World’s most vulnerable countries could become the next coronavirus hotspots

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SYDNEY (ABC/Pacnews) — As coronavirus spreads around the globe, health experts and aid groups fear some of the world’s most vulnerable countries could become new hotspots for Covid-19.

Most are concerned about over-crowded refugee camps and countries that are already facing a crisis — whether that be conflict, malnutrition, another epidemic or over-burdened healthcare systems.

Analysis from aid organization CARE listed 15 “very high risk countries,” most of them in the Middle East and Africa — Syria, Iraq, Yemen, Afghanistan, Somalia, Sudan, South Sudan, the Democratic Republic of Congo, Ethiopia, Nigeria, Uganda, the Central African Republic, Chad, Niger and Haiti.

It found they had three times higher exposure to epidemics and six times higher risk in terms of accessing healthcare.

“This data shows a stark and chilling picture of what we can expect as we start to see the Covid-19 pandemic spread to many Africa and Middle Eastern countries,” said Sally Austin, CARE International’s Head of Emergency Operations.

An outbreak of coronavirus in parts of the Pacific and Asia could also prove devastating, humanitarian workers warn.

What regions might be at risk, and what are the conditions that could hasten the spread of disease or deepen its impact?

Across the Pacific, countries have been locking down or declaring national emergencies in response to Covid-19 — some even before recording a case of coronavirus.

The health systems in several Pacific countries are already under strain and struggling without a pandemic.

In the face of their vulnerabilities, most countries in the region are implementing strong, pre-emptive measures to try to ensure the virus is stopped before it can get a foothold.

More than 100 cases have now been confirmed in six countries: Guam, French Polynesia, Fiji, New Caledonia, Northern Marianas and Papua New Guinea.

Some countries have also battled other recent outbreaks; the measles epidemic in Samoa killed more than 80 people, mostly children, in recent months; while two years ago PNG saw a resurgence of polio, almost two decades after it had been eradicated.

In Papua New Guinea, the police minister has said the country’s health system is not capable of dealing with an epidemic and measures are being put in place to stop people “clogging” up hospitals.

After one case was confirmed in PNG, a 14-day state of emergency was declared that closed the international borders and significantly restricted domestic travel.

The patient was a FIFO mine worker who has since been returned to Australia and so far, no other cases have been recorded, but the lockdown remains in place.

Prime Minister James Marape apologized for the inconvenience but said it was necessary.

Around $22 million (U.S.$13.5 million) of Australia’s aid to PNG will be redistributed to be used to help prepare for Covid-19.

Fiji has five cases and in response has locked down Lautoka — the country’s second-largest city.

The Solomon Islands, Vanuatu, Kiribati and Tonga have all introduced measures to declare national emergencies, lock down borders or restrict activities, despite having not yet recorded any cases of Covid-19.

Katherine Gilbert, from the University of Melbourne’s Nossal Institute for Global Health, said there had been strong leadership in the Pacific health sectors, but that many were spread thinly in remote locations and she was concerned about access to personal protective equipment.

“People in Solomon Islands and PNG still rely on traditional medicine or custom medicine as their first port of call to seek care, so you have the possibility of those that do have symptoms delaying presenting to the formal health system,” she said.

She worried about the impact of isolation on gender-based violence in the Pacific — a consequence of lockdowns that had reverberated in other countries, including Australia.

“It’s definitely something we should be talking about — and there are some great local service providers in the Pacific, but like the health systems, they will be stretched during this time,” she said.

Australia’s Prime Minister Scott Morrison has warned world leaders at an emergency G20 meeting that Pacific Island nations will need help to respond to Covid-19 and must be a focus of international support.

He said Australia has provided some supplies and expertise and is reconfiguring its aid in the region to ensure critical health services can continue to function.

The tiny U.S. territory of Guam has recorded almost half of all Covid-19 infections in the Pacific Islands region, and the White House has declared it a major disaster site.

Guam is an island with a land mass of only 549 square kilometers and a population of just 164,000 people.

The rate coronavirus is spreading in Guam is alarming local officials, who have warned the health system could reach “break point” as early as this week.

“For those of you who’ve played Tetris, and you’re getting to the point where you’re about to lose and you’re scrambling to make room for the bricks as they keep coming through — we’ve been at that point even before Covid-19,” Chief Medical Officer Dr Felix Cabrera said.

“Now, the bricks are coming much quicker.”

Guam recorded its first Covid-19 case in mid-March and it has grown steadily since, with 58 cases recorded and one death as of Monday.

Guam only has 250 staffed hospital beds, which includes 13 staffed intensive care beds.

“At our current spread rate, Guam’s critical care break point could occur by this week,” Dr Cabrera said.

If that happens, Dr Cabrera said the number of deaths could “skyrocket,” but he said there is still time to try to turn things around.

“By aggressively slowing the spread rate, we might prevent a break.”

Guam’s Gov. Lou Leon Guerrero said there is still a “small window of opportunity” for Guam to “counter the worse impacts” and said from today all arrivals will be quarantined for 14 days in a government facility.

It’s not just local transmissions Guam has to contend with, a United States Navy aircraft carrier has been diverted to the island after reporting an outbreak of coronavirus while at sea.

At least 36 sailors have coronavirus and all 5,000 people on board are being tested.

The disaster declaration will make more funding available and Guam’s governor has previously requested testing kits and a deployment of the National Guard.

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