Large number of Covid border cases

Kwajalein Atoll Local Government police officers provide security at the Covid quarantine facility at the Kwaj Lodge at the US Army base at Kwajalein Atoll in this file photo from September 2011. Marshall Islands Covid prevention protocols require that all doctors, nurses and security personnel involved in quarantine live in with the repatriation group for the 14-day quarantine period to eliminate the possibility of spread to the community. Photo: Hilary Hosia.

GIFF JOHNSON

Testing of Marshall Islanders in managed quarantine Friday April 15 saw the largest number test positive for Covid since managed repatriation started nearly two years ago. Seven out of a repatriation group of 72 people tested positive for the coronavirus, according to a government announcement issued late Friday night.

All seven are in quarantine at the US Army base at Kwajalein Atoll. This repatriation group is the first to spend only three days in quarantine in Honolulu prior to departure to the Marshall Islands on Tuesday last week. When the Marshall Islands first began allowing controlled entry to the country in June 2020, the government required two weeks quarantine in Honolulu followed by two weeks quarantine in the Marshall Islands — one of the strictest Covid prevention entry protocols in the world.

These strict quarantine requirements have kept the Marshall Islands Covid free.

“The seven positive tests represent new infections and these individuals do not pose an infectious threat to the community as they remain in secure and monitored quarantine on Kwajalein,” said Secretary of Health Jack Niedenthal in statement released Friday night. “All individuals remain asymptomatic or have mild symptoms and in addition to the protection provided by being vaccinated will also receive oral antiviral medication to prevent progression to severe forms of Covid-19.”

Marshall Islands Covid prevention protocols require that all people entering the country through its monthly controlled quarantine program must be fully vaccinated and boosted. A 14-day quarantine is required. However, due to the positive cases identified Friday, the 14-day period has been extended from Friday instead of from the group’s arrival April 12.

All of the Ministry of Health and Human Services staff and security officials working at the quarantine site tested negative for Covid last Friday, said the ministry.

“We’ve decided that every time someone tests positive in this group, the clock starts over at 14 days — so 14 days from now,” said Niedenthal Friday.

The seven positive cases identified Friday at Kwajalein brings to 14 the number of Covid positive cases in managed quarantine since mid-2020. There has been no community transmission yet in the Marshall Islands, making it one of only a handful of countries globally to remain Covid free throughout the pandemic.

After over a year of requiring two weeks of quarantine in Hawaii, with multiple Covid tests prior to departing to the Marshall Islands, government authorities reduced the Hawaii quarantine late last year to one week. With this group that went into quarantine Friday April 8 in Honolulu, the Marshall Islands reduced its Hawaii quarantine time to three days. Two of the 74 people in quarantine in Hawaii tested positive on their day-three tests and were not allowed to travel to the Marshall Islands.

These are the first border cases involving Marshall Islanders since November 2020. Three Americans in a separately managed Army repatriation group in January also tested positive for Covid in quarantine. In January, as infections around the Pacific escalated due to spread of the omicron variant, Niedenthal warned that if the Marshall Islands gets cases in quarantine, “we can’t afford any mistake. If people test positive in quarantine here, we have to be perfect (to prevent the spread).” Niedenthal noted that lapses in protocols governing quarantine operations in other Pacific islands led to border cases triggering community transmission.

Since it started managed quarantine operations in October 2020, the Ministry of Health and Human Services has required that all of the doctors, nurses and security personnel involved in the quarantine process live in the quarantine facility with each repatriation group as a way to prevent possible community spread in case a person tests positive during the quarantine. That policy remains in effect with the current group in quarantine at Kwajalein.

“As these are border quarantine cases of Covid-19, there are no restrictions of travel between Majuro and Kwajalein, and there are no travel restrictions between Kwajalein and neighboring islands and between Ebeye and Kwajalein,” said the Health Secretary’s statement Friday. He also urged “all individuals aged five years and above (to get) fully vaccinated, which includes being boosted if eligible.”

The Ministry of Health and Human Services has been providing booster shots as well as vaccinating people in the five to 11 age group since late last year. Public health teams have been flying to remote outer islands to continue Covid vaccination services initially begun mid-last year to provide booster shots to adults, as well as vaccinate children.

Covid update:
One more person in managed quarantine at Kwajalein tested positive for Covid Tuesday April 19, bringing the total to eight of people in quarantine with Covid.

This is the group in the RMI Safe Travels Program 4A that returned Tuesday April 11. There are four quarantine sites in operation for this group: The Kwaj Lodge, apartments at the US Army Garrison-Kwajalein Atoll, the Arrak quarantine center in Majuro, and Majuro hospital’s Covid ICU ward.

The latest person to test positive is in one of the apartments at Kwaj and is staying with others who tested positive for Covid last week Friday on their routine day-three Covid test. The Ministry of Health and Human Services reported this week that all persons staying at the Kwaj Lodge, Arrak and Majuro hospital tested negative for the second time.

The discovery of a positive case in quarantine results in extended time in quarantine for the people involved, according to to Health authorities.

“Each time a case of Covid-19 is diagnosed, the quarantine period for individuals sharing the same quarantine space has 14 days added to the overall quarantine time,” said the ministry. “This represents the maximum incubation period for Covid-19. For persons suffering from Covid-19 with mild to moderate disease, they recover in 7 to 10 days and at that point no longer pose an infectious risk.”

If the Kwaj Lodge, Arrak and Majuro hospital groups continue to test negative on their day 14 test next Tuesday, they will be released next week. Those staying with the newly diagnosed case will be eligible for release May 3, pending further negative tests.

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