In the Pacific, urgent action is the key to addressing COVID-19
Pacific nations, led by the smallest and least well-off, moved decisively to restrict travel from a fast-growing list of COVID-19 affected countries.
The remote Pacific nations have been ahead of the world in working to stop COVID-19 in its tracks. As the outbreak started to make international headlines, Pacific nations began closing their doors. In retrospect, as Europe becomes the new epicenter of COVID-19 infections, this looks like a very smart move. So far, the Pacific appears to have been spared the worst of the outbreak.
It was the Pacific nations who are the smallest and least well-off which quickly took this step to restrict travel from a fast-growing list of affected countries. The Federated States of Micronesia, Marshall Islands, and Tonga have all declared states of emergency. Health Declaration forms on arrival are now de rigeur. Many countries (for example, Kiribati, Samoa, Solomon Islands, and Vanuatu) are requiring a 14-day quarantine in a third country for travelers from affected countries. Some went further and placed a ban on entrants from a growing list of affected countries, even extending this to restrict entrants from all countries. Samoa, in addition to quarantine periods in third countries, also requires medical checks prior to and after arrival, including for citizens. In mid-March, Fiji followed the lead of Samoa in banning cruise ship entry—a $50 million business for Fiji shut down overnight.
Most Pacific nations also set out instructions that government officials were to stop or restrict travel within the region and outside the region. In a region that thrives on holding and attending international and regional meetings, workshops, and conferences, this was a significant move which acted to limit opportunities to carry infection into island communities. There are also many Pacific islanders outside the region increasing transmission risks as they return. Security personnel, sportspeople, health workers, teachers, and unskilled laborers are working overseas where incomes are far above those available at home. Many Pacific islanders study in overseas universities on scholarships from development partners. The Pacific is closely monitoring the return of its citizens and actively discouraging the public from travelling.
Why the urgency in these small nations to prevent COVID-19 taking hold? There are several factors.
Firstly, a significant proportion of the population would be vulnerable, the level of non-communicable diseases in Pacific populations is among the highest in the world, and experience has shown people with existing health issues are most susceptible to COVID-19.
Secondly, the health systems in the Pacific, despite decades of investment and capacity building, remain weak. The capacity to undertake infectious disease surveillance, diagnostics (the closest reference laboratories are in Australia, New Zealand, or the United States), and treatment—including having the necessary equipment and medical personnel for infection prevention and control, triage, and optimized clinical management and supportive care—just does not exist in many Pacific countries.
Thirdly, the Pacific experienced a devastating measles epidemic in late 2019—with Samoa at the forefront of the disease, experiencing 83 measles-related deaths and more than 5,600 cases, many of them young children. With this fresh in people’s minds, the threat of COVID-19 taking hold was taken very seriously by all.
And fourth, the economic devastation that COVID-19 could cause was well understood in a region dependent on its people as its largest and most valuable natural resource.
This proactive stance by the Pacific islands has come at a significant financial and economic cost. There are the direct costs of implementing a system of health reporting and tracking for visitors and returning citizens; locating health workers at air and sea ports; and purchasing disposable masks, gloves, and hand sanitizer. Overshadowing this is the indirect costs borne by businesses, workers, and their families. Hotels and restaurants are empty, less staff are needed; big events and the money they bring have evaporated; fewer visitors means less demand for local produce, goods, and services; travel restrictions are impacting air and sea schedules making imports and exports more difficult; and with fewer workers going abroad, remittances can be expected to decline. To go full circle, the result for governments is less tax revenue to spend on health services.
Various scenarios see COVID-19 as a three- or six-month disruption, but for the people, businesses, and governments of the Pacific Islands, it is a life-and-death battle that absolutely justifies the expense and opportunity costs of preventive actions.