Coronavirus Disease 2019 (COVID-19) Health Situation Report #76 09 June 2021 Period of report: 31 May – 06 June 2021

This Situation Report is jointly issued by PNG National Department of Health and World Health Organization once weekly. This Report is not comprehensive and covers information received as of reporting date. Situation Summary and Highlights ❒ As of 6 June 2021 (12:00 pm), there have been 16 391 COVID-19 cases and including COVID-19 deaths reported in Papua New Guinea. From the period of 31 May to 06 June, there were 481 new cases and 2 new deaths reported. ❒ As of 06 June 2021, a total of 38,563 people have been vaccinated for COVID-19 in PNG. This includes 6,063 health and 32,012 essential workers and 488 people over the ages of 45 and those with comorbidities. ❒ Eligibility for vaccination for current phase was expanded to include all persons 45 years and older and all adults having comorbidity. ❒ International Emergency Medical Teams (EMTs) continue to provide care for COVID and non-COVID patients in the Highlands and West New Britain. ❒ A joint RCCE team from NDOH and WHO deployed to Eastern Highlands Province last week to support the Provincial Health Authority to conduct advocacy sessions with health care workers at various health facilities in the province on the vaccines. ❒ Police Commissioner and Controller of the PNG COVID-19 National Pandemic Response David Manning today issued Direction on 2nd June authorizing AstraZeneca vaccination to be administered in the vaccination roll-out program in Papua New Guinea. Controller Manning directed that no vaccine except AstraZeneca shall be administered under the Papua New Guinea COVID-19 national Vaccination Program unless authorized in writing by the Controller. ❒ Full details of all measures can be found at www.covid19.info.gov.pg

Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

Pillar Updates & Priorities

Surveillance: ❒ As of 06 June 2021, a total of 16 391 COVID-19 cases including COVID-19 deaths reported in Papua New Guinea. This represents an increase of 481 new cases and 2 new deaths over what was reported last week. year. The number of reported cases continue to show a downward trend from surge peaks in March and April 2021. ❒ Priorities include to strengthen surveillance, contact tracing, testing and reporting. Also, to strengthen the use of informal sources as additional information sources for surveillance ❒ Work is progressing on the transition to the use of the Go.Data platform for disease surveillance and reporting. The system will be rolled out in 10 provinces for a start ❒ Last week the modelling team from several research institutes in Australia, funded via DFAT’s SPARK initiative, presented to NCC incident management and other key partners including DFAT to explain the modelling work that has been done to date. This included simulations of PNG’s COVID-19 situation, predictions for future scenarios, and how best to use modelling to support vaccine rollout or provincial public health and social measures. ❒ The team have also been focusing on additional data cleaning and analysis, including further aligning reported numbers of COVID-19 cases and deaths with provincial numbers, and investigations fluctuations in the weekly number of tests performed from January 2020 to date.

Quarantine & Point of Entry: ❒ 415 passengers were screened at POE over the last 7 days. ❒ As of 06 June, there were 643 people under quarantine (PUQ) of which 86 were in home quarantine, 399 in hotels, 117 in company sites and 41 in company apartments. ❒ There were no reported positive COVID-19 cases in quarantine during this reporting period. COVID-19 Hotline ❒ For the period of 31 May to 6 June, the COVID-19 National Hotline received 4416 calls. ❒ Of these, 24 (about .54%) were health-related calls. 17 of these were referred to the Rapid Response Team/PHA. ❒ As of 6 June, the hotline had received a total of 246,383 calls. Of these, 6,126 (2.5%) were health-related calls. A total of 2516 calls to date have been referred to Rapid Response Team/PHAs. ❒ The hotline is receiving a high number of calls from people seeking results of Covid-19 tests. ❒ There have also been a high number of callers seeking information about identifying symptoms, preventative measures, provincial vaccination programs and travel related queries

Laboratory: ❒ The laboratory team visited the highlands region to further explore ways on improving testing as well as evaluate the readiness of the new PCR laboratories due to be opened in those regions. ❒ All the laboratories visited have enough COVID-19 laboratory supplies to continue a seamless testing and with no report of sample stagnation. ❒ The PCR testing lab at ANGAU in Morobe has been commissioned and trainings are being facilitated over the next 2 weeks. ❒ Mt Hagen and PCR Lab set up are almost completed the containerised PCR lab for NONGA will be arriving in country on the 15th of June.

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Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

Emergency Medical Teams (EMTs) ❒ There are currently 2 EMT teams operating in PNG. ❒ Heart to Heart international (HHI) has a 5-person team in Kudjip and and Team Rubicon Charlie with a 3-person team who were based in Enga but have completed their mission and are headed to . ❒ The HHI team in Kimbe have been helping to strengthen clinical practices as well as conduct training and awareness on IPC and vaccines. ❒ The HHI team in Kudjip have been actively participating in clinical care in the Surgical and Obstetrics and Gynaecology Units. ❒ Team Rubicon in Enga assisted with a mass casualty event involving tribal fights that occurred in Wabag.

Clinical Management and Infection Prevention and Control: ❒ The clinical management team’s focus for this week has been strategizing to optimise the COVID-19 response for the next 3 months. Priority areas include improving acute care management. This would be done by targeted training courses for clinical staff involved in acute care management augmented by providing necessary equipment and guidelines. ❒ Specific job-aids for different disease severity have also been created and will be circulated shortly after endorsement. Other areas of focus include improving non-COVID essential services and mental health of health-care workers involved in the COVID-19 response. ❒ The IPC team has been involved in preparing and decontamination of the Taurama Aquatic Centre as a location for the proposed Air Lab. ❒ The team have also visited clinics within the NCD to assess and assist in IPC practices. Risk Communication & Non-Pharmaceutical Interventions (NPIs): ❒ National Champions Campaign rollout continues with total champion advocates now at 9 ❒ Filming has commenced for a second provincial health care champion series aligned to provincial vaccine roll out. ❒ Vaccine advocacy training for Health, frontline and essential workers was completed in Eastern Highlands, Central, and West Sepik and provided valuable insights into barriers to vaccine uptake. ❒ Dissemination of ‘Sleeves up Covid-19 Vaccine Champion’ IEC Package materials paused to allow for content update to align to new eligibility criteria for vaccine. ❒ Controller Commander David Manning ‘Vaccine Champion’ content featured in Post Courier 31 May ❒ Establishment of a social listening system is in progress and will provide data to inform message development. ❒ Results from a nation-wide survey on behavioural insights relating to vaccine uptake and Niupela Pasin behaviours has been received. Data is currently being analysed to understand existing knowledge, barriers, and motivators to adapting desired behaviours and will inform a plan for Behaviour Change Communications to encourage Niupela Pasin behaviours and vaccine uptake.

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Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

Niupela Pasin ❒ Niupela Pasin Team closely monitored the Moresby Northwest By Elections to ensure Niupela Pasin Measures were adhered to during the polling day. ❒ Monitoring of the event will continue after polling to cover the counting period until declaration. This is to ensure the whole election process is implemented according to the Elections Standard Operating Procedure (SOP) recently developed and endorsed. ❒ 5 additional Mass Gathering Events were also approved and were monitored for compliance last week.

Logistics and Supplies: ❒ Due to the closure of the Murray Barrack warehouse, there were no major distributions last week aside from PPE items to support the election and Antigen RDT to Rita Flynn. ❒ A site has been identified at Port Moresby General Hospital to establish a new Oxygen Generator Palnt and preparation works are being quoted prior to installation . ❒ First payment for refractory brick materials have been made for the Waste Management project which will commence at the end of July. ❒ The first draft of 10 bed model for the isolation facility project has been completed. ❒ This week the team will complete stock inventory and the installation of the Msupply system will commence with the Rita Flynn facility.

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Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

National Vaccine Rollout

❒ A total of 108 vaccination sites have started vaccinations, out of 182 sites planned to provide COVID-19 vaccinations nationwide. ❒ Eligibility for vaccination now includes all persons 45 years and older and all adults having comorbidity. ❒ As of 06 June 2021, a total of 38,563 people have been vaccinated in PNG. This includes 6,063 health workers and 32,012 essential workers and 488 people over the ages of 45 with those with comorbidities. ❒ Efforts continue for the vaccination of health care workers and other essential workers. East New Britain has been the most successful in reaching their health care workers having vaccinated over 60% of the health workforce.

Figure 1. Cumulative number of persons vaccinated by Region and Province

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Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

National and Provincial Public Health Response ❒ The Pandemic Response Coordination Group and the Health Operations Team continue to meet regularly at the National Control Centre. COVID-19 Control Measures ❒ Police Commissioner and Controller of the PNG COVID-19 National Pandemic Response David Manning today issued Direction on 2nd June authorizing AstraZeneca vaccination to be administered in the vaccination roll-out program in Papua New Guinea. Controller Manning directed that no vaccine except AstraZeneca shall be administered under the Papua New Guinea COVID-19 national Vaccination Program unless authorized in writing by the Controller. ❒ Full details of all measures can be found at www.covid19.info.gov.pg Advocacy support to Eastern Highlands Province ❒ A joint RCCE team from NDOH and WHO deployed to Eastern Highlands Province last week (30 May – June 2) to support the Provincial Health Authority to conduct advocacy sessions with health care workers at various health facilities in the province on the vaccines. The advocacy program also included a session with essential workers in the province. ❒ With vaccine hesitancy among health workers still at a high, the team took a more interactive approach to conducting the sessions taking time to answer questions and dispel misinformation and myths about the vaccines. The team found, much of the hesitancy was based around the common myths on the Astra Zeneca vaccine. ❒ The team assured the health workers that the vaccine was safe and effective in preventing severe illness and death from COVID-19. There was no micro-chip, magnetic fields nor did it change DNA in a person and Niupela pasin preventative measures still had to be followed. They were advised by the team to fact check myths and misinformation by checking with credible sources to make an informed choice on taking the vaccine, but also consider it to protect their patients too. ❒ It was evident that the advocacy trip made an impact on the health workers perception of the vaccine as many health workers took the vaccination the next day and committed \ to encouraging others by sharing the information they received from the advocacy session. ❒ The team will continue onto Chimbu and Jiwaka next week to continue supporting the vaccine advocacy sessions for health workers in the provincial centers.

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Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

Transmission Assessment

There continue to be COVID-19 cases reported from across PNG, with newly reported cases in 21 of the 22 provinces, including the Autonomous Region of Bougainville (AROB) in the previous seven days. Despite low numbers of weekly and monthly tests being reported (see Table 4 for further details of May testing by province), all provinces have now reported over 100 confirmed cases of COVID-19.

In addition, positivity remains high, with some labs reporting test positivity in excess of 20%. Nationally, weekly test positivity has remained above 20% since February 2021. Less than 30% of newly reported cases are linked to a known contact (epi-link) at the time of swabbing, highlighting that the source of the majority of newly diagnosed COVID-19 cases in PNG remains unknown.

While there continue to be low rates of testing and limited contact tracing, it is believed that community transmission of COVID-19 is occurring throughout PNG. With a low level of confidence based on the available data, National Capital District (NCD), Morobe, West New Britain and Western Highlands appear to be in Stage 3, widespread community transmission. In addition, Eastern Highlands, Enga, , Manus, Milne Bay, New Ireland, Northern, Simbu, and Western appear to have localised community transmission (stage 2).

More information on the WHO Western Pacific Regional Office COVID-19 transmission stages can be found here: bit.ly/WPRODashboard

Epidemiology

Figure 3. Epidemiological curve of COVID-19 cases in Papua New Guinea, 15 March 2020 to6 June 2021

Please note: The true extent of the decreasing trend must be interpreted with caution as there are delays in receiving and reporting results from provinces.

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Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

Figure 4. Percentage age and sex distribution of COVID-19 cases (63% male, n=10328), 15 March 2020 to 6 June 2021

Table 3: Number of swabs taken (tests) in May 2021*, by type of test and province

Antigen Rapid Total tests per Province RT-PCR Tests GeneXpert Tests Diagnostic Tests 100,000 population AROB 71 - - 21 Central - 2 2 1 East New Britain 89 184 6 74 East Sepik - 8 4 2 Eastern Highlands 127 292 31 63 Enga 108 21 59 39 Gulf 90 62 - 80 Hela 68 61 16 48 Jiwaka - 33 95 38 Madang - - 7 1 Manus 359 114 297 1151 Milne Bay 62 - - 18 Morobe 61 89 166 34 NCD 148 2 326 106 New Ireland - - - 0 Northern 168 - 2 72 Simbu 7 52 17 20 Southern Highlands 25 2 55 13 West New Britain 780 - - 224 West Sepik - 12 - 4 Western 61 - 2 21 Western Highlands 318 3 505 187 Missing province - 4 60 Total 2542 941 1650 56 Page 8 of 10

Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

*Please note: This update is based on test results received at the National Control Centre by 7 June 2021.

Table 4. Persons Screened by Point of Entry Total Number of Travelers Screened before SOE (until 22 March 2020) 29,387 Total Number of Travelers Screened during SOE (23 March – 16 June 2020) 3,788 Total Number of Travelers Screened after SOE (17 June 2020 – 05 June Air 21,425 2021) Sea 671 Land 6 Total 22,082

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Papua New Guinea Coronavirus Disease 2019 (COVID-19) Health Situation Report 76 (Released: 9 June 2021; Report Period: 31 May - 06 June 2021)

ANNEX A – Photos

Photos 1-3: Vaccine Advocacy event of protective Services personnel

Photo 3: WHO & NDoH representatives meeting with Gulf PCC chairperson, provincial administrator and PHA CEO.

For more information about this Situation Report, contact: Dr Daoni Esorom Greg Cameron Deputy Pandemic Controller Information & Planning Pillar Lead National Department of Health National Control Centre / UN RCO Email: [email protected]; Mobile: +675-72313983 Email: [email protected]

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