On March 18, a Wednesday, Prime Minister Pravind Jugnauth announced that three people in Mauritius had contracted Covid-19. Two cases were from a cruise ship and one was a person who had flown in from the United Kingdom. Grimly, the prime minister told the country: “We are in a state of emergency.”
Exactly eight weeks later — May 13, another Wednesday — Jugnauth’s administration made a very different announcement. After a total of 332 cases and 10 deaths, Mauritius was now Covid-19 free. “Mauritius now has zero active cases,” said the country’s health minister. “We have won the battle … but we have not yet won the war.”
This is how they did it.
When the scale of the pandemic became clear, the World Health Organisation (WHO) designated Mauritius as a high-risk country. Not only did the island have extensive links with hotspots in Europe and Asia — tourism is the foundation of its economy — but it is also the 10th most densely-populated country in the world. These are fertile conditions for the spread of the coronavirus.
As early as January, Mauritius had begun to restrict flights coming in from China. Flights from Europe were soon added to that list, and screening at airports became mandatory for all incoming passengers. Covid-19 arrived anyway.
On the day that the first three cases were confirmed, Jugnauth set up a high-level ministerial coronavirus committee. This was the driving force behind the country’s response, and included the ministers of health, finance, tourism, infrastructure and commerce. It was chaired personally by the prime minister. The committee met every day, including weekends, and sometimes meetings would go on for three hours. Initially the meetings were face to face — later, when one of the committee members became infected, they started meeting online.
“Having a prime minister meeting and chairing the meeting every day, it’s a commitment that I have never seen in any other country,” said Dr Laurent Musango, who sat on the committee.
Musango, a Rwandan physician with extensive public health experience, is the WHO’s representative in Mauritius. He played a key role in advising Jugnauth. Almost every day, the prime minister would call him or send him WhatsApp messages, asking for WHO guidelines on specific issues. “It’s the opposite to what you had in Burundi,” said Musango, referring to that country’s expulsion of the WHO’s advisory team.
The committee quickly took some difficult decisions. The most significant was to immediately implement a national lockdown. All flights and ships were locked down. So were schools, offices and public transport. A strict curfew was imposed. Mass gatherings such as funerals and weddings were banned. Police were deployed to implement these measures, and handed out hefty fines to anyone in contravention.
Many of these measures are still in place, to prevent another outbreak of the disease.
At the same time, the government ramped up the healthcare system. Hotels were turned into quarantine facilities; five dedicated Covid-19 testing centres were set up outside major hospitals; 18 doctors were appointed to answer calls at a special coronavirus hotline; hundreds of hospital beds were identified and isolated for Covid-19 patients; and Air Mauritius planes were repurposed to bring in ventilators and personal equipment from all over the world instead of sun-hungry tourists.
And then Mauritius started testing. Testing, testing, testing. All healthcare workers. Anyone who had been in contact with someone in quarantine, including hotel staff. Anyone identified as a contact of someone who had been infected. As of May 19 , Mauritius had conducted 92764 tests. This works out to a little over 7% of the 1.2-million population — the highest testing ratio in any African country, says the WHO.
With accurate, transparent statistics, released daily in public briefings, Mauritians knew exactly what the coronavirus was doing, and could shape their response accordingly.
Lessons for others
Dr Deoraj Caussy is a Mauritian epidemiologist who has worked around the world on major public health issues: HIV vaccines, polio eradication, arsenic contamination. He returned to Mauritius about 10 years ago to teach at a university and advise on public health.
Earlier this year, as reports about the spread of Covid-19 around the world started coming in, Caussy realised that something was seriously wrong — and that Mauritius would have to act decisively to prevent a major outbreak. He started talking about it. “It was a campaign for me. I published almost weekly to sensitise the population. I went on all the radios to sensitise the government. To get the Covid theme on the public agenda.”
And then he watched as the government took decisive action. One day, a government health worker even knocked on his door to administer a free vaccine against influenza — a measure provided to all of the country’s older population.
There are several factors unique to Mauritius that made it easier to contain the virus, Caussy says. A big one is its geography: islands can shut their border in a way that mainland countries just cannot. Mauritius also has a small, highly-literate and largely co-operative population. It helps too that the country has a history of good governance: on the Mo Ibrahim Foundation’s African governance index, Mauritius has been ranked number one for the past decade.
But there are still plenty of things that other countries can learn from Mauritius, said Caussy. One is the importance of a free press and reliable information. “Freedom of expression. You have to get the public agenda. This is very important.” It means that government actions are scrutinised, and that government officials are forced to be accountable to citizens. It also means that citizens are more inclined to believe what they read in the media, and take it seriously.
Another is political will, said the WHO’s Musango. The government acted early and decisively, which allowed it to get on top of the pandemic before it got out of control. It relied on accurate data and scientific advice, and took action accordingly — even when it came at a considerable cost.
The economic hit was huge and immediate. Initial estimates suggest that gross domestic product will contract by 3% to 6% in 2020. Mauritius is an established welfare state, which will help cushion the blow to the country’s poorest, as will a $300-million emergency relief package for businesses and workers. But the future prospects for the economy are bleak.
“Yes, the country is indeed going to have to rethink its economic model. At least in the short term the country will need to look at generating growth internally and rely less on its export-oriented growth strategy,” said Harshana Kasseeah, an associate economics professor at the University of Mauritius.
“Of course we are going to suffer in the long run. We are going to have to learn to readjust our needs and wants and live with what we can, without external help. We are pretty much looking at being let loose in the ocean, floating and waiting for the sharks to come and bite us,” said Caussy.
Fourteen days after the last coronavirus case was recorded, Parliament passed the Covid-19 Bill, which turns some of its emergency measures into semi-permanent legislation. This is a glimpse into what the post-Covid-19 world might look like: physical distancing and wearing masks enshrined in law, temperature checks outside every building and reduced carrying capacity on most forms of public transport.
Normal life will only return gradually, said Caussy. “It’s like going to the beach. Getting your feet wet slowly, and not getting cold all at once. That’s the best we can hope for.”