(CNN)Reva-Lou Reva is worried. For the first time he can remember, he says hospitals around the Pacific Island nation of Papua New Guinea (PNG) are so overburdened they are closing their doors to patients.
This country only has about 500 doctors for 9 million people. Now it's dealing with a Covid outbreak
"This is very frightening, to know that you don't have any medical facilities open, or very limited, and you cannot easily access them because of the restriction," says Reva, 48, PNG assistant country director of program support for humanitarian non-profit CARE International. "I'm breathless, I can't explain how difficult it is."
Until recently, PNG had largely managed to stave off a major coronavirus outbreak. At the end of February, the country had only reported 1,275 cases, according to Johns Hopkins University.
But over the past month, cases have more than tripled. PNG has now reported at least 4,660 Covid-19 cases and 39 related deaths, including that of MP Richard Mendani, who died age 53 earlier this month, according to a Radio New Zealand report. On Friday, the country reported 560 new infections -- its highest for a single day -- with Prime Minister James Marape admitting there is "rampant community transmission."
While those figures might not seem high compared to other countries, they pose a major issue in PNG, where the government says there are only about 500 doctors for an estimated population of 9 million people. At the best of times, the country's health system is fragile -- now NGOs are warning it could be on the "verge of collapse."
Low testing rates also mean PNG's case load is likely much higher -- something authorities acknowledge. Meanwhile, rampant misinformation in the country means some people are still not taking the threat seriously.
Onlookers warn the crisis could worsen next week as people in the predominantly Christian nation travel home for Easter -- and are calling on neighboring Australia and New Zealand to do more to help.
"Papua New Guinea's health crisis has now reached the level we feared it would a year ago with a surge in cases," Amnesty International's Pacific researcher Kate Schuetze said earlier this month. "A combination of an ailing health system and inadequate living conditions has created a perfect storm for Covid-19 to thrive in the country's overcrowded informal settlements."
For almost a year, PNG seemed to handle the outbreak well.
The country confirmed its first case on March 20 last year -- an man who had traveled from Spain. Within two days, the Prime Minister declared a state of emergency, stopping all incoming and domestic flights, and limiting travel between provinces.
Onlookers and the government were concerned an outbreak in PNG would be disastrous.
"Our country does not have a health system that is capable of defending our people in this time of emergency with the threat of the coronavirus entering and spreading in our country," Prime Minister Marape said in Parliament on April 2. At the time, he said PNG had 500 doctors, fewer than 4,000 nurses, under 3,000 community health workers and only 5,000 hospital bed spaces. "Our existing health capacity is insufficient to fight this battle," he added.
PNG has one of the lowest ratios of doctors per 1,000 people in the world. According to 2018 World Bank figures, the country had 0.07 physicians per 1,000 people -- well below the 2017 average among small Pacific Islands (0.5), the 2017 world average (1.6), or the 2017 level