Covid-free Pacific islands look to rejoin the world


Two of the last four remaining Covid-free nations in the world are preparing to open their borders to re-join the Covid world.

The Federated States of Micronesia has announced its plan to open its borders without quarantine beginning 01 August.

Meanwhile, the Marshall Islands has gradually reduced its quarantine requirements since late last year and the country’s top government administrator said Friday it is no longer “realistic and sustainable” to maintain the two-and-a-half-year border closure.

The Marshall Islands, which since March 2020 when it closed its borders to travel has maintained one of the world’s strictest Covid-prevention systems, is expected to further reduce quarantine as early as next month.

FSM President David Panuelo in a statement published in the Marshall Islands Journal Friday acknowledged that opening this north Pacific nation’s borders “is equivalent to purposefully choosing to introduce Covid-19.”

The health departments in both the FSM and the Marshall Islands have been engaged in an aggressive Covid vaccination programme.

“A significant rationale for delaying the opening of the nation’s borders until 01 August, 2022 is on the premise that the FSM’s vaccination coverage is insufficient (at this time) to prevent widespread human suffering, and the overwhelming of limited medical staff and equipment across the nation,” Panuelo said in his statement.

Both FSM and Marshall Islands have seen multiple so-called “border” cases of Covid in managed quarantine. But there has been no spread into their island communities due to strict rules for quarantine. All four Covid-free nations are in the Pacific. In addition to FSM and Marshall Islands, Nauru and Tuvalu remain Covid-free. Three other areas are also still Covid-free: Macao, Niue and Tokelau.

Until late last year, the Marshall Islands maintained a four-week quarantine system with multiple Covid tests to enter the country: Two weeks in Honolulu prior to departing to the Marshall Islands and a further two weeks in the country. It is currently three days in Hawaii and 14 in Marshall Islands.

The Marshall Islands government is considering eliminating quarantine in Hawaii altogether and reducing the quarantine period in the Marshall Islands.

Government Chief Secretary Kino Kabua said Friday the National Disaster Committee is moving in the direction of easing entry requirements. A Covid “roadmap” is being drafted by the National Disaster Committee that she chairs to present to the cabinet with recommendations for next steps in the Marshall Islands’ management of the ongoing Covid pandemic.

The Ministry of Health and Human Services continues to urge leaders to maintain a quarantine period in Hawaii in order to screen incoming travelers for Covid prior to arrival, and to keep the 14-day protocol in place for in-country quarantine.

However, Kabua and perhaps most of the NDC are expected to support recommendations to the cabinet in the next week to eliminate quarantine in Hawaii and to reduce the quarantine period on Kwajalein and Majuro from 14 to 10 days.

“I don’t believe it’s realistic and sustainable to keep the status quo,” Kabua said. “There is a working group in charge of developing a roadmap that will be presented to the cabinet on the path forward for summer onwards and on when we can expect to relax the entry requirements.”

“It’s certainly a joy not wearing face masks and being Covid-19 free,” said the Chief Secretary. But, she added, “we really should now be talking about what the impacts will be when there is introduction of the virus into the community and the ways to cope and move forward. In other words, what are some things we need to do to manage Covid-19 if and when it hits our communities — testing and environment and workplace modifications. The virus is not going anywhere and it’s only inevitable that it will reach our communities.”

The Ministry of Health and Human Services — and the country — is more prepared to face Covid today due largely to Covid prevention policies that have allowed it to learn from the experiences of island neighbours with Covid and the availability of Covid testing gear, vaccines, and medicine used to treat those who test positive, said Secretary of Health Jack Niedenthal.

“By being careful about reducing our protocols, we now have 30,000 rapid tests on island,” he said. “Palau had issues with testing as did American Samoa and Kiribati. But by waiting and being careful we now will not have that issue. Again, letting science catch up to the virus, we now have testing that other places didn’t have.”

Kabua recognised the Ministry of Health and Human Services for its extensive Covid vaccination programme that she said is “a key component towards moving to a more relaxed entry and eventual opening of our borders.” The ministry reports over 70% of people in the urban centres and remote outer islands are fully immunised. But as this is based on 2011 census population numbers and preliminary results from the late 2021 national census indicate the population has declined by over 20% due to out-migration, vaccine completion numbers are likely closer to 90%. Health staff have made a big push over the past several months to distribute Covid booster shots throughout the country.

“It may be scary to a lot of us here in the Marshall Islands, but the world has moved on and adapted to Covid-19,” Kabua said, adding “so must we. One thing for sure is that the vaccines and boosters work in preventing severe illnesses and hospitalisations.

“At what point do we decide to live with the virus?” she asked. “The roadmap will be our guide.”

While the Marshall Islands is now better prepared, Niedenthal points out that it can expect serious problems from an initial outbreak based on the experience of other island nations with Covid.

“If we look at the recent March Covid outbreak in American Samoa, which has a similar population to us, a better vaccination rate, and similar co-morbidities with their people as we do, in just a little over two months they have had 30 deaths from Covid,” he said. “That’s two months with an average of a (Covid) funeral every other day. An outbreak of this virus potentially comes with months of school and business closures, so there is also a heavy social and economic impact to bear. Finally, there are Covid factors we are just learning about, like the long-term impact on some people’s health who have had even mild cases of Covid.”

But government and business leaders are looking at negative impacts of the extended border closure on economic development and donor-funded projects including major infrastructure projects funded by the United States, Japan and the World Bank delayed for over two years. In addition, the U.S and the Marshall Islands are gearing to negotiate funding and other key provisions of the long-term Compact of Free Association treaty that requires in-person discussions.

FSM President Panuelo made it clear his country is now in a race to be as ready as possible for the announced 01 August opening of its borders to travelers, who after that date will only need to show proof of full vaccination and a negative Covid test to enter the FSM.

“Choosing to open the nation’s borders on 01 August is equivalent to purposefully choosing to introduce Covid-19 into the FSM shortly thereafter,” he said. “Thus, it is essential that the decision be made so the nation transitions from Covid-19 free to Covid-19 protected.”

“Opening up means letting Covid in, and that comes with consequences,” said Niedenthal. “As time has gone by, with many forms of Covid testing, Covid vaccines, new scientific information, and the new Covid medications we have, these consequences for having an outbreak of Covid have lessened. But they are still very concerning.”

Niedenthal said that while the Ministry of Health isn’t making the decisions to lessen quarantine days, the ministry will be “ready to react to whatever situation we encounter. I have a lot of confidence in the people I work with.”

Kabua said her aim to have the Covid Roadmap submitted to the cabinet for initial review the first week of June. The cabinet’s endorsement will launch steps toward re-opening the country’s borders.