Marshall Islands Correspondent


MAJURO, Marshall Islands — The Marshall Islands is one of the last COVID-free nations due to a border lockdown that has been in place for nearly two-and-a-half-years. But government authorities are looking to the end of the year to eliminate quarantine requirements and open the country’s borders.

Palau opened its borders late last year and the Federated States of Micronesia has announced it will open its borders Aug. 1, making the Marshall Islands the last of the Compact nations to do so. Marshall Islands Chief Secretary Kino Kabua said on June 30 that the target date to reopen the borders is Oct. 1.

The Ministry of Health and Human Services has been conducting numerous exercises to prepare itself for the arrival of COVID after the borders open.

The U.S. Centers for Disease Controls forecasts the Marshall Islands is likely to see nearly one in four of the 40,000 Marshall Islands residents test positive for COVID and 28 of those will die during an initial wave of infection.

Marshall Islands Director of Public Health Dr. Frank Underwood, at right, leads a Ministry of Health and Human Services planning session at a school basketball court for setting up Covid triage operations in the event of community spread. Photo by Wilmer Joel

The modeling exercise is part of CDC’s ongoing support to the Marshall Islands and other U.S.-affiliated islands to prepare for and respond to Covid when it arrives. In the US-affiliated island region, Guam and the Northern Mariana Islands were the first to see COVID cases, with both identifying their first cases at the outset of the pandemic in March 2020. Meanwhile Palau saw its first community spread of COVID in January, while American Samoa confirmed its first community spread in March. Among U.S.-affiliated Pacific islands, the lone holdouts are the Federated States of Micronesia and the Marshall Islands.

Based on the experience of these and other islands in the region, the CDC forecasts that the Marshall Islands will experience a two-and-a-half-month wave of cases. The information was provided to Marshall Islands authorities in a briefing by the CDC in May.

To date, the four U.S.-affiliated islands with COVID show a lower related death rate than the U.S. mainland and some other Pacific islands, such as Fiji, the Solomon Islands and Papua New Guinea, according to the CDC.

As one of the last nations to be COVID-free, the Marshall Islands has been able to learn from the experiences of neighboring islands with Covid.

Secretary of Health Jack Niedenthal said in mid-June the most important lesson learned from Palau’s experience with a wave of Covid starting in January is to protect the hospital during the initial stages of a Covid outbreak — this is to protect both the patients already in hospital from being infected by incoming COVID patients and, of equal importance, minimizing the exposure of hospital staff so they can remain functional and on the job.

In Majuro and Ebeye, sites away from the hospital will be used to screen, test and treat people who either have COVID or are sick with other illnesses, limiting who needs to go to the hospital.

“The reason why this is so critical is that on any given day we have anywhere from 60 to 80 people who are patients in the hospital,” he said. “What is triggering our more serious approach at this moment is because there is a lessening of quarantine days by the government now. I believe we have the capability of keeping this country COVID free for as long as we want to be COVID free.”

The nation is well prepared, thanks to the CDC, which has provided tens of thousands of doses of three varieties of vaccines, test kits and COVID oral medicines.

“We already have over 30,000 COVID-19 rapid tests in the country; we have lots of therapeutic and prophylactic drugs that can be used for patients who are seriously ill with Covid. We have all the vaccines we need.”

The major issue for Niedenthal when an outbreak occurs after the borders open is the people to manage it. “Imagine having a major outbreak here in Majuro or Ebeye, and then also having outbreaks on the neighboring islands that don’t have adequate medical facilities for dealing with COVID,” he said. “How are we going to address that situation? We, as a country, are going to be facing numerous difficulties. It will be a true test of leadership from all corners of our government.”

“What I also find sad is that people are viewing the outside world struggling with COVID as ‘normal,’ when in reality, what we have here in the Marshall Islands is one of the last ‘normal’ places on earth. To me, and I don’t mean to sound overly dramatic, we are now living in the Garden of Eden. But like Adam and Eve, sometimes people don’t realize what they have is as wonderful as it gets.” mbj