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Covid-19 endangers Pacific island nations' fragile health systems

Updated: Feb 3, 2022

ADB, UNICEF and WHO delivered medical supplies to Tonga for Covid-19 response in this Oct. 23, 2020 file photo. Courtesy of of WFP.

By Mar-Vic Cagurangan

Once the envy of the world for their coronavirus-free status, Pacific island nations suddenly found their defenses breached by the more transmissible omicron variant.

The exploding outbreaks have stamped out their much-ballyhooed success with keeping Covid-19 off their borders for nearly two years. Their fragile health care systems are in jeopardy as the island communities struggle with the spiraling surge of positive cases.

The wave of omicron-triggered infections that began in January caught Palau, Kiribati, Samoa and Solomon Islands by surprise.

“The pandemic continues to exacerbate the world’s resources and we are beginning to feel both direct and indirect impact of Covid-19 and it has shown that we are not immune to Covid-19’s adverse effects on our health,” Palau President Surangel Whipps Jr said in a statement on Jan. 26. “Palau is a small community and each loss of life is deeply felt by our families, community and nation.”

In order to contain further spread of the virus, Palau shut down its schools for two weeks and switched to distance learning. As of the last week of January, Palau had more than 1,300 cases that quickly accumulated within a short period of time. The number was anticipated to continue soaring.

As of last month, Nauru, Pitcairn Island, Niue and Tokelau were the only islands in the region that have not reported any confirmed cases of coronavirus. However, they remain on the Centers for Disease and Prevention Control’s “don’t travel” list.

Pacific island countries confronted the onset of the virus early in 2020 by closing their borders early, allowing them to keep the virus at bay when the rest of the world was grappling to contain it.

Last month, Kiribati began to reopen, welcoming a chartered flight that brought home 54 citizens, who had been stranded abroad throughout the pandemic while on missionary work. Covid tests from this flight identified 36 positive cases that slipped into the community and quickly shot up to more than 100 in three days.

“There is now an assumption that Covid-19 is now spreading in the community on South Tarawa and Betio,” the Kiribati government said in a statement announcing a curfew.

In Samoa, residents are beginning to get acquainted with measures and social restrictions that have become part of normal living in most countries in the world. Prime Minister Fiamē Naomi Mataʻafa imposed a 30-person cap on public gatherings. Only cargo flights are allowed in and out of Samoa.

The virus transmissions in the community have driven residents to stand in line, either for their first or second dose of the vaccine. The government, however, reported many were turned away later when the AstraZeneca vaccine supplies ran out.

Solomon Islands, which had 650 cases as of the last week of January, reported its first two Covid-related deaths, involving a 51-year-old woman and a 59-year-old man who both had pre-existing conditions, including diabetes and high-blood pressure.

The U.S. government, through the U.S. Agency for International Development (USAID), has provided more than $27.7 million to help Pacific Islands respond to the Covid-19 pandemic.

USAID support, which spans across the Federated States of Micronesia, Fiji, Kiribati, Nauru, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Tonga, Tuvalu, and Vanuatu improves the health, social, economic, and environmental conditions of the Pacific’s diverse communities.

Total U.S. government support to the Pacific Islands for Covid-19 response stands over $118 million, including over $90 million funding support to the U.S. freely associated states from the Department of the Interior, Department of Health and Human Services, U.S. Centers for Disease Control and Prevention, Department of Education, and Department of Labor.

The Pacific islands region has some of the world’s highest rates of NCDs, including cardiovascular disease, type 2 diabetes, cancers and chronic respiratory diseases, which are the leading cause of death accounting for 75 percent of mortalities. Covid-19 clinical management is further complicated in cases with underlying NCDs.

According to the World Health Organization, 14 countries and territories in the Pacific island region have reported Covid cases and deaths. Listed under this bloc are American Samoa, Northern Marianas, Fiji, French Polynesia, Guam, Kiribati, New Caledonia, Palau, Papua New Guinea, Marshall Islands, Samoa, Solomon Islands, Vanuatu and Wallis and Futuna.

Guam, which has been a hot spot in the Pacific islands region, continued to yield high numbers from daily Covid tests. The soaring demand for tests has prompted the government to ration test supplies.

While managing to contain the community spread of the virus for several months, the Northern Marianas has been struggling to repeat its previous success since new cases emerged in October 2021.

“As the front line of the Covid-19 response in the Pacific, we appreciate your participation,” said Sean Callahan, USAID deputy mission director for the Pacific Islands and Mongolia. “With the emergence of variants, including the recent arrival of omicron in the Pacific Islands, it is critical that we continue to learn and adapt to the evolving environment and emerging needs.”

A record surge of Covid-19 is threatening to overwhelm hospitals and fragile health systems in Pacific countries as the virus is running rampant in several countries for the first time, according to the International Federation of Red Cross Red Crescent Societies.

“For nearly two years most Pacific countries have done an incredible job holding Covid-19 at bay. These new outbreaks in small Pacific countries threaten health systems that are fragile and struggling to cope with the needs of Pacific islanders. Every effort must be made to prevent and contain the virus," said Katie Greenwood, Pacific head of delegation for IFRC.

Greenwood said vaccination rates are remarkable in some Pacific countries, but still far low in others.

"It's critical that vaccines doses reach the last mile to everyone across the Pacific, with trusted information about how vaccinations provide protection from severe illness and death," Greenwood said.


Greenwood said the challenge is to build vaccine confidence in Pacific island communities to make sure a critical mass of people are inoculated.

"Although we know physical distancing and isolation within households can be very difficult in many places, with the huge surge of the Omicron variant around the world, these measures, along with wearing masks, are critical for slowing infection rates," she added.

Among the countries in the Pacific region with high vaccination rates include Palau (96 percent) and Fiji (68 percent."

Greenwood noted that the Solomon Islands has only 10 percent; Vanuatu, 22 percent. In Kiribati, only one in three people is fully vaccinated.

"Healthcare systems in many Pacific countries suffer from lack of resources and have limited equipment and infrastructure. This is compounded by challenging logistics and communities spread across remote islands, making the provision of healthcare difficult," Greenwood said.

She noted that Pacific islands countries are already confronted by severe natural disasters such as typhoons and tsunamis. “We must not swap one disaster for another," Greenwood said. "It is vital that every measure is taken to prevent the spread of COVID-19 in the Pacific."

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