The Marshall Islands health secretary is making no apologies for closing the country to all incoming passengers for two weeks, in an effort to buy time to ward off the Covid-19 coronavirus.
The Marshall Islands on Friday indefinitely banned all overseas travel by government employees and elected leaders in an effort to reduce opportunities for the importation of the new coronavirus. Pictured: Passengers boarding a United Airlines flight in Majuro. Photo: Giff Johnson
The drastic measure was introduced by the National Disaster Committee, sealing the country off from all inbound air travel for two weeks. The order came with little warning, leaving dozens of travellers - including returning Marshallese - stranded in Honolulu and Guam.
But Marshall Islands health secretary Jack Niedenthal was unrepentant.
"They have to understand this rationale," he said in an interview. "This disease went from 28 countries a little over two weeks ago…to 128 countries and territories. It's not waiting for people to have lunch, and we had to move quickly."
The Marshall Islands, a vast smattering of atolls in the north Pacific with a densely-populated capital, Majuro, has spent the past eight months battling a dengue fever epidemic that has drained the country's health resources. Since the outbreak started in July, more than 3000 people have been infected with the mosquito-borne illness, a third of them have been hospitalised.
The country has been in a State of Health Emergency for months, doctors and nurses working seemingly endless hours with wards overflowing into corridors, health budgets withered, and the number of cases remaining stubbornly high despite all efforts. Just two weeks ago, the country recorded more than 200 cases in a single week.
So, with the rapid spread of the coronavirus Covid-19 around the world, and with a rise in cases in Australia, New Zealand and, on Thursday, the first confirmed case in the Pacific - a politician from Tahiti - Mr Niedenthal said drastic measures had to be taken.
"We really need this time and, quite frankly, I don't care what the rest of the world thinks about our really strict travel advisory," he said, saying the two-week period allows the Marshall Islands "breathing space" to build quarantine units and prepare Covid-19 response plans.
"We have to protect our people," he said.
"We don't have a lot of specialists when it comes to protecting infectious disease, we just don't have the expertise here, and if Covid comes here and overwhelms our health system we have to prepare for the worst and just hope for the better."
Mr Niedenthal said already overwhelmed health workers on the Marshall Islands - and he himself - were "scared" of the potential devastation such a virus could wreak if it reached the country.
Downtown Majuro. Photo: Hilary Hosia
Last week, there was a suspected case that came back negative. But Mr Niedenthal said that had prompted a most worrying response: People stopped going to the hospital.
Since that suspected case, Mr Niedenthal said the Majuro hospital's outpatients department had gone from seeing hundreds of patients a week regarding dengue concerns to just a few dozen.
Considering the hundreds they were seeing just two weeks ago, that was too fast a drop off, Mr Niedenthal said.
"When I see that very quick drop off right after the suspect case for Covid that turned out to be negative here, to me, I've watched this thing every day for eight months, and when I see that drop there has to be a reason for that to have a sudden drop.
"I really think it's because people are just afraid to come to the hospital," he said. "And that's not a good thing."
Mr Niedenthal said people needed to - and should - have confidence in the health system, and go to the hospital if they suspected they might have dengue.