Lessons from COVID-19-free Vanuatu: intensive health operations for Phase 1 of repatriation and quarantine, May–July 2020

Abstract

International borders to Vanuatu closed on 23 March 2020 due to the global COVID-19 pandemic. In May–July 2020, the Government of Vanuatu focused on the safe and timely return of citizens and residents while ensuring Vanuatu remained COVID-19 free. Under Phase 1 of repatriation, between 27 May and 23 June 2020, 1522 people arrived in the capital, Port Vila, and were placed in compulsory government-mandated 14-day quarantine in 15 hotels. Pre-arrival health operations included collection of repatriate information, quarantine facility assessments, training for personnel supporting the process, and tabletop and functional exercises with live scenario simulations. During quarantine, health monitoring, mental health assessments and psychosocial support were provided. All repatriates completed 14 days of quarantine. One person developed symptoms consistent with COVID-19 during quarantine but tested negative. Overall health operations were considered a success despite logistical and resource challenges. Lessons learnt were documented during a health sector after-action review held on 22 July 2020. Key recommendations for improvement were to obtain timely receipt of repatriate information before travel, limit the number of repatriates received and avoid the mixing of “travel cohorts”, ensure sufficient human resources are available to support operations while maintaining other essential services, establish a command and control structure for health operations, develop training packages and deliver them to all personnel supporting operations, and coordinate better with other sectors to ensure health aspects are considered. These recommendations were applied to further improve health operations for subsequent repatriation and quarantine, with Phase 2 commencing on 1 August 2020.

Antibiotic Consumption in Vanuatu before and during the COVID-19 Pandemic, 2018 to 2021: An Interrupted Time Series Analysis

“…It is also possible that public fear (the hospital being seen as a focus of disease) may have kept patients away from presenting to the hospital. In association, the diversion of core health personnel from normal duties to manage COVID-19 related activities may have caused disruptions in health services generally, thus reducing the amount of antibiotic consumption [ 29 ].…”

“…On 26th March 2020, the first suspected case of COVID-19 was reported, and Vanuatu closed its borders. The border remained closed throughout the remainder of our study period [ 29 ].…”

Lessons from the frontline: The COVID-19 pandemic emergency care experience from a human resource perspective in the Pacific region

“… 21 Another reflexive study examining the lessons learned from repatriation and compulsory hotel quarantine of 1522 Vanuatu citizens and residents to that COVID-19 free Pacific Island country in May–June 2020, highlighted insufficient health staff numbers and the need to strengthen coordination of health operations between Vanuatu's Ministry of Health and provincial health offices to avoid replication and undue managerial burden. 22 …”