BY GIFF JOHNSON
Marshall Islands Correspondent
MAJURO, Marshall Islands — After 26 months with their borders closed for COVID prevention, the Federated States of Micronesia has announced an Aug. 1 opening of its borders, while the Marshall Islands continues to gradually reduce quarantine time for inbound travelers.
The Marshall Islands and FSM are among fewer than 10 countries globally that have experienced no community transmission of COVID. Strict entry control has allowed them to contain COVID to “border” cases in government-managed quarantine. But both governments appear set to open and rejoin the rest of the world, even though it will bring COVID to their islands.
While FSM President David W. Panuelo has announced his government’s expected opening date, the Marshall Islands has gradually reduced its quarantine requirements since late last year and the country’s top government administrator said in late May it is no longer “realistic and sustainable” to maintain the two-and-a-half-year border closure.
The Marshall Islands, which since March 2020 when it closed its borders to travel has maintained one of the world’s strictest COVID-prevention systems, is expected to further reduce quarantine in June for regular repatriation groups.
The two island countries have followed different patterns for border control. The Marshall Islands, which hosts the U.S. Army’s missile testing range at Kwajalein, established a weekly repatriation system for Army workers and their families that started in June 2020 and initially required four weeks of quarantine. By October that year, the Marshall Islands launched its own monthly repatriation program, which has continued to now.
Even with regular repatriation groups, businesses — as well as schools and other entities — in the Marshall Islands have suffered a serious manpower shortage, unable to regularly bring in needed skilled workers. Pacific International Inc. has seen many of its big government-funded infrastructure projects experience delays due to lack of skilled workers. PII CEO Joseph “Jerry” Kramer has looked at options for chartering flights from the Philippines to bring in one or more large groups of workers, who would quarantine in Majuro before being released to the workforce.
In contrast to the Marshall Islands, the FSM has allowed very few repatriation flights and didn’t begin a sporadic process of bringing people into the country until last year.
In a statement issued May 17, Panuelo acknowledged that opening FSM borders “is equivalent to purposefully choosing to introduce COVID-19.”
The health departments in both the FSM and the Marshall Islands have been engaged in aggressive COVID vaccination programs. They are also well supplied by the U.S. Centers for Disease Control with various vaccines and new medications used to treat people who test positive for COVID.
“A significant rationale for delaying the opening of the nation’s borders until August 1, 2022 is on the premise that the FSM’s vaccination coverage is insufficient (at this time) to prevent widespread human suffering, and the overwhelming of limited medical staff and equipment across the nation,” Panuelo said.
Both the FSM and Marshall Islands have seen multiple so-called “border” cases of COVID in managed quarantine. But there has been no spread into their island communities due to strict rules for quarantine. All four COVID-free nations are in the Pacific. According to the World Health Organization, in addition to the FSM and Marshall Islands, Nauru and Tuvalu remain COVID-free, as do a few other islands: Wallis and Futuna, Pitcairn, Tokelau and Niue.
Until late 2021, the Marshall Islands maintained a four-week quarantine system with multiple COVID tests to enter the country: Two weeks in Honolulu prior to departing to the Marshall Islands and a further two weeks in the country; currently three days in Hawaii and 14 in the Marshall Islands.
The Marshall Islands government is considering eliminating quarantine in Hawaii altogether and reducing the quarantine period in the Marshall Islands.
Marshall Islands government Chief Secretary Kino Kabua said the National Disaster Committee is moving in the direction of easing entry requirements. A COVID “roadmap” is being drafted by the National Disaster Committee that she chairs to present to the cabinet with recommendations for next steps in the Marshall Islands’ management of the ongoing pandemic.
The Ministry of Health and Human Services continues to urge leaders to maintain a quarantine period in Hawaii to screen incoming travelers for COVID, and to keep the 14-day in-country quarantine in place.
However, Kabua and perhaps most of the NDC are expected to support recommendations to eliminate quarantine in Hawaii and reduce the quarantine period on Kwajalein and Majuro to 10 days.
“I don’t believe it’s realistic and sustainable to keep the status quo,” Kabua said. “There is a working group in charge of developing a roadmap that will be presented to cabinet on the path forward for summer onwards and on when we can expect to relax the entry requirements.”
“It’s certainly a joy not wearing face masks and being COVID-19 free,” she said. “We really should now be talking about what the impacts will be when there is introduction of the virus into the community and the ways to cope and move forward. In other words, what are some things we need to do to manage COVID-19 if and when it hits our communities — testing and environment and workplace modifications. The virus is not going anywhere and it’s only inevitable that it will reach our communities.”
The Ministry of Health and Human Services — and the country — is more prepared to face COVID today due largely to COVID prevention policies that have allowed it to learn from the experiences of island neighbors with COVID and the availability of COVID testing gear, vaccines, and medicine used to treat those who test positive, said Secretary of Health Jack Niedenthal.
“By being careful about reducing our protocols, we now have 30,000 rapid tests on island,” he said. “Palau had issues with testing as did American Samoa and Kiribati. But by waiting and being careful we now will not have that issue. Again, letting science catch up to the virus, we now have testing that other places didn’t have.”
Kabua said the Ministry of Health and Human Services COVID vaccination program is “a key component towards moving to a more relaxed entry and eventual opening of our borders.” The ministry reports more than 70% of people in the urban centers and remote outer islands are fully immunized. But as this is based on 2011 census population numbers and preliminary results from the late 2021 national census indicate the population has declined by over 20% due to out-migration, vaccine completion numbers are likely closer to 90%. Health staff have made a big push over the past several months to distribute COVID booster shots throughout the country.
“It may be scary to a lot of us here in the Marshall Islands, but the world has moved on and adapted to COVID-19,” Kabua said, adding “so must we. One thing for sure is that the vaccines and boosters work in preventing severe illnesses and hospitalizations.”
While the Marshall Islands is now better prepared, Niedenthal said it can expect serious problems from an initial outbreak. The CDC based on experience with other Pacific islands, estimates a likelihood of 28 deaths from an initial COVID outbreak.
“If we look at the recent March COVID outbreak in American Samoa, which has a similar population to us, a better vaccination rate, and similar co-morbidities with their people as we do, in just a little over two months they have had 30 deaths from COVID,” he said. “That’s two months with an average of a (COVID) funeral every other day. An outbreak of this virus potentially comes with months of school and business closures, so there is also a heavy social and economic impact to bear. Finally, there are COVID factors we are just learning about, like the long-term impact on some people’s health who have had even mild cases of COVID.”
But government and business leaders are looking at negative impacts of the extended border closure on economic development and donor-funded projects including major infrastructure projects funded by the United States, Japan and the World Bank delayed for over two years. In addition, the U.S. and the Marshall Islands are gearing to negotiate funding and other key provisions of the long-term Compact of Free Association treaty that requires in-person discussions. mbj