As the world quickly approaches the highest weekly rate of infection recorded since the start of the pandemic over a year ago, several countries that have largely held COVID-19 at bay so far are seeing surges in infections. 

Papua New Guinea (PNG), a small Pacific island state that successfully shielded itself from the SARS-CoV2 virus until recently, has reported a total of 9,343 cases and 82 deaths, half of which were reported in the last month. This sharp rise in cases holds the potential for a large epidemic, according to WHO officials. 

PNG and the broader Western Pacific region was the focus of the WHO biweekly press conference on Friday.

The global number of new cases per week has nearly doubled over the past two months and continues to increase, along with the number of deaths, at “worrying” rates, said Dr Tedros Adhanom Ghebreyesus, WHO Director General.

The Western Pacific region has been “relatively fortunate” in the pandemic, Dr Takeshi Kasai, WHO Regional Director for the Western Pacific Region, told the press conference. Home to one quarter of the world’s population, the region has only recorded 1.6% of the global cases and 1.2% of the deaths. 

However, several countries in the region, including PNG, are now witnessing surges in cases.

“In remote Pacific countries, even a few cases could have a devastating impact,” said Kasai. “The pandemic means that every corner of every country in every part of the world must be prepared and protected against COVID-19.

“We must continue to pay special attention to small countries who have so far been able to stop the virus [from] coming in,” he added.

The WHO has deployed 13 experts to assist with case management, epidemiology, infection prevention and control, lab support, and information management. Emergency medical teams from Australia, Germany, and the US have also arrived to aid in PNG’s response. 

In addition, several countries have donated much needed PPE, oxygen concentrators, and biomedical equipment, which are critical to strengthen the local capacity across the country.

PNG Began Vaccine Rollout, But Best Defense is Public Health Measures

Australia provided PNG with an emergency supply of 8,000 doses of the AstraZeneca vaccine in late March, enabling the country to vaccinate healthcare and frontline workers. However, out of a population of 8.7 million, only 1,600 people have received at least one dose of the vaccine. 

But the first batch of 132,000 AstraZeneca vaccines was received earlier this week from the COVAX facility. The government expects to administer these jabs nationwide by May, said Jelta Wong, PNG’s Minister of Health. 

“With rising infections, understandable fatigue with social restrictions, low levels of immunity among the population and the fragile health system, it is vital that [PNG] receives more vaccines as soon as possible,” said Tedros. 

In the broader Western Pacific region, several countries are yet to receive any vaccines or have only received very few doses. In this context, “it is important to emphasize that vaccines alone will not end the Papua New Guinea outbreak or the pandemic,” said Kasai.

The supplies that the PNG expects to receive in the coming months will only be enough to protect the most high-risk and vulnerable groups in the country. 

Instead, the country’s best defense is the strong enforcement of, and compliance with, proven public health measures, Kasai stressed. 

Improving Information Sharing Will be Central Topic at World Health Assembly 

Meanwhile, at the upcoming 74th World Health Assembly in May, it is expected that the ongoing evaluations of the WHO’s response to the COVID-19 pandemic will be the subject of numerous discussions, specifically on information sharing. 

Several reports on the COVID-19 response, WHO’s work in health emergencies, and strengthening WHO’s global emergency preparedness and response will be reviewed, according to the provisional agenda. 

In addition, several reports on WHO reform will be discussed. 

“I think we do have to look at how information moves in the system,” said Dr Mike Ryan, Executive Director of the WHO Health Emergencies Programme. “We have so much data, our problem is [establishing the platforms]…so that each user in the system, from the frontline primary health care worker, all the way through to global epidemiologists and modelers, have access to data in real time, at the right time, before, during, and after epidemics.”

“We have not invested enough in accessing, managing, and using data to prevent, to respond to, and to recover from pandemics. This is a major focus for WHO going forward,” Ryan added. 

According to WHO officials, member states are “pushing very hard” for increased investments in the gathering and sharing of local, national, and global surveillance data and the sharing of biological tools and technology to strengthen global preparedness in the face of threats. 

“We will continue to make the system really robust because information is the basis and that’s how we can beat the current [pandemic] and also prepare for the future,” said Tedros. “It’s a learning organization and we will continue to learn and improve our system.”

Vaccine Passports Raise Several Issues if Made Mandatory

Meanwhile, WHO officials advise all individuals and governments to keep a record of vaccinations, but say that there are scientific, ethical, and equity implications of requiring a COVID-19 vaccine for activities and travel. 

“Having a record…of your vaccination status is good for you, that’s good for your health. And it’s good for the authorities to know who’s been vaccinated in any given country,” said Ryan. “That’s very different to what that document is then used for.”

Research is still underway on the efficacy of the vaccines against asymptomatic infection or infection with mild symptoms, as well as protection after national infection. This means that the scientific rationale behind vaccine passports – that those with a vaccine certificate are unlikely to infect other people – is currently unsupported. 

“We cannot take it for granted that, just because somebody is vaccinated, they are absolutely not going to be infected and therefore not be a risk to others,” said Dr Soumya Swaminathan, WHO Chief Scientist.

While a vaccine certificate would likely represent the immunity of the individual, it may not reflect that the person won’t transmit the virus. 

In addition, ethical and equity issues are raised once vaccine certificates are required to access a person’s school, workplace, or international travel, “especially in a world where vaccines are distributed in such a grossly inequitable way,” said Ryan. 

“While some countries have vaccinated over 30 or 40% of their adult populations, others have barely reached 1% or even less,” Swaminathan said. “So this is not something that can be applied globally right now because not enough people have had the vaccine.”

The International Health Regulations Emergency Committee, the committee advising WHO on travel regulations, held its seventh meeting on Thursday. Updated guidance on using vaccination certificates as a prerequisite for travel is expected to be received by Dr Tedros by Monday. 

Image Credits: ABC News Australia, ABC News Australia, WHO.