say will only increase in the coming weeks. In Port Moresby, the capital, stadiums have been converted into temporary field hospitals and existing hospitals are exhausted.
“The COVID center in Port Moresby is full; our field hospital is almost full, ”said Gary Nou, an emergency physician who helped lead the government’s response to the pandemic.
At one of the field hospitals, Nou said, he and others, dressed in full protective gear, often work in wet conditions while struggling to keep their patients cool and hydrated. “As soon as you get off the ground, you are drenched in sweat,” he said. “When we are at maximum, our sanitary facilities are stretched to the limit and waste disposal is stretched to the limit. Every day is a challenge. “
At the large nearby hospital, some wards have been converted to accommodate patients with COVID-19, but doctors say they remain concerned about the lack of beds. Doctors and nurses are having to extend their shifts as their colleagues are infected. More than 120 team members tested positive for coronavirus, said a hospital spokeswoman, adding that the numbers are increasing daily.
In response, Australia donated 8,000 doses of the AstraZeneca vaccine, as well as protective equipment and fans. It also deployed a small team in the country.
Fearing the spread of the virus, Australian authorities have stepped up efforts to vaccinate the population of the Torres Strait Islands, an archipelago bordering northern Australia and Papua New Guinea. Most of the islands are part of the Australian state of Queensland.
“They are our family. They are our friends. They are our neighbors. They are our partners, ”said Scott Morrison, Prime Minister of Australia, last week. “This is in the interest of Australia and it is in the interest of our region.”
Covax, a global health initiative designed to make access to vaccines more equitable, began distributing doses of vaccines to developing countries last month and said it would deliver 588,000 to Papua New Guinea by June.
But in some cases, wealthier nations have failed to honor contracts, reducing the number of doses the initiative can buy, said Dr. Tedros Adhanom Ghebreyesus, director of the World Health Organization, in a statement last month. He warned that the pandemic would not end until everyone was vaccinated.
“This is not a matter of charity,” he said. “It is a question of epidemiology.”
Until then, the authorities in Papua New Guinea will have to fight not only the virus itself, but also a wave of misinformation about the virus and vaccines, transmitted largely by social networks.
“Even for the educated health professional, this is causing a lot of doubts,” said Nou, the doctor in Port Moresby, who conducted a survey of health professionals’ opinions about the pandemic. He said that some in the country believed that the virus was a scam, or that people on the island were immune, or that it would be safer to contract the virus than to be vaccinated.
With the country now waging a total battle against the coronavirus, some public health experts fear that the redirection of resources may have a lethal cost for those with other serious health conditions, such as malaria or tuberculosis. Papua New Guinea has one of the highest rates of tuberculosis in the world.
“It is not good enough just to respond to COVID and then someone die from another cause,” said Dr. Suman Majumdar, an infectious disease specialist at the Burnet Institute, an Australian medical research center. “We fear the worst,” he added, “and this is happening.”
This article was originally published in The New York Times.
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