As of August 10, 2022, more than 150 active cases have been confirmed in Majuro and scattered cases are being reported in Ebeye. There are reports of illness on some outer islands but these are unconfirmed as COVID. There are likely hundreds of active cases though that have not been counted yet as many people have been using home test kits. Three Test & Treat sites are up and running but also packed.

The RMI COVID-19 Situation Report for August 10th reports 7 hospitalizations and Minister of Health Jack Niedenthal noted that they are short 83 health workers out with COVID. The hospital is closed for emergencies only. Health care workers who are not too sick will likely be called back to work, and trained volunteers such as PSS teachers will likely help staff Test & Treat sites. MOH is working to make these sites more efficient in order to reduce the wait of mothers with children, the elderly and those who cannot come to the sites because of disability or access. They are also working to open sites in Long Island Elementary School, Ajeltake, and Laura.

While Niedenthal described long lines, chaos, panic, stress and illness, our PSS contact also said that overall people are faring well and that everybody are in masks and went straight into precaution mode. It is apparent that covid was making its way through the community last week, and so many people have “got it so fast without even knowing it.” People have been announcing their test results on Facebook and asking whoever they have been in contact with to get tested. MOH expects this to be similar to the outbreak in the Federated States of Micronesia. Three and a half weeks after the first reported cases, the FSM has had 18 deaths but the number of cases have begun to level off, as of August 9th, at 7125.

Despite a drop in new cases, there is still cause to be concerned. Yosiwo P. George, Vice President of the Federated States of Micronesia, remains in the hospital after three weeks and unable to eat or drink is receiving nutritional assistance. Other officials familiar with the Vice President’s health status describe deep worry for his condition and suggest that it is worsening. One official described concerns that the Vice President, who wishes to travel to Kosrae so as to be with his family, may not be able to do so in the near future. The State of Chuuk received two incoming flights last week but have requested to cancel a scheduled flight on August 22nd affecting 139 persons scheduled to travel on that date. FSM Government officials are in ongoing conversation with the Chuuk State Government regarding proposed flight dates for September and October.

According to officials from the US CDC and FSM Department of Health & Social Affairs, one out of every three COVID-19-attributable deaths in the FSM are reflective of persons who were either unvaccinated, or only partially vaccinated; that all deaths in the FSM are reflective of persons who had comorbidities such as diabetes, high blood pressure, and/or obesity; and that no death was reflective of a person who received COVID-19-related therapeutics such as Paxlovid or EvuSheld. The COVID-stat report form August 9th reported 0 current hospitalizations and only 4 new cases in Kosrae. Niedenthal notes this with optimism, “Kosrae reported only a handful of cases yesterday. In a month or so, that will likely be the case here in Majuro. Pohnpei is also getting toward the end of their outbreak, so much so that they were able to ship us 500 doses of PaxLovid last night.”

Niedenthal recognized that a lockdown would not work or improve outcomes because in Micronesia “most of us live in houses with many family members.” However, public and private schools have delayed the start of the school year. PSS and likely private schools as well as sending learn from home plans for their students. People are most in need of PPE, children & adult tylenol and testing kits. Many are hoping that this passes quickly seeing as how the BA.5 variant burned through the FSM 3 times faster than the CDC model initially predicted. And, though there may be severe consequences for the very few, the Marshall Islands are not going into this blind.

Niedenthal is also encouraged by the uptake of therapeutics by the population: “the data from FSM shows, the more vulnerable and heavily symptomatic people that take the therapeutics like PaxLovid, the better the health of our people will be when this is all over. …that we almost ran out of PaxLovid is a great sign, it means our people are taking the advice of our doctors when it comes to these medicines.” Another 2000 doses of PaxLovid are scheduled to arrive early next week along with reinforcements including the same people from the CDC and ASPR who helped lead responses throughout the US Affiliated Pacific Islands (USAPI) of Guam, CNMI, American Samoa, Palau and FSM.

Note: Chikin Melele has been sourcing information about community transmission in the Federated States of Micronesia and Marshall Islands from several reliable sources including press releases from the FSM government, the public social media posts of RMI Secretary of Health Jack Niedenthal, official reports from various departments posted on social media including the RMI Consulate-Arkansas, as well as personal communications from contacts in Majuro. Reference also this FSM COVID-19 Update Briefing (August 8th 2022) on Facebook.