Escalating COVID crisis overwhelms Papua New Guinea hospitals

Amid an escalating COVID-19 crisis in Papua New Guinea (PNG), the south-west Pacific’s largest and most populous island nation, the fragile health system and its hospitals are being overwhelmed by the number of cases.

Radio New Zealand reported on October 11 that since PNG’s first reported case of the Delta variant, the virus had been largely left to “fester and spread.” The capital Port Moresby is undergoing a third wave of the pandemic, while a health disaster is unfolding around the country, including in the heavily-populated Highlands region.

Meanwhile, less than 1 percent of the population of nearly 9 million is fully vaccinated, the lowest vaccine coverage in the Western Pacific.

The government largely kept the coronavirus at bay for all of last year, through tight border closures. The Delta strain was first detected on July 10, after the captain of a Philippines ship tested positive, and underwent isolation at the Port Moresby General Hospital. Health professionals warned that the combination of very-low testing rates, a high percentage of positive tests and an extremely slow vaccine rollout provided a “recipe for a major spread.”

Daoni Esorom, the deputy controller of PNG’s national pandemic response, said officials were so concerned that low testing rates were potentially masking a serious outbreak, that they ordered doctors at the hospital to swab all corpses of those people who had died from unknown causes, or who had respiratory illnesses, to ascertain if they had COVID-19.

However, in August, Chief of Medical Emergency Services Sam Yockapua, claimed the rate of transmission and hospital admissions had gone down sufficiently to be “focusing too much” on COVID-19. Reflecting the strategy of the government of Prime Minister James Marape to prioritise business interests above public health, Yockapua said PNG had not been able to enforce lockdowns as in New Zealand or Australia and had to “live with” the disease.

Health authorities scaled back the limited testing regime, on the pretext that it would allow them to “shift focus” to vaccinating vulnerable sections of the population. Consequently, the official statistics drastically understate the reality of what is happening.

What health data is available shows a sharp spike in cases from April through June, and another this month, with 3,935 active cases since September 28. On 14 October, 412 new cases were reported, with a seven-day average of 306 cases. The country has officially recorded a total of 24,041 cases and 266 deaths.

The health system has long suffered from shortages of drugs, lack of funding, crumbling infrastructure and a severe lack of health workers. Shortly after a sit-in during March 2020, by 600 Port Moresby nurses protesting inadequate personal protective equipment, over 4,000 nurses were ready to strike nationwide over the lack of preparation for a coronavirus outbreak. However, the PNG Nurses Association called off the stoppage at the last minute.

With the hospital system now swamped, clinicians warn that the situation is much worse than officials admit, with provinces seeing far more cases than the National Control Centre records. Port Moresby General Hospital is reporting positive COVID testing rates of 60 percent and is scaling down its services due to the surge in patients.

The hospital currently has 50 COVID in-patients with numbers expected to explode over coming weeks. The Guardian reports that surgeries are on hold indefinitely, consultation clinics are closed until further notice, and pathology services, the TB clinic, emergency and radiology departments and all other essential services will be affected.

In Lae, the second largest city, the Angau general hospital is admitting an average of five new cases a day and experienced 19 deaths in September alone. It is the city’s only public hospital, serving a population of 76,255, but has just 320 beds, and a further 150 temporary beds. Authorities have been forced to turn the town’s stadium into a makeshift hospital and morgue.

In the Eastern Highlands, deaths from the virus are being recorded at the hospital in Goroka every day, forcing a two-week lockdown in a bid to stem the surge. Dr. Kapiro Kendaura, the director of curative health services, described the situation as critical. “Our Covid centre is always at capacity,” he told the Guardian. “Our emergency department is always full with Covid patients. We are in dire need of oxygen, amongst other things,” he said.

In the Western Highlands province, the country’s most densely populated region, the Mount Hagen general hospital is on the brink of closure, due to an influx of COVID-19 cases and an acute shortage of government funding. It is the only hospital serving a population of 46,256.

Mount Hagen’s clinical head John Junior McKup told Radio NZ that they recently had over 90 positive patients arrive in a day. “Regularly the numbers have been like 50 or 60 positives in a day. But we’re sending home all the mild and moderate cases to self-isolate at home. We’re only keeping all the severe cases in the hospital,” the doctor revealed.

In one three-week period, over 800 positive cases and 22 deaths from COVID-19 were recorded in the region. According to the provincial health authority, the hospital will be forced to shut down before Christmas if government funding is further delayed.

The PNG government this month formally lodged a “request for assistance” with the Emergency Medical Teams Secretariat in the World Health Organisation. The request stated that from September 20–26, there were 600 newly confirmed cases, including 17 deaths. It admitted that new cases and deaths are significantly underreported “due to the very limited testing across the country and inconsistent reporting from several provinces.”

The government blames “misinformation” and widespread reluctance to be vaccinated for the catastrophic situation. In reality, the fault lies with the crisis-ridden Marape government, which has responded to the pandemic with a mixture of incompetence and blatant self-interest.

According to the PNG Post-Courier, in the midst of the dire healthcare situation, Marape and other government MPs recently travelled to Morobe Province to a health care event, where they were greeted by hundreds of mask-less people. The event “reeked of bad taste,” the Post-Courier observed.

Marape’s visit received widespread criticism on social media, with one person saying: “This is infuriating to see. No wonder people don’t follow niupelapasin [PNG’s official plan] if the people making the mandates about it keep hosting events like this!”

While Pandemic Controller David Manning has banned gatherings of more than 20 people, politicians with an eye towards next year’s elections are traveling around the country, attracting large crowds, indifferent to COVID protection and the risk of spreading the virus.

The abject failure of the government’s vaccine roll-out was further underscored last month when it was forced to transfer to Vietnam 30,000 doses donated by New Zealand, to avoid them being thrown out as they reached their expiry date.

PNG, one of the most impoverished countries in the world, remains largely dependent on the COVAX program. Only 2.5 percent of people in low-income countries have received at least one dose of a COVID vaccine. Vaccines have not been distributed on the basis of need, let alone a global public health strategy, but are being provided to advance the economic and strategic interests of competing powers.