Code Red: Covid arrives

Covid hit town, sneaking in the back door just like the famed Marshallese trickster Letao. But local residents rose to the challenge, with virtually everyone donning face masks within minutes of learning that Covid was here. And, despite Covid, people still have to eat, right? The popular Uliga Protestant Church women’s takeout lunch program was in high demand Tuesday, with Almi Juano helping customers to get their plates. Photo: Wilmer Joel.


This is how the Marshall Islands went from being one of a handful of places in the world to still be Covid-free two-and-a-half-years into the pandemic to joining the rest of the world August 8.
Majuro hospital authorities discovered the first “cluster” of Covid positive cases Monday afternoon.

Parents brought their 17 and nine year old sons into Majuro hospital’s out-patient clinic because they were sick with flu-like symptoms: Coughing and a scratchy throat. The Ministry of Health and Human Services had launched routine Covid testing of patients with these type of symptoms several weeks earlier as concern about the possible spread of Covid increased due to increasing numbers in repatriation groups.

Dr. Cody Jack administered Covid tests on the two boys. Both rapid antigen tests showed positive. Per MOHHS Covid protocol, Dr. Jack picked up the phone and rang Dr. Frank Underwood, director of Public Health with the news, who in turned called Secretary Jack Niedenthal. While this communication was happening, Dr. Jack was already repeating the Covid test on the boys to confirm the initial result. The answer: Both positive a second time.

Then the parents, who were sitting in out-patient waiting, were called in for Covid tests. They were also both positive. None of the four had a history of travel or any contact with quarantine operations.

Health authorities said it was likely that the virus was moving around the Majuro community at least four-to-five days before the first cases were identified August 8.

MOHHS’ Covid protocol kicked into high gear at this point. “To the credit of MOHHS staff, they jumped right in, they knew what to do,” said Niedenthal. Rapid antigen tests (RAT) were administered to all staff in the facility. Two came back positive: A nurse and an Emergency Room doctor. Then two security guards tested positive. Next, they proceeded to test all inpatients in the medical wards, with a handful of the patients testing positive.

The Covid fallout hit Secretary Niedenthal, who’d had a sore throat since Sunday evening, but had put it down to swimming at Laura Beach Sunday. When he returned home Monday night after 11pm, before entering his house, he self-administered a Covid test, which showed he, too, was positive for Covid. He proceeded to test family members at the house who were negative. He then isolated himself in a room in his house and continued to engage via online platforms with health workers, US and international agencies, and others as the Covid operations began moving fast.
By mid-day Tuesday, over 50 people were confirmed positive, including over 30 Majuro hospital workers. By Wednesday, 83 MOHHS workers were out with Covid.

“We’re losing people quickly and we don’t have a lot of wiggle room (because of staff shortages),” Niedenthal said.

He indicated that President Kabua would sign letters to the US government and the World Health Organization Wednesday seeking additional Covid aid. CDC has provided medical surge support teams to both Palau early this year and now the FSM following their Covid outbreaks, and is expected to expand its support in response to the Covid outbreak in progress.

An example of this support from CDC was the immediate response to the RMI need for more PaxLovid, the therapeutic medicine given to people who test positive with symptoms to help reduce their symptoms.

“Dr. Frank informed me (Wednesday) that they were running out of PaxLovid because the uptake was so great, which is really wonderful,” Niedenthal told the Journal Wednesday afternoon. “So I put that message out to my CDC colleagues and they’re sending in 500 doses on tonight’s (Wednesday’s) United flight, and then another 2,000+ doses should be coming in on Tuesday when they (CDC team) come in.”

Mr. Casual Taxi Driver is the cool dude in his magnificent mask. Taxi drivers, workers, store customers all donned face masks within hours of the Covid outbreak. Photo: Wilmer Joel.

More Covid news:

• It is mostly business as usual in the private sector after the arrival of Covid — except for face masks and lines to implement “social distancing.” But businesses are open and doing a brisk business.
• The hospital is not open to regular service, however, having shifted to its test to treat centers at MIHS, DES and the tennis courts by the hospital.

• Meantime, AMI shut down its flights to the outer islands this week in order to contain further spread of Covid for the time being, while government ships were halted. This included one vessel that left last Saturday for Wotje with students and teachers heading to Northern Islands High School on Wotje. As of Wednesday it was anchored in Maloelap awaiting further instructions from Majuro.

• The government moved quickly Monday night to announce a halt to the start of the new school year with all island schools scheduled to open this week.

• Quarantine in Majuro was ended after two-and-a-half-years. Tuesday’s United Airlines flight to Majuro was the first since March 2020 where passengers could freely deplane, collect their luggage and walk out of customs to greet their friends and family in the airport terminal. They were supposed to stay at home for five days.

• President David Kabua delivered a brief 90-second statement to the nation Monday night via an online live stream in which he announced that the Ministry of Health and Human Services had confirmed six people positive in the capital of Majuro. The President’s short speech was the first official notice of news that in the fashion of a small island had spread several hours prior to his speech. “I advise people to remain calm and follow the protocols to prevent Covid,” Kabua said. President Kabua, who wore a face mask while speaking, advised the country to follow established protocols of wearing face masks when in public.

• Laboratory tests of people who were positive for Covid while in managed quarantine last month showed the BA.5 variant dominated. Ministry officials said they were proceeding on the basis that BA.5 is what they are seeing in the current outbreak.

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