COVID-19: the situation so far and challenges for PNG

Screening for coronavirus at PNG International Airport began in January 2020 (Credit: PNG National Department of Health)
Screening for coronavirus at PNG International Airport began in January 2020 (Credit: PNG National Department of Health)
Written by Michael Kabuni

Papua New Guinea (PNG) became the first country in the Pacific to declare a state of emergency (SOE) in response to COVID-19. Section 226 of PNG’s Constitution lists an “outbreak of pestilence or infectious disease” as grounds for declaring a national emergency. With more than 470,000 confirmed cases and over 20,000 deaths worldwide at the time of publication, the first recorded case in PNG on 13 March 2020 was sufficient reason for the National Executive Council (NEC) to declare an SOE. Among other things, the SOE gives the government the power to control the movement of people, vehicles, and goods; maintain and regulate transport; and regulate or prohibit use of public roads.

The emergency lockdown, which prevents the movement of people between provinces and puts restrictions on international flights, will only last for 14 days, subject to an extension of another 14 days. All schools and universities have shut for two weeks starting on 23 March. Non-essential services are shut, including most government departments, the courts and small businesses. The only exceptions are essential services such as banks, hospitals and shopping malls.

This blog gives a summary of the statistics, the situation in PNG leading up to the SOE and some of the challenges PNG faces.

What do the statistics look like?

According to the National Health Department’s Situation Report issued on 13 March – the latest publicly available data – 25,262 people entering PNG have been screened since January. Almost 3,000 have been identified as ‘persons of interest’, of which 2,230 are being actively monitored and 697 have completed the 14-day follow-up period.

A rapid response team comprised of medical professionals has investigated 16 people. Of those investigated, 14 samples were collected, with 10 testing negative for coronavirus while four samples are pending results. The other two did not meet the case definition for coronavirus and were not tested. Sixteen other individuals who were in direct contact with the first positive case are currently being quarantined.

First confirmed case

The SOE comes after the first confirmed case of COVID-19 was reported in Bulolo District in Lae, Morobe Province. On 13 March, a 45-year-old Australian man employed by Harmony Gold Mine in Bulolo returned from a trip to Spain, one of the hardest hit European countries for coronavirus. He did not show COVID-19 symptoms of coughing, flu or fever at the Jacksons International Airport, where a basic test for temperature and a self-administered travel history and health form was all that was required to enter PNG. But 24 hours after transiting to his workplace in Bulolo, he began to show signs of flu and a slight fever and was immediately isolated.

Swabs were taken and sent to the Medical Research Institute in Goroka for testing. Three announcements followed. First the Health Minister Jelta Wong declared a probable case, and Prime Minister James Marape followed up by declaring the result as negative. Further tests were conducted and the prime minister confirmed the positive result for COVID-19. Police Minister Bryan Kramer then stated on Facebook that the inconsistent results were due to faulty test equipment, and that requests had been made for further testing to be conducted in Melbourne.

Challenges for PNG

While the government responded to the confirmed case by immediately declaring an SOE and 14-day lockdown, the varying test results and inability to detect the virus at Jacksons International Airport has led to widespread criticism on social media. It has also shone a light on the key challenges PNG faces in relation to the pandemic.

First, there is no way of knowing whether there are other positive cases of COVID-19 in PNG. When the World Health Organization (WHO) declared COVID-19 as a global public health emergency on 30 January, PNG relied on screening done at airports in Singapore, Hong Kong and Australia to determine whether passengers could enter PNG. The government is now calling for anyone who has entered PNG since 7 March to come forward for testing. This includes those who travelled with the man who tested positive in Bulolo, who had himself travelled from Singapore to Port Moresby before transiting to Lae. Even the Chief Medical Officer for the emergency committee set up under the SOE, Sam Yockopau, has suggested that COVID-19 may have entered PNG since December 2019 but only presented as the common cold or flu.

Second, is poor health infrastructure. The initial swabs were flown to the Medical Research Institute in Goroka, which has the test equipment. However, there are no isolation facilities for anyone testing positive. Initially an isolation ward was delegated at the Port Moresby General Hospital, but the Nurses Association protested, arguing the lives of more than 1,000 patients would be at risk if coronavirus was brought into the ward. Things may improve when 10,000 AusAID donated COVID-19 test kits, which are awaiting clearance, are released for distribution around the country. The UN is also setting up 30 temporary isolation wards.

Third, managing the PNG–Indonesian border. Indonesia has the highest death rate from coronavirus in the world at 9.3%. The 820 kilometre border with Indonesia has long been a challenge for understaffed and ill-equipped immigration officials and the PNG Defence Force. It will be a massive task to immediately lockdown the movement of traditional border crossers – people living within the vicinity of either side of the border.

Fourth, there is the challenge of funding. PNG has been struggling with high debt and low revenue over the past few years. The government has requested an aggregate K860 million (US$252 million) from the IMF, ADB and World Bank to fight COVID-19. The World Bank component (US$20 million or K68.2 million) will be spent on priorities identified by WHO and PNG’s National Department of Health in its National Emergency Response Plan. These priority areas include: modular isolation facilities for priority provinces; laboratory equipment and supplies to expand testing facilities, including financing for specimen transport; training and technical assistance for infection prevention and control, and rapid response in priority provinces; and risk communications. The funding from the ADB (US$50 million or K170.5 million) and IMF (US$182 million or K620.7 million) will be used to fund priorities identified in the National Emergency Response Plan.

Conclusion

The PNG government has not handled the initial case of coronavirus well, but subsequent quick action has been impressive. The declared SOE was the best decision for PNG given the dire state of the health system and lack of access to health facilities outside of urban centres. Most PNG provinces are isolated due to lack of road networks, so if the air and sea travel restrictions are effectively implemented, it will reduce the spread of the virus if other positive cases are detected. However, if it does spread, it will be very difficult to bring under control. The success of the SOE will also depend on how the funds are managed. After the last SOE declared in 2018 in Southern Highlands following the devastating earthquake there, K450 million (US$132 million) was allocated for disaster relief. Even then, there were complaints of lack of funding affecting disaster response. Diligent management and timely allocation of the funds is important for fighting COVID-19.

This post is part of the #COVID-19 and the Pacific series.

 

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Michael Kabuni

Michael Kabuni is a Teaching Fellow in Political Science at the University of Papua New Guinea.

25 Comments

  • Govt to clarify next steps to carry forward after 14 days.

    The govt and the Health Department have been doing fine to contain the coronavirus since the positive case was declared in PNG.

    Those who believed to be affected were tested and found negative. It is impressive that the Australian man who was the first infected with the Virus was sent back to Australia.

    Some of these people who were believed to be infected by the virus tested negative, then what’s the next step that the government will take?

    As as concerned citizen, I urge the govt to stop all the Seaports and Airports and propose control mechanisms, making sure to stop fly-ins.

  • Our health system in PNG is weak and fragile. Deploy more health professionals, do more awareness on GLOBAL PANDEMIC situation COVID-19 basically on preventive measures since we do not have quarantine and isolation centres in PNG to cater for the infected ones and suspect cases.

  • A very good article. PNG’s other borders, with Australia and Solomon Islands, are also places to be concerned about. Australian government assistance in minimising movement across both would be a valuable assistance.

    • Should there be any extension after this 14 days of lockdown, it must be updated ASAP so the citizens are fully aware of the situation.

  • We should commend the prime minister and his government for putting the people first by declaring SOE as this is the only way for us to prevent the coronavirus… Moreover,for declaring a national fasting and prayer day for God is our only protector who will guide and continue to protect us from coronavirus…

  • After this 14 days of shut down is up, what would be the next move to continue this fight against the spread of COVID-19 in the country? I just hope that the govt would give directions for a 14 day quarantine/isolation for people travelling into the country from overseas. Given PNG’s lack of capacity, technology and funding to fight the spread of COVID-19, we cannot allow room for mistakes to be made at all international ports both on land and at sea.

  • All along, the disaster and emergency officials have been right in advocating on the statement: “The cost of inaction far outweighs the cost of proactive planning.”

  • Some of our people are not taking this situation seriously, we have some people currently in Indonesia and few are kept in Boram hospital for isolation where three people escaped from isolation making it very to hard contain the virus if they are positive. This message goes to all the good citizens, please follow instructions and we keep PNG safe

  • Due to our lack in many areas, the government’s swift response to declare SoE and 14 days lock down was and is the only best way for us to avoid and contain the virus. We don’t have the cure, nor proper isolation areas with adequate bed space, ventilation equipment, and even personal protective equipment (PPEs) for clinicians to use. That’s the main reason why the nurses went on strike recently.

    It’s a sad case at Pom Gen Hospital when they ran out of proper masks, gloves and hand sanitizer. The clinicians can work but they need to protect themselves also. The right mask to use is the N95 mask, which I last heard from a nurse was going for K100 on backmarket. Our clinicians unfortunately are using the surgical masks which are not quite effective against the virus.

    To make a hand sanitizer (WHO recommend), we’ll need ethanol (or isopropyl alcohol), hydrogen peroxide and glycerol. Last week Monday I found a 125ml of glycerol which I made 5L of hand sanitizer and gave to the Pom Gen triage team, who are at the forefront of receiving patients. We’ve also given few of our snakebite equipment to the covid-19 team to use till they purchase their equipment. They are yet to buy equipment for covid-19 isolation camps. But it all depends on when the gov’t secures funds. Above all, let’s all do the best we can to help avoid viral infection. Washing hands and staying at home is paramount.

    It’s also an eye-opener for the gov’t to start investing in building local capacity in research, science and technology (RST), and not only on the extractive industry. The inconsistent results due to faulty equipment at IMR is a typical recipe for disaster. We need up-to-date state of the art equipment to get best results first hand and not after a series of inconsistent results. In such cases of national and global interest, there should be no room for error.

    The last I read was that the virus has mutated and now have strain S and strain L. (My opinion: If a local PNGan gets infected, and if it mutates to suit our genome, that’s another story.) I’m entitled to my opinion and its not to put fear into anyone or any institution.

    Finally, it’s possible to locally develop the test kit if we have the right equipment and capacity. Currently, they are trying to analyze samples using the real-time PCR machine at the IMR lab at UPNG Medical School. That’s good news and I’m hoping this works. I salute the medical doctors and nurses who are out their working including lab techs of IMR and hospitals. For now, let’s stand with our PM and pray and hope that no local would be infected with this virus. It’s a death spirit working through fear, and we must conquer it first through prayer.

    God Protect Papua New Guinea.

    • Thanks Ben for the insights. Charles Campbell Toxinology could be asked to help. You guys did some of the most advanced studies on developing Snake antivenoms, and your guys expertise will help. Especially in tests and experience over the years. We need all the help we can get from our local scientists.

  • I salute our prime minister for taking a bold step in declaring SOE in PNG immediately. It is still unclear yet the status of COVID-19 in our country, therefore we hope the Government in its upcoming sitting would extend the SOE. And this time really making sure that citizens are all locked down taking seriously this epidemic….
    May God help us.

  • Compare Last years death rate from month ending March to This years March ending, and see if the death rate have increased count this year. This will confirm if we might actually have active cases in PNG. A call for a review on post mortems on relevant bodies deceased by a contributing symptom to the COVID-19 virus – if this can be done then the families of the identified deceased would be known as persons of interests.

  • Hi guys thanks for the comments, and update on the stats:

    15 of the 16 people who had direct contact with the xo formed case have tested negative.

    29,000 people entered PNG from overseas from January till the lockdown on 24 March.

    More than 2000 persons monitored in Port Moresby, and almost all 22 provinces have persons of interest being monitored.

    Some high risk areas include the PNG-Indonesian border, but also tourism hotspots like Tufi and Kokoda in Oro Province, Kimbe and Milne Bay. Oro has 11 persons of interest being monitored. Details have not been released, but those vulnerable would be villagers and rest house owners along the 96km Kokoda trail, and Tufi Dive Resort employees – these two combined have the highest tourist visits per year in PNG.

    On a different note, US & Indonesia underreported the cases until tests increased, revealing high numbers. We hope that is not the case with PNG.

  • Looking at the statistics, us getting our first case through the Indonesian Border is high and I think if a significant portion of our security forces, immigration and health team are posted there, it should at least give us some bit of confidence. Thanks to the local MPs and Governors there who joined hands to fight the virus.
    Our founding fathers were so wise to have one International Portal of Entry in Jacksons Airport which we are at least good in screening our inbound travelers unlike America and other developed countries who are struggling to monitor and screen people coming inform all ports of entry.

    Our first imported case should have been easily detected because the guy was coming from Spain a densely infected country at the time of his travel. We could have quarantined all on board right there and then upon arrival. …

    My fear is if we have local transmission even what we borrow from IMF or WB might not support us progressively to fight this virus with our own pressing needs to be attended to and a mildly deficit budget, man may the GOD of Heaven help us.

    Thanks for the day of prayer and fasting.

  • If the government can spend millions of kina on THIS COVID-19 pandemic swiftly, then they can spend even more on killer diseases like TB, Aids, MALARIA, etc. Wow so frightening…..

  • I wonder how PNG could manage to gather all of these 25,262 people entered the country since January 7 for testing. What if 100 plus of them are with positive result, then we may think that thousands of people in PNG may have been infected already. It will be very hard to control off. This is an incurable disease and spread widely very quickly so please the government must do something to prevent further spreading. I am so glad with the government for quickly taking up appropriate approach in declaring a state of emergency (SOE) and lockdown of PNG for 14 days.

  • A very large percentage of the virus illness is spread by people who do not yet display symptoms or have it unknowingly and have very minor effects. Our only hope here is “social distancing ” where everyone adopts the attitude that they may already have the virus in their body and everyone around them may be infected, and all surfaces outside the home may have the live virus on it…so you have to wash your hands or use a hand sanitizer many times a day.
    Trouble is that people do not do this until a lot of people are sick. Then it is too late for many who will die.
    Traffic between the islands is still going on, in crowded boats. We are in trouble, like most of the world, but most in the islands here do not think the virus will affect us.
    THE GOVERNMENT IS NOT BEING SUCCESSFUL at providing awareness or restrictions.

  • Our government can be commended for approving SoE after 1 person confirmed hoping that all provinces are making it their business to make sure the 14 day lockdown preventive measures are adhered to. It’s now every one’s responsibility to avoid being infected and to stop its spread.
    However, it’s super important to pray for God’s intervention in this contagious global Pandemic.

  • I’d be surprised if the PNG govt did anything well. They suck up so much international money like a vacuum cleaner and still fail to improve their citizens lives. They’re a waste of space!

      • Reading through the situation report is very stressful and given the current scenario our borders and international flights should be completely locked down for the next 90 days and that’s how serious it gets when one takes into account the government and the country’s ability to fight COVID-19.
        The challenge is unthinkable.

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