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COVID-19 lessons for the Pacific in 2021

Opinion: From COVID-19 containment to suppression in the Western Pacific Region: 2020 Lessons for 2021

Compared to other parts of the world, the Western Pacific Region has been comparatively fortunate. Although the Region’s 37 countries and areas are home to more than a quarter of the world’s population, they have reported just 1% of globally confirmed cases to date. Most countries have avoided the so-called “red line”, or the point where critical care needs surpass health care capacity, large numbers of health care workers are infected, service quality declines, and deaths rapidly increase.

Of course, 2020 was a very difficult year – in particular, for healthcare workers, and for those who have lost loved ones and livelihoods. My thoughts are with the families of these people every day, and with the healthcare workers who have been working so hard over the past year. We all need to remain vigilant, in order to keep case numbers down, and health systems operating, and as far as possible, transmission of the virus in check.

As we embark on a new year, there are still many unknowns about COVID-19. However, it is still useful to reflect on some of the lessons that can be learned from our experiences and what we can take forward into 2021.

There are several reasons why the Western Pacific Region has fared relatively well, and important lessons that can be learned from countries in our Region’s experience. Clearly, long term investment is critical. Countries in the Region have spent more than a decade preparing for events with pandemic potential, by strengthening their health systems in anticipation of an event like the COVID-19 pandemic.

Under the Asia Pacific Strategy for Emerging Diseases and Public Health Emergencies, or APSED, now in its third iteration, countries developed their response plans – and, crucially, the capacities and systems to implement them. Under this shared strategy, systems were set up – such as for contact tracing – which have proven to be critical in the COVID-19 response.

Countries that have successfully controlled COVID-19 had a very strong public health plan to manage positive cases. Most countries were able to scale up the right mix of public health interventions at the right time, to avoid health systems being totally overwhelmed.

China showed us early on that this virus could be suppressed, with strong public health interventions. Australia and New Zealand’s experience has reinforced this. We also saw in places such as the Republic of Korea, the importance of quickly scaling up testing – and linking this to the public health response.

In the Pacific, where there are some of the few remaining countries in the world yet to record a single case of COVID-19, countries and areas continue to prepare their health systems. Strong public health measures, proactive communications with their public, combined with border closures and stringent border quarantine measures, have slowed or stopped the spread of COVID-19. Fiji and New Caledonia, for example, which reported cases of COVID-19 in the community earlier in 2020, have now gone more than 240 days without reporting a case of COVID-19 outside of border quarantine.

From Japan, we learned the benefits of using a cluster-based approach. And of course, Japan also taught us about the renowned three C’s. I understand that now, even small children in Japan know about the three Cs: avoiding closed spaces, crowded places and close-contact settings.

There are many other important factors: for instance, good systems for multi-source surveillance have been crucial – to enable countries to monitor trends, assess risks, and adapt response strategies accordingly.

Communication from trusted sources including governments, healthcare workers and scientists has also been so important – for establishing and sustaining social norms around protective behaviours, and building community support for public health measures. We have been observing very effective communication in many countries including Viet Nam, Singapore and New Zealand. I have been impressed so many times with the communication of those countries. I have also observed in many countries, a strong community commitment to protecting the most vulnerable.

I am also very proud of the spirit of solidarity that characterized interactions between countries of our Region in 2020 – from technical exchanges on issues such as laboratory testing and clinical management, to working together in joint incident management teams, and commitments to support equitable access to COVID-19 vaccines. Countries in the Region really have come together, borne out of a recognition that no country is safe until every country is safe.

Of course, none of the things I have described are unique to the Western Pacific Region. But they came together in 2020 in a unique way – sparing us from the scale of devastation that we are currently sadly seeing in other parts of the world. But this is obviously no time to be complacent: the pandemic is far from over, and how COVID-19 evolves in 2021 depends on all of us: our individual and collective actions will determine the course that the pandemic takes next.

As the holiday period draws to a close and we begin this new year, I encourage everyone in COVID- contained countries across our Region, those who are able to be together with their families and communities in-person, to discuss what they can do to be ready to apply the public health measures that we see working elsewhere in our Region, as and when they are needed.

Dr Takeshi Kasai, WHO Regional Director for the Western Pacific

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