About 250 COVID-19 cases doesn't seem like all that many.

In some countries, if that was the number of new cases in a day, authorities would be happy.

That's the total number of cases across the Pacific (excluding Australia and Hawaii). But there are still signs that should have Australia worried about its nearest neighbours.

There are concerns some countries could just be running a few weeks behind other parts of the world, and the Pacific has been identified as particularly vulnerable if hit by coronavirus.

Pacific Island countries are aware of the risks they face and have been proactive in guarding against the disease, with 10 countries yet to record a single case.

But even in countries that are coronavirus-free, the fallout of lockdowns around the world and economic uncertainty could be particularly hard felt.

What is happening in the Pacific?

So far there are 255 confirmed cases of COVID-19 in the Pacific Islands region and seven people have died as a result.

Fiji's Government said Australia had given support in the form of relief supplies as the country battles the COVID-19 pandemic. ( Facebook: Fiji Government )

The majority are in the US territory of Guam, which has 140 confirmed local cases and has also recorded cases on board a US Navy ship docked on the island.

Among Australia's nearest neighbours, PNG has eight cases, Fiji has 18 and New Caledonia has 18.

But there is a risk of those numbers growing.

"We have to keep watching on widespread community transmission and we must prepare for that," said Dr Corinne Capuano, the Director of the World Health Organisation's Division for Pacific Technical Support.

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In Fiji, authorities are trying to contain COVID-19 while also trying to repair the damage from a recent tropical cyclone.

Cyclone Harold also battered Vanuatu and Tonga, which currently don't have any cases of the coronavirus.

Cyclone Harold destroyed homes and boats and stripped parts of Vanuatu of vegetation and crops. ( Supplied: Maxar Technologies )

They have had to implement measures to prevent the virus entering, while assisting thousands of people who desperately need help.

Dr Capuano, who is based in Fiji, said the majority of cases there were people in quarantine because of possible contact with confirmed patients.

"That has really helped with containing the disease so far," she said.

In Papua New Guinea, there are already concerns about undetected community transmission.

While PNG only has a handful of cases, they're spread across the country in four different provinces. The cause of some of the infections remains unknown.

Markets in Port Moresby have reopened with new hygiene and strict social-distancing measures. ( Facebook: Justin Tkatchenko MP )

But there hasn't yet been any reports of clusters of flu-like symptoms or pneumonia.

PNG is also at a higher risk because it has a land border with the Indonesian territories of Papua and West Papua, where there are reports of numerous cases and several deaths.

Its population is also much bigger than other Pacific Island countries.



Why is the Pacific vulnerable?

While there are about nine million people living in PNG, there are only 5,000 hospital beds.

PNG's Prime Minister James Marape has been up front about the reality of the coronavirus there.

"If we aren't aggressive to stop the virus from spreading, through stopping people moving around, then our hospitals and health systems don't have the capacity to deal with the outbreak," he recently told the nation.

But the problem with a weak health system is not isolated to PNG.

The World Health Organisation said limited health infrastructure and the capacity of health systems to respond is a worry "across the Pacific".

Countries in the region have limited medical supplies and health professionals and are often already overburdened with other diseases.

"Pacific countries are also vulnerable to infectious diseases, even without COVID-19," Dr Capuano said.

The Australian High Commission in Papua New Guinea has been teaching locals preventative COVID-19 measures. ( Twitter: John Philip )

"They are prone to natural hazards, extreme weather events and we have just seen Tropical Cyclone Harold hitting several Pacific countries."

In acknowledgement of challenges they face, Pacific countries have declared states of emergency and were some of the first in the world to close their international borders.

The Marshall Islands is entering its eighth week cut off from the world.

The early measures likely played a role in ensuring the list of countries without a COVID-19 case is dominated by those from the region.

How has COVID-19 already impacted countries?

Even those Pacific Island countries without a single case are already feeling the brunt of COVID-19. The economic impact will be severe.

The Republic of Palau is made up of more than 300 green islands, covered in white sand and surrounded by crystal blue water.

It's hardly surprising that tourism makes up about half of the country's GDP. But with travel bans in place in most countries, it is already feeling the loss of overseas visitors.

Other countries, like Fiji, the Cook Islands and Vanuatu are also highly dependent on tourism.

Some of the most picturesque locations in the Pacific have low infection rates, but coronavirus could destroy their economies. ( Flickr: Kyle Post )

Neelesh Gounder, an economics lecturer from the University of the South Pacific, has warned Fiji's economy is in "freefall" and "could even go into a depression".

The World Bank has warned the economic outlook for Pacific Island countries this year "is subject to substantial risks due to their economies' reliance on grants and tourism."

Possible reductions in commercial fishing because of travel restrictions, and a falling oil price will also hit the region and that's on top of job losses caused by domestic lockdowns.

There are also concerns about food security during the pandemic; the Australian Government is understood to be assessing the issue in each country.

While many Pacific Islands grow their own fruit and vegetables, staples like rice are often imported.

What is being done to address this?

Pacific Island countries have all developed national plans for COVID-19 and are mobilising people and resources to respond.

The Madang Art Maniacs have been raising awareness about COVID-19 in PNG. ( Supplied: Madang Art Maniacs )

The Pacific Island Leaders Forum has brought countries together to form a Pacific Humanitarian Pathway on COVID-19, to expediate assistance and cooperation.

International partners have also formed a joint Incident Management Team to respond to the pandemic.

"Coordination is absolutely crucial in dealing with COVID-19, we are facing an unprecedented crisis," Dr Capuano from the WHO said.

"I strongly believe that it's only by coming together in an unprecedented way that we will be able to get out of this crisis together."

Even more help will be needed.

Countries like Fiji, the Cook Islands and Palau are economically reliant on tourism, which has disappeared amid the global coronavirus lockdowns. ( Reuters: Jason Reed )

Prime Minister Scott Morrison has told leaders of the G20 that Pacific Island nations "must be a focus of international support".

Australia is by far the biggest aid donor in the region, and the Government is reconfiguring that funding to help countries defend against and respond to COVID-19.

It has also delayed repayments for PNG on a loan the country has with Australia.

Australia has given PNG an extension on loan repayments amid fears it would struggle to contain a major outbreak. ( Facebook: United Nations in PNG )

There already signs that the upheaval in the region could see countries competing to help to increase their influence.

The coronavirus outbreak has been met with a fresh outbreak of geopolitical manoeuvring and the Pacific is far from immune to that.

In fact, it was a focus of posturing between China, the US and Australia even before coronavirus. That's likely to increase in the months ahead.