Women's Health

Marshall Islands, once nearly Covid-free, faces outbreak


As a remote Pacific nation, the Marshall Islands has been almost completely unaffected by Covid-19, recording only a handful of cases throughout the pandemic, with no community transmission detected.

But in just over a week, more than 4,000 people have tested positive out of a population of around 60,000, including the country’s Health and Human Services Secretary Jack Niedenthal. He provided updates on Facebook and said 75% of those tested in Majuro, the capital, had Covid, “an incredibly high positivity rate”.

In an interview on Tuesday, Mr Niedenthal said there was some panic and concern given that the islands, roughly halfway between Hawaii and the Philippines, had not recorded a single case of Covid. Last year.

“So people were thinking, ‘Hey, these guys really know what they’re doing,'” he said. “The problem is that people started wanting to travel, they missed their loved ones, some leaders travelled.”

As life began to return to normal, keeping the virus out was impossible, he said. Mr Niedenthal expected the number of cases to continue to rise, given the dense population. “The next three to four days are going to be quite difficult,” he said.

Hundreds of healthcare workers have been among those infected. At Majuro hospital, vaccinations were halted because almost the entire team was absent, most of the medical records officers were absent and the housekeeping staff was reduced to one person, he said. .

On Aug. 10, Niedenthal called healthcare workers back to work even if they tested positive, saying they would be screened and not interact with patients. He said it was a drastic measure that “has been taken around the world and in the Pacific as Covid numbers are rising rapidly and we have no other choice”.

Hospitalizations and deaths tend to lag behind the number of cases, but as of this week there had been few serious cases, including six deaths.

The population is highly vaccinated: 72% are fully vaccinated in Majuro and 61% have boosters, according to government data. The Marshall Islands closed its borders in early March 2020, taking more drastic measures than its neighbors at the time. It was one of the last places on the planet to have its first cases, when two travelers were quarantined before spreading it in October 2020.

Mr Niedenthal said the first known cases of the current outbreak were in a group of teenagers who had no known travel history or contact with anyone who had been in quarantine. “So we knew we had issues because they came from a crowded community,” he said.

He said that in recent days people have been worried, but there is a strong sense of community on the islands. “It’s not like the panic in the United States where everyone is buying toilet paper,” he said.

And unlike at the start of the pandemic, the islands now have access to Covid treatments, such as Paxlovid, an antiviral drug that has been shown to prevent severe Covid cases, sent by the US government. Representatives from the United States Centers for Disease Control and Prevention have arrived on the island in recent days to help with the response.

Other governments have stepped in: Taiwan has donated thousands of masks, protective gowns and other hygiene products, while American Samoa has sent shipments of Paxlovid. The Australian government has provided protective gear, test kits, masks and face shields.

Angeline Heine Reimers, a government worker in Majuro, said catching the virus had become almost “inevitable”. Many people live in multi-family homes, she said, adding that 15 of the 16 people who live in her home had contracted the virus.

“The good thing is that we had all been vaccinated,” said Ms Heine Reimers, 46, adding that each of their cases had been mild. Many Marshallese live with comorbidities that put them at higher risk if they become ill, and the Marshall Islands has one of the highest rates of diabetes in the world, according to data compiled by the World Bank. “Everyone is really scared,” Ms Heine Reimers said.

Marie Davis Milne, the mayor of Ebon Atoll, about 240 miles southwest of Majuro, said authorities were trying to prevent the spread of the virus by stopping most planes and ships that travel between neighboring islands .

She said that over the past few days she had volunteered at testing sites in Majuro, where some people had waited in the scorching sun for hours. “Even if it’s raining, they don’t move,” Ms Davis Milne said. “They don’t want to lose their place in the queue.”

Jenny Gross and Livia Albeck-Ripka contributed report.

nytimes-Health

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