SYDNEY - The remote island of Kadavu is a narrow volcanic island in southern Fiji that has few roads and just 10,000 residents scattered across coastal villages.

Despite its solitude, Kadavu recorded its first apparent case of Covid-19 last week - a 63-year-old woman from a small village who died before she could reach the local hospital.

The case highlights the challenge currently facing Fiji, a Pacific nation that is in the grip of one of the world's worst Covid-19 outbreaks. A further 591 cases and six deaths were reported in Fiji on Monday (Aug 23).

Since the current outbreak began in April, almost 5 per cent of the nation's 940,000 residents - or 44,118 people - have been infected, with 442 deaths.

Fiji's outbreak has led to heightened concerns about the small island nations of the Pacific, which have long proven to be some of the most susceptible countries to pandemics.

The Spanish flu, for instance, killed about 22 per cent of Western Samoa's population, believed to be the world's worst outbreak from that pandemic. In Fiji, a measles outbreak in 1875 killed about a quarter of the population.

Not surprisingly, most Pacific nations were quick to shut their borders when Covid-19 emerged last year. Some, such as Tonga, remain among the few nations still with no recorded cases.

But, elsewhere, the virus has now arrived, with devastating results.

The World Health Organisation has warned that Pacific nations are particularly vulnerable to Covid-19 outbreaks, due to their weak public health systems and the difficulties of reaching and contacting remote populations to provide medical care and information.

In addition, the region's rates of underlying health problems such as diabetes and obesity are already among the highest in the world.

French Polynesia, an overseas territory of France, is currently facing a disastrous outbreak. In the three days to Monday, the territory, which has a population of almost 300,000, recorded about 2,745 cases. It has recorded about 39,000 cases, more than 10 per cent of the population. Most of the territory's cases occurred after it reopened its borders to tourists last year.

Fiji, which is also a popular tourism destination, has been more cautious about allowing international visitors to enter. Its current outbreak is believed to have started with an infected traveller returning from India, who passed the virus to a soldier guarding the quarantine facility.

Fiji's government has been reluctant to impose lockdowns due to the economic and social costs. But regional curfews have been imposed as well as bans on travelling between regions.

The Prime Minister, Mr Frank Bainimarama, has declared a "no jabs, no jobs" policy, requiring that workers must be vaccinated by Oct 31 or risk dismissal.

"It does not matter if you are the CEO of a company, a sole trader, or a salaried employee - you must be vaccinated to continue working or else that business will risk being shut down," he said in a statement last month.

The pandemic has been an economic disaster for Pacific island nations, which are heavily dependent on tourism.

A report last week by ANZ Bank said the Pacific islands' tourism-dependent economies were "decimated" last year.

"This is a difficult period for Pacific island economies," the report said.

"Pacific island governments with limited resources do not have the fiscal firepower to run large stimulus programmes like the developed world."

Analysts believe the best hope for the Pacific nations is to vaccinate their populations quickly.

Despite the logistical difficulties of delivering vaccines to populations spread across remote islands and atolls, vaccination rates have been increasing. Fiji plans to have 50 per cent of the eligible population vaccinated by the end of August.

The nation of Palau recently declared that it had achieved herd immunity after 80 per cent of eligible residents were fully vaccinated. More than 65 per cent of those aged 12 to 17 have also received at least one dose.

Meanwhile, Nauru, a tiny nation which has fewer than 10,000 residents, claimed in May that it was the first country in the world to have delivered a first dose to all adults. More than 80 per cent are now believed to be fully vaccinated. Fortunately, Palau and Nauru are yet to record Covid-19 cases.