[Blog] Action Plan for Fighting Covid-19 in 3 Weeks

Strict Quarantine Measures and Compulsory Free Testing for 

Everyone 75% of Population at Risk because of high rate of Diabetes & Heart Disease As coronavirus sweeps across the world, including Mauritius, and as the global death toll continues to shoot up, the whole of humanity realises that we are in desperate times. And desperate times call for desperate measures to halt this death march that we are forced to witness. 

But glimmers of hope have appeared in some parts of the world, like in the cities of Vo’ Euganeo in Italy and the Hubei province in China, which includes the now infamous capital city of Wuhan.
 
Some words on COVID-19 

Scientists agree that COVID-19 spreads mainly from person-to-person between people who are in close contact (within about 6 feet) with an infected person through respiratory droplets produced when an infected person coughs, sneezes or even just breathes normally without using masks. These droplets can land in the eyes, mouths or noses of people who are nearby or possibly be inhaled into the lungs (Centres for Disease Control and Prevention [CDC] 2020). 

However, although people are most contagious when they show symptoms, scientists are not giving too much significance to the spread of the virus by people who are asymptomatic, that is, people who are infected but they do not show any symptoms. There are also people who got mild infections and who did not see a doctor. These are the main reasons for the virus spreading like wildfire, and for improperly implemented quarantine and lockdown measures being ineffective.
 
People who are asymptomatic or with mild infections are roaming around freely and going to supermarkets, pharmacies and filling stations. In so doing, they are spreading the virus the most without the slightest clue or concern about it. 

Both people and Government do not seem to realise how dangerous the virus is. Some people believe that the coronavirus is similar to the common flu and that they will develop resistance after they contract it. There is also the myth that kids and young people are not affected by it or get a full recovery after being infected. This virus mutates and often leaves permanent or long lasting scars in lung tissue.
 
Even the WHO's Director General Tedros Adhanom Ghebreyesus said the following: "I have a message for young people: You are not invincible, this virus could put you in hospital for weeks or even kill you.” (BBC News 2020; Nebehay 2020; World Health Organisation [WHO] 2020). Why is this extremely dangerous for Mauritius? Mauritius is extremely vulnerable to coronavirus, and if drastic actions are not implemented properly, we will be literally thrown back to the Dark Ages.
 
Covid-19 is already having a huge impact on our economy as recession looms ominously. Because we are a service-based economy (hospitality, financial services, IT...etc.), and because we are highly dependent on imports, the compounded effect of these two are literally killing our country. 

The country is already under lockdown since Friday 20th March and financial specialists are estimating the financial cost to amount to Rs1 – 1.3 Billion per day. But more importantly, it is the health conditions of Mauritians 2 that is of a greater cause for concern. 

According to the Mauritius NCD Survey 2015 Report (Magliano et al. 2015, p. 5&6), we have:  

• 22.8% who are diabetic and 19.4% are pre-diabetic

•  45.5% suffering from obesity and 44.1% suffering from elevated total cholesterol

•  28.4% suffering from hypertension

•  3,000 to 3,500 Mauritians died from health complications related to cardiovascular diseases 

• (CVD) in 2019 (Government of Mauritius 2019) Covid-19 is proving to be fatal to people with the above conditions. 

In addition, since we have an ageing population like Italy, the elderly are also very vulnerable to coronavirus. As such, we can potentially have more than 75% (several hundreds of thousands of people) of the population who are at risk of dying. 

CASE STUDY 1: The Hubei Province, China 

The Hubei province, the Chinese province at the centre of the coronavirus outbreak, reported no new infections for the first time after more than two months of fighting. China adopted a bruteforce strategy

– containment measures which included a total lockdown on activities and travel, and mass quarantine on nearly 60 million people. Not even supermarkets, filling stations, pharmacies were allowed to operate. Roadblocks were set up to seal off cities, public transportation was shut down completely and private cars were mostly banned from the roads.

In Wuhan, restrictions on individual movement were implemented, with residents mostly barred from leaving their homes for more than five weeks. The government dealt with food shortages by setting up a delivery service for food. Massive testing campaigns were also key to detecting potential vehicles of the virus.

Makeshift quarantine centres were quickly erected to accommodate thousands of patients with proper individual isolation rooms. It is this heavy-handed set of measures that allowed China to triumph against COVID-19 (Qin 2020; Chang, Che & Bloomberg 2020). 

CASE STUDY 2: The Vo’ Euganeo City

Italy Vo’ Euganeo, in the province of Padua, in the Veneto region of northern Italy, is the city where the contagion started. The first dead person from the coronavirus in Italy also lived there. Since the announcement of the first death, the city went into full quarantine for about 3 weeks.

After seeing the successful containment of the coronavirus in Hubei, this Italian city decided to adopt a similar strategy.

During that period, all of its 3,300 residents went through 3 mass virus testing – one at the beginning of lockdown, and two others at strategic points in time. Following the first test, the city authorities found that 3% of the population has been infected, and the authorities knew the names and address of the infected persons. These were placed in quarantine first.

The quarantine worked wonders as after 15 days 3% had become 0.25%. Soon the number of new infections dwindled to zero. But the city remains on high alert and does not accept tourists, does not allow residents to leave, to prevent any new outbreaks (Armitage 2020; Chalmers 2020).

As WHO's Director General Tedros Adhanom Ghebreyesus said "We have a simple message to all countries — test, test, test,". 3 

The Mauritian Action Plan  Total Lockdown with Travel bans and Public Closures (for 3 weeks)

• - Mauritian Airspace needs to be completed shutdown with no travel in or out 

- The Port should be closed likewise 

- Designated major supermarkets, pharmacies, filling stations and bakeries are to remain open but they must not allow members of the public to access their premises 

- The supermarkets, pharmacies, cooking gas companies and bakeries must set up home delivery systems so that people do not need to move 

- Online payment to their bank account should be favoured. If not, payment by card upon delivery is to be favoured as cash is a big means of spreading the virus - Free food & amenities packs distribution to the poor by government 

- Filling stations will service only designated vehicles like government vehicles, delivery vehicles, ambulances, police vehicles…etc. 

- All other buildings and offices like shops, malls, business companies, schools, government institutions…etc. should be closed - Work and study from home should be encouraged wherever possible - Strict curfew and quarantine of whole of Mauritius is to be observed. No movement of people to be tolerated with possibility of heavy fines and prison terms for contraveners 

- Several Police divisions and the Special Mobile Force (SMF) must be deployed to place roadblocks for maintaining ban on individual movement and maintain law and order 

- Each village can use its community centre, area health centre or mediclinic as centre to coordinate activities like patient testing, food & amenities distribution to the poor and transport of patients, with at least 2 doctors and nurses working there - Infected people should be redirected to nearest quarantine centre 

- Each constituency must have a Coordination Cell with a hotline for managing activities and monitoring the situation in the village community centres, area health centres and/or mediclinics - A Central Command Centre for managing the Coordination Cells to be set up by PMO  

Supplies• & Logistics 

- Good grade protective coveralls and suits, masks, gloves and goggles for officers responsible for law and order, for medical personnel and for ground personnel responsible for patient testing, food & amenities distribution and transport of patients 

- Medical equipment like respirators and testing kits. 3 tests x 1.3M individuals = 3.9 M testkits. There are cheaper WHO-approved testkits available like the one developed in Bangladesh (Verdict 2020) and India (Sharma 2020) rather than the more expensive American or European ones - Basic food & amenities packs (bread, vegetables, rice, wheat and canned foodstuff…etc.) and amenities (toilet paper, anti-bacterial solutions, mask, gloves, medication…etc.) to be distributed to poor families periodically 

- Makeshift quarantine areas need to be set up. Emptied hotels, gymnasiums, and halls can be used as isolation areas. We had only 4415 beds available in public & private sector hospitals (Health Statistics Unit 2019, p. i) in 2018 4 

- Transportation for police/military forces, medical personnel, temporary ground personnel and patients + for mass testing, mass distribution of food & amenities and medical emergencies - Hotlines for each Coordinating Cell and Central Command Centre  

Man Power

• - According to the HEALTH STATISTICS REPORT 2018 for Mauritius and Rodrigues (Health Statistics Unit 2019, p. i), we have 3210 doctors (public and private) and 4400 nursing officers (public and private), which is not enough 

- Call upon healthy people to volunteer as temporary ground personnel, helping both medical and law & order personnel and in food distribution. 

Payment can also be offered for enlistment (medical students, pre-reg doctors, private security guards...etc.) - 

Government officers and Mauritius Telecom employees can operate the hotlines - People can be trained in doing basic virus testing and law enforcement  Monetary, Personnel and

Logistical help

• Mauritius cannot fight this situation on its own. It needs to inject money in the battle right now. Either we spend now or we lose more on the long term. Furthermore, Mauritius needs to call upon its allies like India and China in our dire times.
 
- Open lines of credits and grants to Mauritian government 

- Donation of several tons of masks, gloves, glasses, testing kits, protective suits, antibacterial solutions, and medical equipment. China offered to Greece 8 tons of medical supplies which included 550,000 medical masks, surgical masks and protective gear, goggles, gloves and shoe covers (ANA 2020; Kampouris 2020). 

- Ask for help in terms of medical personnel. China sent help to Italy (Marymount Talks 2020; Sylvers & Pancevski 2020) in the form of 300 intensive-care medical doctors and 31 tons of medical aid including respiratory machines, tens of thousands of masks and other vital hospital equipment, to be distributed by the Italian Red Cross Sequence of Events  

Before Lockdown• 

- Give a few days to people to buy stuffs - Bring in all medical equipment and personnel, foodstuffs, anti-bacterial solutions we can get by air  During Lockdown

• - Police and SMF are to maintain law and order - 1 st testing of each and every person in Mauritius the same day - Free food and amenities pack distribution to all poor families 2 times/week for 3 weeks

- 1 person per family comes out to fetch the food packs to minimise contamination

- Do anti-bacterial spraying on the food pack and then bring them inside the house 5

-If someone becomes sick, phone Coordinating Cell hotline and ask for emergency transport by Government authorities - Infected people to be put in makeshift quarantine facilities and/or hotels - 2 nd testing to be carried out after 1.5 to 2 weeks to check if there are any changes in number of cases - 3 rd testing to be done in 3rd week to ascertain complete disappearance of virus before lifting lockdown and re-opening airspace and port  

After Lockdown

• - Mandatory quarantine procedures of all who enter Mauritius via airport and port to prevent any new outbreak from outsiders Final Note Half-baked measures are simply not going to work. The reaction rate of the government has been very slow and we have already lost a lot of ground to the invisible enemy. The Government must go in hard and go in RIGHT NOW! 
May God help us all and our beloved country Mauritius! 

Dr Visham Ramsurrun 

BSc., Ph.D, Post-Doc, PGCert HE, HCNA, CCNA, FHEA, MIEEE 
Senior Lecturer in Computer Science & Researcher Middlesex University Mauritius 22/03/2020