RMI extends travel ban

Kwajalein Hospital Chief Medical Officer Dr. Craig Corey shows Kwajalein Mayor Hirata Kabua the Covid-19 test machine used at the US Army base. Photo: Hilary Hosia.

The RMI National Disaster Committee extended the Covid-19 border closure for another month with the issuance of a new Travel Advisory late last week.

Chief Secretary Kino Kabua issued Travel Advisory 14 June 4, extending the ban on incoming travelers to July 5. It also continues the ban on travel between Majuro and Kwajalein on United Airlines or other international carriers.

A change was instituted for container ships and fuel tankers “that have a history of entering Majuro and Ebeye ports and records indicating that they have had the same master and crew members with consistently healthy medical records and no record of disembarkation from their vessels.”

These vessels are allowed to come into RMI ports to discharge cargo without meeting the previous 14-day quarantine, but still must adhere to a no human-to-human contact policy in the offloading process.

In other Covid-19 news over the past week:

• Differing Covid-19 prevention quarantine protocols between the NDC and the US Army Garrison, Kwajalein Atoll for repatriation of essential Army base personnel led to a special meeting June 10 in Majuro to come to agreement. Details were not immediately available from the discussions Wednesday.

USAG-KA Commander Col. Jeremy Bartel met with the NDC and RMI leaders in Majuro and leadership at Ebeye over the past several weeks, which led to RMI Cabinet and Ebeye leadership approval of the Army’s plan to bring in six workers for the base despite the now three-month travel ban.

But disagreements on Covid-19 prevention protocols to be followed prompted the National Disaster Committee and the Ministry of Health and Human Services to call off a scheduled visit to Kwajalein Wednesday this week for Covid-19 prevention discussions with the Army, as an indication of their concern. This resulted in a quick decision by Col. Bartel to instead fly to Majuro Wednesday for meetings with government leaders, the NDC and others.

While Cabinet and Ebeye leaders have endorsed Bartel’s repatriation plan for essential base workers, in the background, the National Disaster Committee and the Ministry of Health and Human Services have pushed a two-step quarantine process that is at odds with the Army’s plan.

This led the Army command this past weekend to request — and receive — an exemption from the NDC’s two-step repatriation protocol for the six individuals who arrived at Kwajalein Tuesday this week. They were immediately put into a 14-day quarantine on the base.

The five medical staff and one firefighter were listed as essential workers for the base, which Bartel says is currently down nearly 300 on its normal workforce because of the Covid-19 travel ban.

The NDC and public health officials have issued a two-step quarantine plan that is to be used once the green light is given for repatriating Marshallese now stuck overseas. It involves a supervised quarantine for two weeks in Honolulu, with repeated testing for Covid-19, and another 14-day quarantine in Majuro or Kwajalein, also with repeated testing.

The Army’s plan is to test returning workers in Honolulu prior to departure, then on arrival and throughout the 14-day quarantine at Kwaj — a plan that was explained in detail in a well-attended public meeting on Ebeye two weeks ago, and to RMI officials in Majuro during meetings with Bartel and US Ambassador Roxanne Cabral in recent weeks.

The NDC is taking a cautious approach to repatriation of people from the United States because it has the world’s highest number of Covid-19 infections and deaths.

• The RMI government endorsed a $42 million economic response plan for the Covid-19 coronavirus. Approved by Cabinet June 2, the plan to spend $42,336,463 on Covid-19 related activities went for a public hearing before the Nitijela Appropriations Committee late last week.

Nearly half of the $42.3 million is from the Asian Development Bank, which is providing nearly $20.5 million. Other large amounts are coming from the US Centers for Disease Control, $5.4 million; US CARES Act, $3.9 million; World Bank, $2.5 million; European Union, $2.7 million; US Department of Education, $1.9 million; and Taiwan, $1.2 million.
A total of $6 million is set aside for economic relief, and another $6.7 million is for recovery.

• The RMI lost half of its coronavirus testing capability late last week when the US Centers for Disease directed the RMI — and other US-affiliated islands in the region — to halt use of the Abbott ID NOW lab equipment.

This brand of testing was in use in the White House in Washington, and throughout the US-affiliated island area. The CDC advised the islands late last week to “temporarily discontinue testing with Abbott ID NOW” equipment and test kits.
Majuro and Ebeye hospitals also have another system for testing for coronavirus known as GeneXpert.

Health Secretary Jack Niedenthal said the hospitals still have the GeneXpert lab testing gear, but the CDC directive reduces the number of test kits now available by about half. CDC in an advisory said the halt on Abbott ID NOW test kits was “temporary and is expected to change when new information becomes available.” The directive was not explained further.

• A total of 157 Marshallese stranded by the RMI border closure in March have been approved to receive a $500 ex gratia payment from the RMI government, according to the Office of the Chief Secretary.

Four hundred fifty-six names were submitted to the RMI for consideration of the Covid-19-related one-time payment. A total of 211 were university students studying abroad in Palau, Fiji, Vanuatu, Hawaii, US Mainland, Taiwan, Germany and Okinawa.

The 211 students may be able to meet the criteria for the ex gratia payment system that was approved April 27 by President David Kabua and the Cabinet.

The Office of the Chief Secretary said in a statement: “As with RMI citizens and residents who had traveled and are now stranded, an RMI student also needs to provide documentation that he or she is stranded.

For instance, recent graduates or those whose schools were closed down and were required to return to RMI but could not due to the border shutdown, are eligible for the ex gratia assistance, unless they received other sources of income such as financial assistance under (the US) CARES Act, educational leave income, and/or advancement of foreign scholarships.”

The Office of the Chief Secretary (OCS) said it is seeking information to ensure students abroad are assisted by either ex gratia Covid‐19 financial assistance provided by the RMI government or by other sources.

For RMI citizens who traveled out and are affected by the border shutdown, OCS screened 245 individuals who applied for the ex gratia Covid-19 financial assistance, on top of the 211 post‐secondary students around the world.

Of the 245 individuals, 157 are eligible and have been advised to fill out a payment form. An additional 19 are eligible pending confirming of a return ticket to RMI, 69 are ineligible, and six are currently undergoing the verification process, with expectation of more names to be submitted.

In late May, the National Disaster Committee voted to put in a second sub‐criteria related to “exit date” criteria applicable only for expectant mothers who traveled off-island to give birth. This amendment allows for an extended window for consideration of eligibility for pregnant women in line with airline policies that require them to fly months prior to their due date and allow for post‐delivery care for mothers who had just given birth.

The new criteria states that expectant mothers would have had to travel between October 1, 2019 and March 22, 2020 to meet criteria two on RMI exit dates.

• Prior to the arrival of long-awaited essential personnel to the United States Army Garrison – Kwajalein Atoll (USAG-KA) installation Tuesday, Commander Colonel Jeremy Bartel and Chief Medical Officer Dr. Craig Corey took Kwajalein Mayor Hirata Kabua and the Journal through the step-by-step look at the quarantine process that has been planned for months.

The briefing took off at the USAG-KA headquarters where Col. Bartel showcased written protocols he referred to as a “living document” that gets modified as new information is learned. The book, a thick binder containing multiple action plans and standard operating procedures, covers a range of multiple scenarios imagined and the steps necessary to carry out the procedures, according to Bartel.

Mayor Kabua expressed confidence as Dr. Corey walked him through the rigorous process for managing a case of Covid-19, should one be diagnosed: through the hospital emergency room and past the negative pressure room, where critical patients would be treated.

Bartel and Corey said all incoming personnel would be assumed Covid-19 positive throughout the whole process and will be treated as such for the duration of 14-day quarantine. The individuals returning to Kwaj are tested for Covid-19 prior to departure from Honolulu, on arrival at Kwaj and during and at the end of the quarantine period.

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