As covid cases drop, Marshall Islands praised for ‘unprecedented’ response

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Marshall Islands Red Cross Society volunteers
Marshall Islands Red Cross Society volunteers were among hundreds who responded to the Ministry of Health and Human Services' need for support at community test to treat sites in the early stage of the country's first covid outbreak. Image: RNZ Pacific/Red Cross

By Giff Johnson, editor of the Marshall Islands Journal and RNZ Pacific correspondent in Majuro

United States-based medical doctors have praised the Marshall Islands for an “unprecedented” response to its first covid outbreak, as the positive case numbers declined dramatically this week after a record-setting first two weeks.

“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 Marshall Islands last week to assist the Ministry of Health and Human Services.

Brostrom has been engaged in the US response in all US-affiliated islands, including most recently in the Micronesian states of Pohnpei and Kosrae.

The Marshall Islands was seeing above 1000 positive cases daily last week, but those numbers dropped to the low hundreds by Monday this week as the omicron BA.5 variant appeared to peak and drop off quickly.

Last week, Johns Hopkins University, which tracks covid cases globally, reported that the Marshall Islands set a seven-day all-time record for the rate of positive cases of covid.

“But what the data also shows is a jurisdiction that is able to test, treat and provide access to healthcare,” said Dr Brostrom.

“BA.5 will behave the same everywhere,” he said. “The Marshall Islands had access points for people to get tested and treated, it was prepared and it handled thousands of people in a short period of time.”

14 died in two weeks
No deaths have been reported since last Friday. During the first two weeks, 14 people died of covid. The majority of the deaths were among people who were not vaccinated or partially vaccinated, the ministry reported.

Health authorities put the low number of deaths down to widespread use of PaxLovid, a five-day treatment that Dr Brostrom said was 90 percent effective in reducing symptoms of covid.

“The use of PaxLovid in Marshall Islands is appropriate, by the book, and unprecedented,” Brostrom said.

He said PaxLovid had been well used in all US-affiliated islands with covid. But uniquely in the Marshall Islands, 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.

‘One of the best responses to this pandemic the world has seen’
Health Secretary Jack Niedenthal praised health workers and community volunteers for their response under pressure when more than 200 were initially sidelined by covid in the early days of the outbreak.

“As this current outbreak of covid-19 begins to lessen, the facts say, even with the complicated logistical issues and limited resources that we have in the Marshall Islands, and even though we have a very immuno-compromised population, we have had one of the best responses to this pandemic the world has seen,” said Niedenthal.

“Our goal from the beginning has been resolute: Let the science catch up to the virus, and now we are seeing the result of over two years of diligent prevention and preparation.”

Among unprecedented events in the Marshall Islands, Niedenthal said the nation was the “only country in the world to have been able to offer people of all ages vaccines before we had community spread of the virus”.

He added: “Our current fatality rate of 0.1 percent of covid-19 cases ranks as among the best in the world with only Palau having a similar fatality rate for this virus.”

Dr Brostrom was part of a “surge support medical team” involving CDC, WHO, Taiwan and other medical officials that arrived during the second week of the outbreak.

What the visiting doctors have seen in the first two weeks of the outbreak was “an amazing delivery (of services) that we haven’t seen elsewhere,” Dr Brostrom said.

Speed in setting up care sites
Dr Brostrom said the Ministry of Health’s speed in setting up the alternative care sites in the community was key to dealing with the BA.5 variant that is in Marshall Islands. BA.5 is milder in its effect than earlier variants but much more contagious.

“It is so fast that if you spend a week to get sites set up, you missed the boat.”

He said the country had seen a five-day surge in cases, a further five days at the peak number, and now five days of numbers dropping down.

“It is most certainly going down,” he said.

“It’s amazing to see how the Ministry of Health has responded — not just now, but for two and a half years,” said Dr Sheldon Riklon, one of two Marshallese US-trained medical doctors working at rural clinic in Majuro.

“The Marshall Islands has done well. The Ministry of Health leadership prepared the Marshall Islands for this.”

This article is republished under a community partnership agreement with RNZ.

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