PaxLovid: RMI’s magic bullet

A team of Red Cross volunteers was among hundreds of people who volunteered to help staff the Ministry of Health and Human Services alternative care sites set up at MIHS, DES, the tennis courts next to the hospital, at Long Island Elementary School, and Laura Clinic.


Important facts emerged from the first two weeks of the Covid outbreak, as of Tuesday this week:

• 12 of the initial 14 deaths from Covid were dead on arrival (DOA) at Majuro or Ebeye hospitals, meaning the 12 did not seek or receive medical care for their condition. It also means only two had died in the hospital in the early stage of the outbreak.

• The majority of the deaths were among people who were not vaccinated or partially vaccinated.

• The Marshall Islands confirmed 13,000 positive cases earlier this week, two weeks into the outbreak. This has been documented by Johns Hopkins University in the US as the world’s highest-ever rate of spread in a seven-day period.

• The Ministry of Health and Human Services has been able to maintain a steady supply of the miracle drug PaxLovid, thanks to its good working relationship with both the US government and other US-affiliated islands in the region. This means that people who test positive with Covid, have symptoms and meet other criteria (age, health condition) have a proven Covid treatment available.

• A big decline in the number of daily positive cases Monday this week compared to the end of last week. Last week, several days saw close to or over 1,000 new cases in Majuro and Ebeye was running in the 300-400 range. Monday’s Covid situation report from the Ministry of Health showed new cases for Majuro at 219 and Ebeye 139.

“The really great news is that both Majuro and Ebeye numbers have seen huge downturns in positive cases, especially on Majuro where we went from 690 cases a few days ago to only 219 cases reported yesterday (Monday) despite being open for the same hours,” said Health Secretary Jack Niedenthal Tuesday this week.

The latest delivery of PaxLovid arrived in Majuro Tuesday morning — 8,000 doses shipped from the United States by the Health and Human Services Department. This supplements the over 2,000 doses already distributed to people in Majuro, Ebeye and the outer islands the past two weeks.

“8,000 doses of PaxLovid arrived today (Tuesday),” said Niedenthal. “5,900 for Majuro and 2,100 were sent directly to Kwajalein/Ebeye. We will also be sending this medicine out to the neighboring islands to help fight Covid-19 outbreaks there, which is important because some of the neighboring islands never got the booster rounds of the vaccination.”

The unfortunate element in the deaths of the 12 who did not receive medical attention is that PaxLovid is helping many people to reduce their symptoms to non-severe levels.

“We knew that PaxLovid would be critical in our response to this disease because we have so many immuno-compromised people here in the RMI,” said Niedenthal.

Niedenthal said PaxLovid is essential for Covid treatment on the outer islands due to lower levels of vaccination protection on remote islands. Through Monday, Covid had been confirmed on eight outer islands: Ailinglaplap, Ailuk, Arno, Aur, Jaluit, Maloelap, Mili and Wotje.

“I said well over a year ago that the magic bullet for Covid would be a pill,” Niedenthal said. “PaxLovid comes very close to this because it really helps prevent people who are immuno-compromised from getting severe symptoms.”

In related Covid news: US-based medical doctors were overflowing with praise for the Marshall Islands Ministry of Health and Human Services response to the Covid outbreak.

“The Marshall Islands has exceeded most expectations to deliver testing and treatment for large numbers of people, and to provide care for those with Covid,” said Dr. Richard Brostrom, the US Centers for Disease Control Field Medical Officer who arrived in RMI last Tuesday. Brostrom has been engaged in US responses in all US-affiliated islands, including most recently in Pohnpei and Kosrae.

“The use of PaxLovid (in RMI) is appropriate, by the book, and unprecedented,” he said Wednesday this week. He said PaxLovid has been well used in all US-affiliated islands with Covid. But uniquely in RMI, more people sought healthcare and didn’t stay home when they got Covid, he said. “It was an opportunity for the Ministry of Health to deliver PaxLovid,” he said.

A lot of work went into Covid preparation for RMI, Brostrom noted, including the plans for the test to treat facilities and pre-staging supplies in advance of the first outbreak. What the visiting doctors have seen in the first two weeks of the outbreak is “an amazing delivery (of services) that we haven’t seen elsewhere,” he said.

Dr. Sheldon Riklon, who works at the University of Arkansas Medical School, has been working at the Laura Clinic since he arrived in Majuro last week to assist the ministry in delivering services. “It’s amazing to see how the Ministry of Health has responded — not just now, but for two and a half years,” said Riklon. “RMI has done well. The Ministry of Health leadership prepared RMI for this (Covid outbreak).”

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