Pacific countries, already hard hit by epidemics, take extreme coronavirus measures

Several Pacific countries have taken heavy-handed measures in an effort to stop a new and largely unknown coronavirus from taking hold in a region already strained by several severe epidemics.

While authorities and the World Health Organisation maintain the risk of an outbreak in the Pacific is low, little is being left to chance in countries that have battled some of the largest outbreaks of either measles, dengue fever, influenza or polio seen in generations.

That's especially the case in measles-devastated Samoa, where some of the strictest quarantine measures were imposed in the wake of an emergency Cabinet meeting on Friday.

Only a month after a measles epidemic claimed the lives of 83 people, mostly children, government officials said they didn't want to take the risk.

"Samoa has a history where it's been devastated by past pandemics, particularly in 1918 and obviously recently with measles," said Michael Baker, an epidemiologist at Otago University in Wellington.

"I can really understand Samoan health authorities taking a really cautious approach."

In the emergency measures introduced on Friday, anyone travelling to Samoa - including from New Zealand - is required to undergo medical clearance at least three days before heading to the country.

It also imposed rules that compel anyone who has been in - or transited through - China to "self-quarantine" in a country free from the coronavirus for at least 14 days. The Faleolo Hospital, across the road from the main airport, had been set aside as a quarantine centre, with two Samoan sailors held in isolation there, although the government said they did not have the coronavirus.

Already, six Chinese nationals have been caught out by the new rules. On Sunday night, they were returned to Nadi from Samoa aboard a Fiji Airways flight for not meeting the self-quarantine requirements.

Samoa's prime minister, Tuilaepa Sailele Malielegaoi, told a media briefing on Tuesday that notices had been sent to Fiji, Australia, New Zealand and American Samoa.

"There was opposition from representatives from some of these countries, but our travel restrictions will remain," he said. "What we are doing are preventative measures for our people and we don't want to end up treating them."

Samoa is not alone in imposing heavy restrictions.

Papua New Guinea late on Tuesday announced it would ban travellers from "Asian countries", with the health department conceding that it would struggle to cope if there was a local outbreak of the coronavirus. It also said citizens and residents returning from "Asian countries" would be quarantined for two weeks, and the land border with Indonesia would also be closed.

The notice from the immigration minister, Westly Nukundj, did not specify which countries were included in the ban, or how it would be enforced.

In the Marshall Islands, where authorities are in their sixth month of battling a dengue fever epidemic that continues to worsen, the country's health secretary, Jack Niedenthal, said the border had effectively been sealed.

"It's really got us scared," he said, referring to the coronavirus. "It seems to be spreading fast from human to human, and the only thing you can do there is check for fever at the airport, which is what we're doing already for measles."

"We just feel like we're fighting a war here, it's just been awful for the last six months."

In Palau, the government said it would suspend charter flights from China, Macau and Hong Kong at least until the end of February, and government workers were also restricted from travelling. Vanuatu was considering similar measures, while the Cook Islands Cabinet was weighing up whether to turn back travellers who had been in China.

All inbound travellers to Tonga were now required to fill out a health check form, and Fiji had stepped up airport monitoring.

In French Polynesia, the government said it would stop issuing work and residence permits to Chinese citizens. As of Wednesday (NZT), anyone arriving from Asia via Japan or New Zealand is required to show a medical certificate that's less than 15 days old.

In a statement, the World Health Organisation said it was working closely with Pacific governments to strengthen their capacity to detect and respond to cases.

"Several Pacific countries have instituted measures at international points of entry to try to mitigate the risk of the virus being imported," a spokesperson said. "In the Pacific, where there are limited air and sea points of entry, this may be an effective measure to mitigate the risk of the diseased being imported.

"However, WHO strongly recommends that countries conduct their own risk assessments and consider public health, social and economic implications of these restrictions before they are applied," it said.

With much still unknown about the new strain of the coronavirus, which has sickened more than 4,000 people worldwide and killed more than 100 in China, the outbreak's centre, Professor Baker said it was hard to gauge how effective the measures would be in reality.

This was especially so with the apparently seven-day incubation period, where a person could be carrying it while displaying no symptoms.

Still, in a region that has been rattled by several epidemics in the past year alone, it was unsurprising that extreme measures were being taken, he said.

He added that there was also an onus on New Zealand and Australia - the main points of entry to most Pacific countries - to help protect them from its spread. As developed countries with extensive health systems, an outbreak in those two countries would be more easily managed than if it were to reach the Pacific, he said.

That was the case last year when a measles outbreak hit parts of Auckland, striking down hundreds of children but ultimately leading to no deaths. It's widely believed the measles was exported to Samoa from New Zealand, where it had devastating consequences in mere weeks.

In New Zealand, authorities maintain that the risk of a coronavirus outbreak remains low, although limited screening began on Monday and the government is urging citizens to avoid non-essential travel to China.

Professor Baker said the Ministry of Health's Pandemic Plan did have a section about how Pacific countries would be protected, which could include exit screening at airports or, in extreme circumstances, halting flights.

But he said input from Pacific governments was needed too.

"All of these measures carry a cost in terms of limiting people and being very hard on businesses as well," said Professor Baker. "So, if you're going to introduce measures that are quite extreme you then have to weigh that up against the benefits and costs of doing that."

In a region heavily dependent on tourism and business from abroad, that would likely be a step too far for many countries. But Jack Niedenthal, the Marshall Islands health secretary, said the coronavirus was not being taken lightly.

"We're leaving nothing to chance here."

Reporting was contributed by Bernadette Carreon in Palau and Monica Miller in American Samoa.