Some clarity about Covid-19

University of PNG’s school of medicine and health science head of reproductive health, obstetrics and gynaecology and Port Moresby General Hospital senior consultant specialist clinician PROF GLEN MOLA addresses the misinformation and misconceptions towards the Covid-19

MISINFORMATION on the coronavirus (Covid-19) is worrying because it is negatively affecting the people’s response to combat the high community transmissions in Papua New Guinea.
As of last Tuesday, the total Covid-19 reported cases stands at 8,984 which included 71 deaths and all the 22 provinces in the country have reported cases of the Covid-19.
More than 1,500 essential front line workers in the National Capital District have been vaccinated with the AstraZeneca vaccines and the first batch of the Covax facility arrived on Tuesday from India.

Is Covid-19 epidemic a hoax and why are not so many Papua New Guineans dying right now?
It is a very real worldwide pandemic, millions have died and continue to die from this nasty disease.
The propagation of this misinformation has the potential to lead to thousands of deaths in PNG if people pretend that the Covid-19 does not exist, because then we will not take care to prevent the spread.
With about 10,000 cases reported to date, we are in the exponential surge phase of this epidemic in PNG.

Covid-19 infection is just like a mild flu or the same as influenza?
It is not.
Influenza mainly affects the upper respiratory tract then moves down to inflame the air sacs in the lungs where oxygen-carbon dioxide exchange takes place.
The Covid-19 also starts in the upper respiratory tract, but this is where the similarity ends.
If the individual is not able to eradicate the Covid-19 virus at this early stage, it moves down into the lungs and affect the walls of the small arteries that surround the air sacs (also therefore impeding oxygen-carbon dioxide exchange).
The Covid-19 can affect the small arteries (endotheliosis) all over the body and cause all sorts of devastating effects in many organs.
This is why, for example, that a significant number of Covid-19 infected people lose their sense of smell and taste because the infection has affected their brain.
And then there is “Long Covid”.
A significant number of people (about 10 per cent) who get the Covid-19 go on to long-term or even permanent disability.
They end up with things like long-term shortness of breath, chest pains, no sense of smell or taste, joint pains (like arthritis), and cannot walk well or do other physical things such as participating in sports.
And the risk of “Long Covid” is not related to the severity of your initial infection morbidity; so even mildly symptomatic cases of the Covid-19 can go on to a “Long Covid” condition disability.

Will taking home remedies (such as lemon tea, honey tea, herbs, good diet, breathing in steam etc,) protect you against the Covid-19, or help you not to get too sick if you are infected?
There is no scientific evidence that any of these home remedies are effective in either specifically preventing the Covid-19 or reducing death or disability.
Please do not misunderstand me here: a healthy diet and daily exercise is critical and beneficial to long-term good health – especially in reducing the risk of cardiovascular and metabolic (e.g, diabetes) disease.
And, of course we all know that those with these kind of co-morbidities are much more at risk of serious morbidity and death from the Covid-19 infection.
And do not get obese or smoke.
Everyone should know their BMI (height/weight ratio) and for good health BMI should be between 18 and 25.
There is nothing wrong with drinking hot lemon juice, eating lots of garlic or taking innocuous herbs.
If these make you feel good, by all means continue, but do not think that these are proven efficacious alternatives to effective proven strategies like vaccination.
Some things like breathing in steam could damage your airways.

“God will protect you, so just relax”
God protects us all.
But God does not usually do (and we should not expect God to do) what we can do for ourselves.
God helps those who help themselves and the view that PNG has a special place in God’s heart, over and above other places is not only gratuitous and spiritually arrogant, but also offensive to other members of God’s family.
Pray to worship, love, honour and fear God, but please do not presume to tell God what to do.
And do not “relax” if you have children to look after.
Also think about the older members of your family who might be at serious risk of morbidity and even death if they are infected.

“Covid-19 is (overseas)
man-made and all we have to do is keep foreigners out of PNG and we will be safe”
The Covid-19 is a Corona-Sars type virus that made the jump from animals to humans, probably in a Wuhan China ‘wet-market’ at the end of 2019.
Many infectious agents have made this kind of jump over the centuries – even human HIV infection could have arisen like this in the 1950s or 1960s.
There are literally hundreds of species of Corona viruses in both humans and various animals.
But whatever is the actual source of this Covid-19 virus, it is now causing massive community transmissions in PNG communities, and keeping foreigners out is not a very useful thing to do at this stage.
It was a good strategy in 2020, but things have now changed.
Indeed, this is one of the things we doctors are realising with great anxiety – that the situation with regards to this epidemic in PNG is changing rapidly, and this means we need to change the way we do things almost daily.

“The Covid-19 is not as bad as HIV, TB, malaria etc, and, therefore, we should just focus on these serious health and medical problems and not be too focused on the Covid-19”
The Covid-19 is “bad” – just like HIV, TB, malaria, cancer etc are bad.
But all these other “bad” medical conditions are often treatable.
There is good medicine nowadays to keep HIV infected people healthy for decades so that they can lead a normal life.
There is very effective treatment for TB and we can also treat most cancers as long as you present at the very early stage of the disease.
However, there is no effective treatment for the Covid-19; if you get sick with your Covid-19 infection, the best we can do is prevent over-reaction of your body to inflammation and give you supplementary oxygen (if the oxygen concentration in ordinary air is insufficient to keep you alive) – and until (hopefully) your body develops sufficient immunity to the virus.
Doctors are not giving up on treating HIV, TB, cancer, and other health and medical problems, – but the Covid-19 is making it harder for us to do everything.
Please help us to cope – by not propagating conspiracy theories, by following “Niupela Pesin”, and getting ready to get the vaccine when it is available.
Health workers are also human beings and many are getting depressed and frustrated by the continuous barrage of “bullshit” that is appearing in social media.

Covid-19 vaccines “not safe”
Covid-19 vaccines have all gone through rigorous and standard testing.
It is true that this process has been done faster than usual, but it has been done properly.
This process has been done as an emergency because this epidemic is possibly the major health emergency of this century.
The AstraZeneca, Moderna, Pfizer, Johnson and Johnson vaccines have passed through the three phases of research process and have been found to be safe.
When concern was raised by European doctors that the Oxford AstraZeneca vaccine could be associated with an increased risk of blood clots, the issue was thoroughly investigated, and in fact data shows there is a higher rate of blood clots in the unvaccinated group of people in Europe.
The ‘European Agency for (monitoring) Medicines’ declared that the AstraZeneca vaccine was in fact safe for use throughout Europe on March 19. The idea that we in PNG need to repeat all the research is plainly ridiculous.
And in PNG we just do not have the capacity to do detailed and thorough monitoring like the Europeans can.
People who make these kind of suggestions either do not believe Papua New Guineans are members of the human species, or have no idea of research protocols and monitoring procedures.

Are the Covid-19 vaccines being brought to PNG so that they can be tested on us Papua New Guineans as “guinea pigs”?
Millions of doses of the vaccines have been rolled out in the US and Europe with minimal side effects and good efficacy.
The protection against death and serious morbidity that these vaccines provides is between 65 and 95 per cent, depending on the vaccine and the type of the Covid-19 that you get.
This is why we convinced the Australians to help us get an advanced shipment of 8,000 doses (that arrived last month), because we desperately need to protect our frontline health workers who are at enormous risk to themselves personally, and their families, by continuing to provide health and medical care.
Of course, vaccination is voluntary, but I would advise any person over the age of 18 to be keen at the opportunity to have their immunity boosted by this well researched, safe and effective vaccine.
If you decide not to get the vaccine and then you get sick from the Covid-19, you may reflect on your decision, but there is nothing we can do at this point to save you if you are destined for a serious morbidity or mortal version of the Covid-19 disease.

“The Covid-19 vaccines are not necessary in PNG at this time”
An MP passed away from the Covid-19, doctors at PMGH have tested positive and some of them have serious disease and have needed oxygen therapy to assist breathing (as well as many other members of the community), (71) of whom have died.
We are in an exponential upsurge phase of this deadly infection.
The vaccine will provide protection to vulnerable people (frontline health workers, those aged above 55, those with co-morbidities (like high blood pressure, impaired glucose tolerance, obesity, smokers, TB, HIV etc.).
One problem for us in PNG is that many people do not know if they have high blood pressure, glucose intolerance, or have taken note of what their BMI is. I would urge everybody to stop smoking, and if you are aged above 40, get a blood pressure and blood glucose check.
And if there are enough doses of the vaccine, then the younger people may also get the chance to receive the vaccine too, because you have a low risk of serious morbidity or death.

The Covid-19 vaccines are “not effective”
All the Covid-19 vaccines are very effective (in fact the protection given is between 65 and 95 per cent).
The research is clear.
It amazes me that intelligent people with access to the internet just use it to access conspiracy theories and porn, and do not bother to look at the world-wide evidence about things that could mean the difference between life and death!
Health workers are risking their lives to continue to provide health services, and many people are just spending their time on screens accusing us of unethical practice, criminal and corrupt misuse of Government funds and putting forward false, ridiculous, unfounded conspiracy theories for which there is no evidence.

This statement addresses the 10 frequently asked questions/misconceptions. It was translated into Tok Pisin and was approved by Pandemic Controller and Police Comm David Manning for circulation.