Pacific Islands’ zero-Covid strategies unsustainable, professor says

Countries all over the world have seen Covid-19 cases surge since the emergence of the highly transmissible omicron variant, with new infections soaring by 20% globally over the past week.

In the Pacific Islands, however, it’s been a different story.

Many of the small island states nestled in the Pacific Ocean have had no new cases of the virus for months — and some of those countries have remained virtually Covid-free throughout the pandemic.

As of Tuesday, Tonga, Samoa, Wallis and Futuna, Kiribati, the Marshall Islands, Micronesia, Vanuatu and the Cook Islands had no active cases of the virus, according to figures from Our World in Data.

Maintaining a long-term state of zero Covid infections has largely been achieved by closing the islands off to all non-essential international travel and implementing strict quarantine measures to control the spread of the few cases that have been imported.

Although many of the islands’ borders are still closed, some have tentatively begun to reopen. Those countries that remain isolated now find themselves in a precarious position as they attempt to balance public health with the recovery of their tourism-reliant economies.

Andrew Preston, a professor of microbial pathogenesis at the University of Bath in the U.K., told CNBC that zero-Covid strategies were unsustainable, partially due to the emergence of omicron.

“The scenario under which zero Covid had the greatest credibility was maintaining it while very high levels of immunity were built with vaccination,” he said. “However, for most countries, it has proved very difficult to get a level of vaccination high enough to prevent any spread of an imported case, and now with the ability of omicron to reinfect and infect those vaccinated it appears to be a non-starter as a long-term policy.”

Zero-Covid strategies have also taken a huge economic toll on many of the islands, putting pressure on governments to ramp up vaccination so that borders can be reopened safely.

According to an IMF report published in October, GDP across the Pacific Islands contracted by 3.7% in 2020, with tourism-dependent countries — Fiji, Palau, Samoa, Tonga and Vanuatu — expected to have seen a 6.5% decline in real GDP in 2021.

The Cook Islands, which has political ties to New Zealand, currently has no cases of the virus. Its Covid response strategy is linked to the situation in New Zealand, where 80 new cases were recorded on Monday.

Some restrictions are in place, including limits of 100 people at social gatherings and the enforcement of social distancing in restaurants and bars. Face coverings are encouraged but not mandated.

Last week, the Cook Islands took steps to reopen its borders. All incoming visitors must travel via New Zealand, where they are required to spend 10 full days before departing for the Cook Islands. Visitors must also provide evidence of Covid vaccination as well as a negative PCR test.

In a statement on Dec. 16, Cook Islands Prime Minister Mark Brown said the “best weapons” the country had had throughout the pandemic had been “isolation and closed borders, and now mass vaccination.”

“We have worked very, very hard in the last two years to maintain our Covid-free status, and these [travel] regulations and our continual drive to get all our eligible people vaccinated, is a continuation of that,” he added.

According to official data, 96% percent of the eligible population — those over the age of 12 — in the Cook Islands has been fully vaccinated against Covid. Around 70% of the population has received a booster dose.

By reopening to the world, the Cook Islands government will be hoping to recoup some of the substantial economic losses the country has suffered because of the pandemic. The Asian Development Bank estimates that the Cook Islands’ GDP loss through the crisis could be as heavy as 32%.

For other Pacific Island countries, borders remain closed as authorities work to catch up with the Cook Islands’ vaccination success. Reopening too soon could be a huge public health risk, given that populations likely have little or no immunity acquired through infection — particularly to the omicron variant.

Samoa and Tonga have fully vaccinated around 60% of their populations, according to Our World in Data, while just over half of people living in Wallis and Futuna have received two doses. Meanwhile, in Kiribati, roughly one-third of the population is fully vaccinated.

In some Pacific Island countries, wider health considerations also add to the risk. In Samoa, for example, Covid poses a significant risk to much of the population due to high rates of non-communicable diseases that the WHO says account for approximately 68% of the country’s premature deaths.

Berlin Kafoa, director of the public health division at the Pacific Community, told CNBC there was “huge concern” over the potential for severe Covid epidemics as Pacific Island countries reopen their borders.

“The consequences are dire, as Covid-19 outbreaks will overwhelm fragile health systems if [these countries] are not assisted now,” he said in an email, adding that the WHO and other U.N. agencies were working with Pacific Island governments to prepare each country.

Individual countries and territories across the region are currently working to set vaccination targets at which they feel they can safely reopen their borders. However, Kafoa said that all Pacific Island countries faced challenges in terms of accessing Covid vaccines, vaccine hesitancy and misinformation.  

Official data from Vanuatu — which has kept cases near or at zero throughout the pandemic — shows just 37% of the population has been fully vaccinated.

Being heavily reliant on tourism means the rate of Vanuatu’s economic recovery is pinned on being able to safely reopen its borders. Tourism accounted for 31.7% of national GDP in 2018, a 2020 report from the U.N. said. The industry was responsible for more than one-third of jobs nationwide prior to the pandemic.

Olivier Ponti, vice president of insights at travel analysis firm ForwardKeys, told CNBC that as of Jan 8., first-quarter international bookings to the Pacific Islands stood at 12% of pre-pandemic levels.

French Polynesia, which reopened last May, was seeing the strongest recovery, Ponti said, with bookings to the country currently at 75% of the levels seen the same time two years ago.

Flights to Fiji and New Caledonia were up to 51% and 38% respectively of the levels seen in Jan. 2020. Vanuatu, meanwhile, “is not expecting any international visitors,” Ponti said.