Measles emergency needs enforcement

By James Robertson 26 November 2019, 10:55PM

The figures now being released on a daily basis are heartbreaking. But what’s more chilling is a future when they lose their power to shock. 

The National Emergency Operations Centre yesterday announced 32 deaths from measles, all but 4 children, and more than 234 cases new cases on Tuesday alone.

These jumps in diagnoses are worrying reading.

Experts like Dr Helen Petousis-Harris from Auckland University say the figures show that the epidemic is still escalating and not nearing its tipping point.

In many ways 2019 has been the year of measles; worldwide cases have tripled and some countries have been absolutely devastated. 

In the Philippines this year there were 500 deaths - most of them children - and more than 35,000 cases. 

In that country, which suffered from a similar vaccine scandal, such as that which killed two one-year-olds in Savaii last year, they too suffered from plummeting vaccine rates. But they only dropped as low as 70 percent among newborns last year.

In the same year, our vaccination rate was nearly half that much - or about 40 per cent according to World Bank data - following the tragedy in Savai’i.

What’s more we are in a perfect storm of conditions for an outbreak to spread: only between 28 and 40 per cent of Samoa’s total population has received the measles vaccine; trust in the health system is at an all-time low and much of our population is very remote. 

The human stakes are high.

The Government, with its state of emergency has, effectively, declared martial law under the constitution. That is no small thing but is, we believe, commensurate with the threat at stake.  

But we believe that more needs to be done between now and when this latest order expires on December 15 to enforce it if we are to avoid months of more fatalities. 

Walking through Apia one does not get any sense of emergency, despite the decrease in foot traffic in some commercial areas. 

In too many places in town, outside supermarkets and in public places children under 19 are congregating, or wandering the streets in groups, acting as street vendors. And it’s unclear if anyone is asking for identification cards, to ensure that people are underage when entering public gatherings, such as at the cinemas as per the Government's orders against young people joining public gatherings. 

Although 2019 provides no shortage of measles cases, Dr. Petousis-Harris says that Samoa’s current outbreak reminds most of all of a 1991 epidemic in New Zealand.

That lasted for six months.

When it comes to combating epidemics speed is of the essence. Reaching as many unvaccinated children as possible is the quickest way to reduce the time an epidemic takes to peter out.

But as the story on the front page of Monday’s newspaper made clear (“Early treatment saves lives) there are far too many parts of Samoa where families distrust their Government.

We have called for mobile vaccine clinics to reach people who are currently unvaccinated; for partnerships with church and community groups and just about every new approach imaginable to vaccinations.

But if there is going to be no substantial change to the way vaccines are dispensed, then it is incumbent on the Government to start pulling on the only other lever it has, and start enforcing its state of emergency provisions more seriously. 

For millennia keeping people isolated in their homes has been a proven method to containing the outbreak of disease.

Village councils, too, have a role to play in enforcing the dispersal of crowds and some are being more proactive than others. 

We approve the public service and the Courts for their recent action seeking to discourage people from coming into contact with each other.

Coming into Christmas, it’s worth asking whether other churches should follow the lead of the Church of Jesus Christ of Latter-day Saints (LDS), in cancelling or restricting or closing its services in the name of containment, or involving themselves in the campaign to vaccinate churchgoers. 

Samoa is looking at two futures: One is difficult, disruptive and short. The other is deadly. 

By James Robertson 26 November 2019, 10:55PM

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