This island nation had zero COVID cases for months. Now he is overwhelmed.

Emergency rooms are overcrowded, healthcare workers are getting sick, and misinformation about the coronavirus is spreading. It has all left Papua New Guinea, an island nation north of Australia, mired in deadly crisis as tripling infections over the past month have inundated an already fragile healthcare system.

The wave of cases, which authorities have described as a “great epidemic”, probably started in February. About 70% of symptomatic patients test positive, one of the highest rates in the world. Of the country’s 39 deaths from the virus, 30 have occurred in the past six weeks and are expected to increase. Confirmed infections have exceeded 4,100, having remained at zero until June, although the actual number of cases is believed to be much higher.

The cost to healthcare workers has been severe. About 10% of workers tested positive at the country’s main hospital, in Port Moresby, a city of 380,000 that has been hit the hardest. In field hospitals, workers, sweating under protective gear, rush between beds to tend to the dying.

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“We fear that we are going to fill all these beds and then we will have nowhere else to continue to care for COVID patients,” said Mangu Kendino, emergency room physician and chair of the COVID-19 committee at Port Moresby General Hospital. “We are tired, weary, weary.”

One year after the pandemic, countries around the world are entering a new phase as they vaccinate increasing portions of their populations and reopen schools, restaurants and offices. But the crisis in Papua New Guinea is another reminder that the global emergency is far from over – that the virus will continue to wreak havoc and sow death until everyone is vaccinated, a prospect that can take years.

The situation in the island nation is exactly what public health experts have warned of as rich countries buy into the world’s vaccine stocks and leave the pandemic behind, while smaller, poorer nations are left with the limit. in the hand. Having largely avoided serious outbreaks for many months, Papua New Guinea is now experiencing heartbreaking scenes not unlike Italy at the start of the pandemic. This month, a patient, suffering from an asthma attack, died in a hospital parking lot.

“They have a hard time accessing medical care at the best of times,” said Rob Mitchell, an emergency physician specializing in triage in the Pacific. “I’m afraid the current case numbers are just the tip of the iceberg.”

It is not clear why Papua New Guinea just suffered a severe outbreak. It has an especially young population, and some experts speculate that the virus may have been circulating more widely all along, but that many cases were asymptomatic or mild and went unnoticed. Others say it could be the result of public apathy over rules like wearing masks and practicing social distancing.

“When the WHO first announced the pandemic and we locked ourselves down, the government reacted quite quickly,” said Dr. William Pomat, director of the PNG Medical Research Institute. But late last year, he added, “a lot of us became very complacent. A lot of the things we were supposed to do, we no longer did. “

As infections rise, doctors are working overtime, trying to keep up with a demand that they hope will only increase in the coming weeks. In Port Moresby, the capital, stadiums have been converted into temporary field hospitals and existing hospitals have been expanded to full capacity.

“The COVID center in Port Moresby is full; our field hospital is almost full, ”said Gary Nou, an emergency physician who helped lead the government’s response to the pandemic.

At one of the field hospitals, Nou said, he and others, dressed in full protective gear, often work in humid conditions as they struggle to keep their patients cool and hydrated. “As soon as you get up off the floor, you’re drenched in sweat,” he said. “When we are maxed out, our sanitation facilities are stretched to the limit and waste disposal is stretched to the limit. Every day is a challenge. “

At the nearby main hospital, some wards have been converted to accommodate COVID-19 patients, but doctors say they remain concerned that there are not enough beds. Doctors and nurses have to extend shifts as their colleagues become infected. So far, more than 120 staff members have tested positive for the coronavirus, a hospital spokeswoman said, adding that the numbers are increasing daily.

In response, Australia has donated 8,000 doses of the AstraZeneca vaccine, as well as protective equipment and ventilators. It has also deployed a small team in the country.

Fearing the spread of the virus, Australian authorities have stepped up their efforts to vaccinate the population of the Torres Strait Islands, an archipelago that borders northern Australia and Papua New Guinea. Most of the islands are part of the Australian state of Queensland.

“They are our family. They are our friends. They are our neighbors. They are our partners, ”said Scott Morrison, Prime Minister of Australia, last week. “This is in the best interests of Australia and our region.”

Covax, a global health initiative designed to make access to vaccines more equitable, began distributing vaccine doses in developing countries last month and has said it will deliver 588,000 to Papua New Guinea in June.

But in some cases, richer nations have failed to honor contracts, reducing the number of doses the initiative can buy, said Dr. Tedros Adhanom Ghebreyesus, director of the World Health Organization, in a statement last month. He warned that the pandemic would not end until everyone was vaccinated.

“This is not a charity issue,” he said. “It is a question of epidemiology.”

Until then, Papua New Guinea officials will have to combat not only the virus itself, but also a tidal wave of misinformation about the virus and vaccines, transmitted largely through social media channels.

“Even for the educated healthcare worker, it is causing a lot of doubt,” said Nou, the Port Moresby-based doctor, who conducted a survey on the views of healthcare workers on the pandemic. He said some in the country believed the virus was a hoax, or that people on the island were immune, or that it might be safer to get the virus than to get vaccinated.

With the country fighting an all-out battle against the coronavirus, some public health experts worry that redirecting resources could come at a lethal cost for those with other serious health conditions, such as malaria or tuberculosis. Papua New Guinea has one of the highest tuberculosis rates in the world.

“It is not enough to respond to COVID and then someone dies from another cause,” said Dr Suman Majumdar, an infectious disease specialist at the Burnet Institute, an Australian medical research center. “We have feared the worst,” he added, “and this is happening.”

This article originally appeared in The New York Times.

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