Covid-19 testing of Marshall Islanders in managed quarantine saw the largest number test positive for Covid-19 since managed repatriation started nearly two years ago.

Seven out of a repatriation group of 72 people tested positive for the coronavirus last Friday, according to a government announcement issued late Friday night.

All are in quarantine at the US Army base at Kwajalein Atoll. This repatriation group is the first to spend only three days in quarantine in Honolulu prior to departure to the Marshall Islands on Tuesday this week.

When the Marshall Islands first began allowing controlled entry to the country in June 2020, the government required two weeks quarantine in Honolulu followed by two weeks quarantine in the Marshall Islands - one of the strictest Covid-19 prevention entry protocols in the world.

These strict quarantine requirements have kept the Marshall Islands Covid-19 free.

"The seven positive tests represent new infections and these individuals do not pose an infectious threat to the community as they remain in secure and monitored quarantine on Kwajalein," said Secretary of Health Jack Niedenthal in statement released Friday night.

"All individuals remain asymptomatic or have mild symptoms and in addition to the protection provided by being vaccinated will also receive oral antiviral medication to prevent progression to severe forms of Covid-19."

Marshall Islands Covid-19 prevention protocols require that all people entering the country through its monthly controlled quarantine program must be fully vaccinated and boosted. A 14-day quarantine is required.

However, due to the positive cases identified Friday, the 14-day period has been extended from Friday instead of from the group's arrive on April 12.

"We've decided that every time someone tests positive in this group, the clock starts over at 14 days - so 14 days from now," said Health Secretary Jack Niedenthal Friday.

"They get another test on day seven. If someone tests positive on day seven the clock starts again for 14 days."

The seven positive cases identified Friday at Kwajalein brings to 14 the number of Covid-19 positive cases in managed quarantine since mid-2020.

There has been no community transmission yet in the Marshall Islands, making it one of only a handful of countries globally to remain Covid-19 free throughout the pandemic.

After over a year of requiring two weeks of quarantine in Hawaii, with multiple Covid-19 tests prior to departing to the Marshall Islands, government authorities reduced the Hawaii quarantine late last year to one week.

With this group that went into quarantine last Friday in Honolulu, the Marshall Islands reduced its Hawaii quarantine time to three days.

Two of the 74 people in quarantine in Hawaii tested positive on their day-three tests and were not allowed to travel to the Marshall Islands.

These are the first border cases involving Marshall Islanders since November 2020. Three Americans in a separately managed Army repatriation group in January also tested positive for Covid-19 in quarantine.

In January, as infections around the Pacific escalated due to spread of the omicron variant, Niedenthal warned that if the Marshall Islands gets cases in quarantine, "we can't afford any mistake. If people test positive in quarantine here, we have to be perfect (to prevent the spread)."

Niedenthal noted that lapses in protocols governing quarantine operations in other Pacific islands led to border cases triggering community transmission.

Since it started managed quarantine operations in October 2020, the Ministry of Health and Human Services has required that all of the doctors, nurses and security personnel involved in the quarantine process live in the quarantine facility with each repatriation group as a way to prevent possible community spread in case a person tests positive during the quarantine.

That policy remains in effect with the current group in quarantine at Kwajalein.

"As these are border quarantine cases of Covid-19, there are no restrictions of travel between Majuro and Kwajalein, and there are no travel restrictions between Kwajalein and neighboring islands and between Ebeye and Kwajalein," said the Health Secretary's statement Friday.

He also urged "all individuals aged five years and above (to get) fully vaccinated, which includes being boosted if eligible."

The Ministry of Health and Human Services has provided booster shots as well as vaccinating people in the five to 11 age group since late last year.

Public health teams have been flying to remote outer islands to continue Covid-19 vaccination services initially begun mid-last year to provide booster shots to adults, as well as vaccinate children.