MAJURO — United States-based medical doctors 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 U.S. 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 U.S. response in all U.S.-affiliated islands, including most recently in Pohnpei and Kosrae.
The Marshall Islands was seeing above 1,000 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 of 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 with over 30,000 cases per one million population.
“But what it (the Johns Hopkins data) also shows is a jurisdiction that is able to test, treat and provide access to healthcare,” said Brostrom. “BA.5 will behave the same everywhere,” he said, making the point that the key was being prepared. “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.”
No deaths have been reported since last Friday. During the first two weeks, 14 people died of Covid — but 12 of these deaths from Covid were dead on arrival at Majuro or Ebeye hospitals, meaning the 12 did not seek or receive medical care for their condition. 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 Brostrom said is 90% effective in reducing symptoms of Covid.
“The use of PaxLovid (in Marshall Islands) is appropriate, by the book, and unprecedented,” he said Wednesday this week. He said PaxLovid has been well used in all U.S.-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.
Health Secretary Jack Niedenthal praised health workers and community volunteers for their response under pressure when over 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 Thursday. “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 this western Pacific nation is 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” and added, “Our current fatality rate of 0.1% of Covid-19 cases ranks as among the best in the world with only Palau having a similar fatality rate for this virus.”
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 is “an amazing delivery (of services) that we haven’t seen elsewhere,” Brostrom said.
Dr. Sheldon Riklon, one of two Marshallese U.S.-trained medical doctors who works at the University of Arkansas Medical School, has been working at rural clinic in Majuro 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 Wednesday. “Marshall Islands has done well. The Ministry of Health leadership prepared the Marshall Islands for this (Covid outbreak).”
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,” said Brostrom.
He said the country has 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.
Health authorities had dispensed over 2,000 doses of PaxLovid on Majuro, Ebeye and in remote outer islands through last weekend. Some of the initial PaxLovid was quickly shipped to Majuro from the Federated States of Micronesia and American Samoa health authorities that stepped in to help the Marshall Islands as Covid cases were spiraling upward in the two weeks after the August 8 confirmation of community spread.
On Tuesday this week, a new delivery of 8,000 doses of PaxLovid, shipped by the U.S. Health and Human Services Administration, arrived in the Marshall Islands to allow the ministry to continue using the Covid drug to treat serious cases.
“We also knew that the medicine (PaxLovid) would be a critical weapon in our fight against Covid when it gets to the neighboring islands, because some of the outer atolls weren’t very well covered like Majuro and Ebeye route with regard to vaccinations,” Niedenthal said Wednesday. “We just didn’t have the time nor the resources to be able to do this. I said well over a year ago that the magic bullet for Covid would be a pill. PaxLovid comes very close to this because it really helps prevent people who are immuno-compromised from getting severe symptoms.”
The Ministry of Health sent medical teams to several of these atolls last week and more teams were going out this week to other islands to provide testing and treatment services.
Marshall Islands authorities say the Covid drug PaxLovid is a “magic bullet” that has helped reduce severe health complications in the country. A new shipment of 8,000 doses, donated by the United States Health and Human Services Department, arrived Tuesday.
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.
