Responding to COVID-19 in Brunei Darussalam: Lessons for small countries

• Published in: Journal of global health 2020-06, Vol.10 (1), p.010363-010363
• Main Authors: Wong, Justin, Koh, Wee Chian, Alikhan, Mohammad Fathi, Abdul Aziz, Anita B Z, Naing, Lin
• Format: Article
• Language: English
• Subjects: Accountability; Brunei - epidemiology; Collaboration; Coronavirus Infections - epidemiology; Coronavirus Infections - prevention & control; Coronaviruses; COVID-19; COVID-19 diagnostic tests; Critical care; Disease transmission; Epidemics; Global health; Grass roots movement; Health care; Health care access; Health services; Health surveillance; Humans; Imports; Management of crises; Medical supplies; Natural disasters; Outbreaks; Pandemics; Pandemics - prevention & control; Personal protective equipment; Personal relationships; Pneumonia, Viral - epidemiology; Pneumonia, Viral - prevention & control; Population; Protective equipment; Public health; Religion; Risk assessment; Severe acute respiratory syndrome coronavirus 2; Social distancing; Social networks; Sports facilities; Trade restrictions; Transparency; Viewpoints
• ISSN: 2047-2978; 2047-2986
• DOI: 10.7189/jogh.10.010363

On January 30, 2020, the World Health Organization (WHO) declared Coronavirus Disease 2019 (COVID-19) a “Public Health Emergency of International Concern”, and the disease now affects almost all countries and areas. Table 1 Challenges and opportunities of small countries in preparing for community transmission of COVID-19 Characteristics Challenges Opportunities Multiple land borders and high connectivity to other countries Vulnerable to multiple importation events Implementation of proportionate measures at point of entry Export of disease to other countries Travel and trade restrictions Collaboration with neighbouring countries for rapid exchange of information and joint risk assessment Lack of state capacity or prior experience in managing large outbreaks or natural disasters Infrequent activation of existing coordination mechanisms may result in over-reliance on strong interpersonal relationships for multi-agency working Ensure rationalisation of managerial responsibilities in crisis Institutional memory and resilience are more fragile Clarity on accountability for different plans and procedures, supplemented by documentation of processes to reinforce resilience Limited local health workforce and health service facilities Healthcare services may quickly become overwhelmed with demands for critical care beds and other equipment Health workforce can be redeployed in early phases of the epidemic to regain control Other non-COVID-19 health services may be neglected Contact tracing and quarantine measures can slow down epidemic progression Reliance on imports for PPE and essential medical supplies Supply chain disruptions and travel restrictions may limit availability of essential medical supplies to effectively manage the pandemic PPE and essential drug stockpiling during ‘peacetime’ can be augmented by regional collaboration and strong bilateral and multilateral relationships to ensure supply lines remain constant Information tends to spread quickly in smaller communities with multiple information sources False information may spread quickly and cause public panic, which can be difficult to control on unconventional platforms or social media Ensuring transparency and openness of information from health authorities that are responsive to public concerns Heterogeneous population and significant foreign worker population Different cultural expectations surrounding social distancing measures Engagement with community and religious leaders for targeted approac