By Lisa Williams
The Cook Islands' top Health official says the country is doing all it can to avoid the scenario of sending Covid-19 patients to New Zealand.
As New Zealand citizens and under a special agreement, Cook Islands medical referrals have been coming to Auckland for decades.
For now, the Cooks is one of a handful of Pacific countries with no reported cases of Covid-19 but Ministry of Health - Te Marae Ora head, Josephine Aumea Herman, said the global trends had galvanised the 'puna' districts of Rarotonga to act as if the virus had already arrived.
Dr Herman said while the latest batch of 275 swabs came back negative, the possibility of having to medivac seriously ill coronavirus patients to New Zealand was something officials were still very much aware of.
"We've been very clear about this. We do not have intensive care unit capability in this country. We only have two ventilators," she said.
"We are reviewing how things might turn out if we might have someone who is very unwell and might need referral to New Zealand."
A medivac protocol for Covid-19 patients from Rarotonga was still being worked out with details far from final, according to sources close to the discussions.
Rarotonga is currently home to a Pacific medivac service led by domestic operator Air Raro. But it's likely a high-level signoff would be required from New Zealand for any Covid-19 referrals to get the green light.
From the Te Marae Ora perspective, the focus for now was ensuring testing and public health systems keep Covid-19 out of the country.
"We need to understand that if New Zealand is already at full capacity then this would be a very difficult bridge to cross. For us our biggest weapon right now is our public health measures and that's where we're focusing our energies until such a time, we need to face the next one," said Dr Herman.
"Everything is fluid at this point in time. What we were talking about one week ago has completely reversed to another or changed to another strategy for us.
"So while we have had discussions with New Zealand regarding this with Covid-19 and so forth I think it's still fluid and we don't know what the future has in in place for us."
Dr Herman if New Zealand ICU capacity was under strain, "why would we be trying to add more to that? This is common sense for many of us and we shouldn't try to look too far into the future."
The national hospital on Rarotonga sent patients that could leave, home. It's revamped two main wards into a Covid-19 wing. Anyone wanting to visit must be screened by phone first and in most cases referred to doctors at a village clinic.
There were hopes that in-country testing will kick in as early as next week, once equipment from the World Health Organisation touched down on Air New Zealand flights scaled back from almost daily to once a week, with non-passenger, freight-only arrivals.
The in-country testing capability would replace a current system of sending swabs to Wellington and then waiting for results.
In the meantime Te Marae Ora was continuing to hope for zero cases.
"The ministry has reached out and engaged with civil society, local businesses and other government bodies to focus on what it can control," said Dr Herman.
Dr Herman said the puna or district initiatives to help share messages and get information from all homes on Rarotonga had created house-by-house reporting and 'quarantine' protocols.
The ministry head indicated that New Zealand's lockdown and earlier restrictions had helped to strengthen the Cook Islands border controls and Covid-19 national response plan.
She said the lockdown continued that layer of protection and Cook Islanders stranded in New Zealand should understand that.