Is PNG sleepwalking through the pandemic?

The heat on Papua New Guinea’s hospitals appears to have eased, but some worry the country could still be asleep to the full extent of its Coronavirus (Covid-19) outbreak, JOHNNY BLADES writes

Earlier this year, soaring case numbers stretched PNG’s health system and workforce to the limit.
But senior clinicians in Port Moresby say the rates of transmission and admission to hospital for the virus have dropped significantly over recent weeks.
The trend of less cases and hospital admissions has come as a relief to PNG’s chief of medical emergency services Dr Sam Yockapua, who previously warned about the risk of focussing too much on the Coronavirus (Covid-19) and ignoring other pressing comorbidities in the country.
“The rate of transmission and admission has gone down significantly in the last three to four months,” he said.
“And the numbers do not lie.”
Dr Yockapua said PNG had not been able to enforce lockdowns like New Zealand or Australia, and had to live with the disease.

Lack of data a concern
The Covid-19 is now considered by some in PNG as simply another disease alongside others at large, including malaria, tuberculosis, typhoid, cholera and even polio.
“I think we should stop punishing ourselves and keep living,” Dr Yockapua said, adding that sections of the population may have developed herd immunity.
This theory was rejected by his colleague Professor Glen Mola, the head of obstetrics and gynaecology at Port Moresby General Hospital, who said the problem was health authorities had little handle on how many people have the Covid-19.
For instance, he said the Institute of Medical Research in the town of Goroka had done around 2,800 Covid-19 tests since January.
“Only 2,800 tests in the whole of the five million people in the Highlands, and 468 of them were positive; that’s about 18 per cent.
“But we have no idea who that 18 per cent are, we just don’t have that information.”
PNG’s health system is under-resourced and often lacking in basic supplies.
Many communities live in remote regions, and sick people often do not present to health clinics for treatment.
Prof Mola said cause of death was not routinely recorded in PNG.
So far, PNG’s National Pandemic Response Controller has reported 192 deaths from just over 17,800 confirmed cases.
The positive cases are now reported in a small dribble.
A far cry from the surge that began in February when around a thousand cases were confirmed per week, and for the next several months.
However, clinicians in Port Moresby, the epicentre of PNG’s outbreak, report the health workforce has bounced back to its pre-outbreak levels.
Port Moresby General Hospital senior oncologist Peter Olali said many health workers had been infected, and some had died.
But now it was feeling quieter on the Covid-19 front.
“We have not really seen any numbers, not just rising, but in terms of very sick ones related to the Covid and all that,” Prof Mola said. “We haven’t really seen deaths in the country and here in our hospitals.
“We’re not really hearing (about Covid-19 related sicknesses)
from the provincial hospitals as well.”

Ill-informed
Some national leaders have recently challenged health officials’ warnings about the dangers of the Covid-19, even touting what they claim to be natural immunity in Papua New Guineans.
Prof Mola cited the example of a prominent Highlands MP who claimed a spate of deaths in his province was not linked to the virus. So he said last week: ‘I’ve had to pay for 10 funeral expenses (we call them haus krais)’, but none of them have died from the Covid,” he said.
“How on earth does he know?
“Has he tested all the bodies, has he done a verbal autopsy?
“How on earth does he know that they haven’t died from the Covid?”
Testing for the virus was scaled back by PNG’s pandemic response authorities in June, as they shifted their focus to vaccination.
Vaccination has moved slowly, in no small part because misinformation about the safety of vaccines is rife and has created great hesitancy.
The government has focussed on vaccinating key frontliners such as health workers.
Prof Mola said students starting as new medical staff at the hospital this week were offered a choice of the AstraZeneca vaccine donated through the Covax facility, with Australia’s help, or the Sinopharm vaccine from China.
“So we ask them all of course, you’re all vaccinated, aren’t you?” he said.
“Because you’re not coming into our clinical space unless you are.
“And there were two who were not vaccinated.
“I said, well okay, you can go and do something else or you can get vaccinated.
“So they both decided to go and get vaccinated.”
If outbreaks in neighbouring countries like Indonesia and Fiji were anything to go by, PNG remains highly vulnerable to the Covid-19, particularly if the Delta strain of the virus is left unchecked.
Several cases of Delta recorded in PNG last month were quickly isolated.
But without more testing and information on infections and deaths, PNG health authorities cannot be sure of the extent of the situation they are really dealing with. – RNZ

‘Deaths maybe Covid’

The Guardian reports the deputy controller of PNG’s national pandemic response, Dr Daoni Esorom, as saying they now require doctors at the country’s biggest hospital to swab all bodies of those who had died from unknown causes or who had respiratory illnesses, to see if they had the Coronavirus (Covid-19).
Dr Esorom said testing had reduced since March making it difficult to know how widespread the transmission of the Delta variant is.
His comment comes after a range of senior clinicians in Port Moresby spoke to RNZ Pacific about lower admission rates due to the Covid-19 at hospitals in PNG, although the lack of information about people infected and sick from the Covid, as well as incomplete data on cause of deaths, could be hiding the real extent of the outbreak across PNG.
“If you have a low level of testing, and have a high uptake of detection of positive cases (at the moment it’s 12 per cent) and you have a large pool of unvaccinated people, that is a recipe for major spread of the Delta variant,” Dr Esorom said.
He said there was anecdotal evidence of increasing number of deaths due to unknown causes.
PNG has officially confirmed 17,832 Covid-19 cases and 192 known deaths.
The Delta variant was first detected five weeks ago and now there have been 12 confirmed cases.
An outbreak in March saw PNG’s partners scramble to send emergency doses of vaccines but the rollout had been slow, with fewer than 100,000 doses administered among a population of about nine million people. – RNZ