Small Pacific Island countries (PICs) are vulnerable to disease outbreaks. The measles outbreak in Samoa is a grim reminder of this vulnerability. Now another threat is at the door step of the island nations. Their geographical remoteness and isolation from rest of the world may seem to be an advantage and may appear to seclude them from the threat of COVID-19 but the lack of regular interaction with the outside world may be the thing that may decide their fate.
History shows that introduction of a new disease to a group of people that are isolated can wipe their population completely. The reason is that they have not developed immunity to the disease. Also in areas where there is frequent interaction of people there is also regular transmission of infections from people from different areas so the population immunity is primed all the time. Without this regular interaction may result in population immunity being weakened. Pacific island people are at risk because their population immunity (in the general sense) is not regularly primed.
One of the first step that PICs have taken is travel restrictions – from selective travel to complete ban in some countries. It may seem drastic and overreacting but in light of what I described above stopping people from going into their countries may be the cheapest and best strategy. Preventative public health interventions are the main tools at the disposal for PICs because they do not have the resources nor the skilled manpower to contain COVID-19 spread if it hit their shores.
Some small island nations can afford to quarantine inbound passengers because of small population and low volume traffic of inbound passengers. Again the objective of such public health measures are to contain and manage the threat.
Risk communication, public health awareness messages targeted at vulnerable segments of the population (e.g. the elderly, people with co-morbid chronic diseases) also will play an important role. Social distancing is now the key message – avoiding crowds, avoid social gatherings, avoid church services being driven into the community.
Social distancing is a difficult concept for the Pacific Island people because this is what we do – socialise. Telling the population to avoid contact, avoid sharing time and meal together, avoid going to church, asking friends and family members to stay afar from you is difficult to swallow because social distancing is like a big wedge being driven into the “pacific way of life”. It is a challenge that health educators will have to overcome. I think if we can make people see the danger of close interaction during this current pandemic, we will see pacific island people coming together to prevent COVID-19 landing and spreading on their shores.