Mongolia shares the world’s longest land border with China, but its early and highly centralized pandemic response has been so effective that not a single person in the landlocked country has died from covid-19. A former army colonel turned public health official recounts how Mongolia enacted its extensive quarantine and testing regime under a state of emergency.
We first heard about a new virus spreading in China around New Year’s Eve. On January 10, we issued our first public advisory, telling everyone in Mongolia to wear a mask.
Here’s the thing: we don’t actually have a great public health system. That’s why our administrators were so afraid of covid-19. We don’t have many respirators, for example. We were really afraid that if we got community transmission even once, it would become a disaster for us. What was in everyone’s head was to be prepared before the spread. Another reason we were so keen to protect the community is because we have the world’s longest land border with China—2,880 miles [4,600 kilometers]—as well as continuous human flow for education and business from China to Mongolia.
0 Covid deathsAs of August 17, 2020. Source: WHO Dashboard
Davaadorj RendooTS.NOMIN ERDENE, RESEARCHER, DEPARTMENT OF EPIDEMIOLOGY AND EMERGENCY OPERATIONS, NCPH
Mongolia is a big country with a sparse population, about 3.2 million people. Because our country has a very harsh, dry, and cold climate, every year from November to February we have an awful flu season, and the Ministry of Health always encourages people to practice good hygiene and wash hands, especially young children. So many of our suggestions were not new.
We have been doing tests since January. We even started randomly screening pneumonia patients for covid-19 but never found a patient. We got the majority of our test kits from the World Health Organization (WHO), including rapid tests, and were able to scale it up pretty quickly.
In February, we started flying Mongolians living abroad back home and testing them.
We did not detect a single domestic case until March 9. One French national working in the southern province of Dornogovi was discovered to have had coronavirus. Since that day, the Ministry of Health has been conducting daily situation briefings to talk about how many cases were imported, what the high-risk areas are. After that case was announced, people became even more obedient to our directives. But we were so ready for this case. We really had enough time to prepare.
For that French national, we undertook very extensive contact tracing and identified 120 people who had had some contact with him. This is not the first time we have done contact tracing; it has been part of the mandate of the National Center of Communicable Diseases since its inception. We do this for all kinds of disease, including sexually transmitted diseases.
We also opened a dedicated, 24-hour covid hotline. People were getting all kinds of wrong information from social media. One big hoax was that because Mongolians eat very healthily and live in traditional nomadic lifestyles, we would not get the virus and had a “natural immunity.” Another big one was that because it is cold and dry, the virus does not survive here, and it only survives in warm and wet climates. Today, even the majority of herders and nomadic people have satellite TV with solar energy, so they can still access information.
One side effect of this lockdown has been a significant reduction in cases of seasonal flu, pneumonia (a very serious problem every year), and foodborne and digestive illness.
Every day, we are still concerned, but our people are getting less worried. It’s summer now; the weather is getting nicer. People are going for picnics, riding horses. We have set up a lot of temperature checks at recreation spots in the countryside. Almost all the public spaces, starting with the malls and pharmacies, still require masks. But we realize that in the rural areas, wearing a mask every day is not possible.
We don’t know how long the state of emergency will last. Some of our highest officials have said we will close our borders indefinitely. We cannot take anything for granted. In Japan, they lifted restrictions and the virus came back. Until the end of this summer, we are not easing quarantine at all. But schools will have to start in September. What we still recommend every day to the public is to stay ready, because community transmission might be just around the corner.
This interview has been condensed and edited for clarity.
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