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World COVID-19 numbers fall in Papua New Guinea but there are fears many cases have been missed

13:30  04 may  2021
13:30  04 may  2021 Source:   abc.net.au

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For more than a year, nurse Nellie Kamblijambi has been caring for COVID-19 patients in Papua New Guinea's biggest hospital, the Port Moresby General.

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When cases surged in March and April she saw many colleagues get infected and the hospital get inundated with patients.

"It was very busy," she said.

"There were deaths every day, new admissions every day."

Cases in PNG jumped almost ninefold in two months and more than 11,000 have now been recorded, but because of low testing numbers, it is assumed many cases have been missed.

In recent weeks, hospitalisation rates at Port Moresby General have stabilised.

"It's fluctuating, so some days it's going up and some days it's going down, so we cannot say it's decreasing yet," the hospital's CEO Paki Molumi said.

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After getting almost vertical, the graph of the country's weekly COVID-19 case numbers has been falling, however, it comes with a warning that the decrease may be in part because of delays in getting test results from regional areas.

At a screening tent outside the Port Moresby General, one in three people are still testing positive.

When 7.30 visited the COVID-19 isolation ward at the hospital, where the most serious cases are treated, the 18 beds were full.

Ms Kamblijambi moved between the patients, most of whom were on ventilators, checking their condition, but also stopping to provide comfort.

She lovingly stroked the hair of one older woman who looked exhausted.

More COVID-19 patients were being kept in other parts of the hospital.

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"We just have to create space. We can't just turn them away," she said.

In recent days the hospital has moved the COVID-19 patients to a bigger ward.

While Ms Kamblijambi was checking patients, other staff were looking for a body bag — someone had died and there were no body bags.

Equipment and resource shortages are a constant issue for medical workers in PNG, even outside of a pandemic.

The virus has put a spotlight on the already dismal state of PNG's underfunded health system.

At the start of the pandemic it was estimated there were 5,000 hospital beds and 500 doctors for the country's 9 million people.

But health workers have rallied in recent weeks to try to build capacity.

New field hospital helps ease pressure

A few hundred metres up the road, a new field hospital has been opened at the site of an indoor sports and aquatic centre.

The Australian-funded facility is initially being used to treat mild and moderate patients, to ease the burden on the Port Moresby General.

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St John Ambulance PNG is running the facility. The CEO Matt Cannon said they had been slowly scaling up the number of patients they are admitting from Port Moresby General.

Thirty patients were inside when 7.30 visited.

"We have the bed capacity to scale that to up to 270 patients, if it becomes required, but that will require more nursing and medical staff," Mr Cannon said.

Many mild patients in PNG are being allowed to do home isolation.

The centre has also been set up to handle more serious cases, if needed.

"This has given us some resilience if we see a continual increase or even a worsening of the situation here in PNG," he said.

Another temporary COVID hospital that had been operating in Port Moresby has been closed, and its remaining patients moved here.

Mr Cannon checked in with the nurses on duty who tell him one patient, a woman who is five months pregnant, was being transferred to Port Moresby General, as her condition had worsened.

"She coughed up blood twice today, so that's our concern," the nurse explained.

For the moment, local staff are being assisted by an emergency medical team from a German humanitarian organisation, The Johanniter, but the team is coming to the end of their stint and will be heading home within days.

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"We aren't seeing as many hospitalisations as we would expect to see in other countries which have had similar spikes," Mr Cannon said.

"So that's giving us some respite for the moment, but there is still concern and there is still need to prepare.

"We just don't know the trajectory of this virus in PNG."

Further surges likely in PNG

COVID-19 has now been detected in every province of Papua New Guinea and the Prime Minister has said there is "rampant community transmission" in parts of the country, but he says the current caseload is "manageable".

The director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, said the sharp increase in cases was a worry.

"WHO is very concerned about the potential for a much larger epidemic [in Papua New Guinea]," he said.

Twenty health workers from Australia are working in Port Moresby as part of an emergency medical team, known as an AUSMAT team.

Mark Little is leading the team and said things were "a lot better" in the capital than a month ago.

"The numbers have stabilised and have come down — how much they've come down is difficult [to know] because it's difficult to accurately plot data here, but our sense is certainly the situation is a lot more stable than it was when we first arrived," he said.

"Having said that, they're still getting cases every day and this hospital is seeing people dying every day, at least a death a day.

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"So, they're by no means out of the woods and there's still a long way to go."

There is a risk of further surges, especially outside the capital, where there are even fewer health resources.

Several provinces are still experiencing extensive delays in testing people and say it is difficult to know how bad the spread is.

The AUSMAT team is designed to offer surge support and is scheduled to return home within days.

"I think it's highly possible that there will be surges but my personal opinion is that it will be surges in the provinces, there'll be a surge in one province or another province, and the response will really be dependent on what [PNG] asks for and what the Australian government offers, to decide what we do in the future," Dr Little said.

An emergency medical team from the UK is expected to arrive soon and a team from America is currently working in Mount Hagen.

The AUSMAT team has helped set up a triage system outside the Port Moresby General Hospital to better protect staff inside, and to allow them to focus on other issues.

Most services had to be scaled down or halted when the COVID surge hit and getting them functioning again is a focus for CEO Dr Molumi.

"TB [tuberculosis] is still there, malaria is still there, heart disease, kidney disease is still there," he said.

"If we don't provide those services, we are creating another co-morbidity for the virus to attack.

"So, we've got to get back to providing those services."

Focus turns to vaccinations and oxygen supplies

A national rollout of the COVID-19 vaccinations has now begun in PNG, after being officially launched by the Prime Minister today.

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The country has received more than 130,000 doses of AstraZeneca, under the global COVAX facility, that have now been distributed around the country.

The rollout is targeting 3 per cent of the population identified as frontline workers.

But supplying vaccines is just a start. People need to be convinced to take them.

Less than half of an emergency supply of 8,000 provided by Australia have so far been administered in the capital Port Moresby. Some local businesses are now being invited to get their staff vaccinated.

Seventy per cent of doctors from Port Moresby General have had the jab and less than 10 per cent of nurses have opted in.

So far, Nellie Kamblijambi has not taken it.

"After I read, went online, watched from YouTube all this, still I am not convinced to get the vaccine," she said.

"So maybe later. I'll see first how the people who got vaccinated first, how they go and then I'll decide from there."

There has also been a focus on ensuring there is enough oxygen at health facilities across the country.

"Of all the treatments, oxygen is the drug that will save lives and India is the classic example," Dr Little said.

AUSMAT has been assisting with developing an oxygen strategy for the provinces, with a focus on getting it there "in a timely manner".

"There certainly is enough production, AUSMAT believes. It's the distribution systems which we've been working on and really mapping where the oxygen cylinders are, where the concentrators are," Dr Little said.

"There's been a large push to move a large number of oxygen concentrators to the provinces and WHO is looking at bringing in oxygen plants, oxygen-generating plants, to support the country as well."

Collapsed gold mine kills at least 15 in Guinea .
Overhanging rocks crushed some victims and buried others inside the clandestine mine.Overhanging rocks collapsed on Saturday morning, crushing some victims and burying others inside the mine.

usr: 1
This is interesting!