Coronavirus: Where will be the last place to catch Covid-19?

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Parishioners wash their hands as a preventative measure against the spread of the COVID-19 coronavirus

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AFP

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Parishioners wash their hands preventively in the capital of Malawi, Lilongwe


On January 12 – less than three months ago – the coronavirus was confined to China. No cases were found outside the country where it appeared.

And then, on January 13, the virus became a global problem. One case was recorded in Thailand before Japan, South Korea and the United States.

Around the world, a net of cases has become a deluge.

There are now more than a million cases of Covid-19 worldwide, in countries ranging from Nepal to Nicaragua. But as the death toll rises and hospitals overflow, is the coronavirus still free of coronavirus?

The answer, perhaps surprisingly, is yes.

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EPA

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In North Korea, no cases reported and more missile tests


193 countries are members of the United Nations.

As of April 2, 19 countries have not reported a Covid-19 case, according to a BBC count using data from Johns Hopkins University.

The 19 countries without Covid-19

Comoros; Kiribati; Lesotho; Malawi; Marshall Islands; Micronesia; Nauru; North Korea; Palau; Samoa; Sao Tome and Principe; Solomon Islands; South Sudan; Tajikistan; Tonga; Turkmenistan; Tuvalu; Vanuatu, Yemen

Some, experts agree, are likely to have unreported cases. North Korea, for example, is officially zero, as is war-torn Yemen.

But there are countries where the virus has not landed. Most are small islands with few visitors – in fact, seven of the 10 least visited places in the world, according to UN data, are Covid-19 free.

This remoteness means one thing: in the age of social distancing, island nations are the original self-isolators.

But the president of such a place is not complacent. In fact, he told the BBC, Covid-19 is already a national emergency.

Nauru in the Pacific Ocean is almost 200 miles (320 km) from anywhere – Banaba Island, part of Kiribati, is the closest land. The nearest “main” city with direct flights is Brisbane, 2500 miles to the southwest.

It is the second smallest state in terms of land (after Monaco) and, with just over 10,000 people, the second smallest in terms of population (after Tuvalu).

It is also one of the least visited places on Earth. Although it does not appear in the most recent UN data, a tour operator claims that the country only has 160 tourists a year.

You may think that such a distant place would not need to go further. But a country with a hospital, no ventilators and a shortage of nurses cannot take any chances.

  • Travelers were banned from China, South Korea and Italy on March 2. Five days later, Iran was added to the list
  • In mid-March, Nauru Airlines suspended flights to Fiji, Kiribati and the Marshall Islands, and its only other route – Brisbane – was cut from three times a week to once a fortnight
  • After that, all those who came from Australia (mainly returning residents) were placed in 14-day quarantine in local hotels.
  • And, although there hasn’t been one recently, any asylum seeker – Australia has a migrant processing center on the island – will also be quarantined for at least two weeks.

This policy, says President Lionel Aingimea, is called “capture and containment”.

“We keep things at the border,” he says. “We use our airport as a border and our transit facilities as part of our border.”

People in quarantine are checked daily for symptoms. When some developed fever, they were further isolated and tested for Covid-19. The kits were sent to Australia, but all returned negative.

Although they are going through a crisis, ordinary Nauruans are “calm and collected,” said the president. As for him, he is grateful to the other countries for their help – in particular to Australia and Taiwan, with which Nauru has complete relations – and to his religion.

“When we started to make this policy of capture and containment, I went to God in prayer, and he gave me a Scripture that I keep in heart, which is Psalm 147, verses 13 and 14. It has kept me in good stead as we cross – as the Bible says – this valley of death. “

And, as he tries to keep Nauru Covid-19’s balance sheet at zero, he knows that the rest of the world is not so lucky.

“Whenever we look [Covid-19] on the map, it looks like the world has an epidemic of measles – there are red dots everywhere, “he says.

“So we make sure as a nation … we think our prayers will help all other nations get through these difficult times. “

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Getty Images

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There are fears of impoverishment Nauru would not be able to cope with a possible epidemic


Nauru is not the only small Pacific country to declare a national emergency – Kiribati, Tonga, Vanuatu and others have done the same.

Dr. Colin Tukuitonga, from Niue in the South Pacific, is sure that this is the right policy.

“Their best bet is undoubtedly to keep the bloody,” he said from New Zealand. “Because if it comes in, you’re really drunk.” “

Dr. Tukuitonga is a public health expert, a former Commissioner of the World Health Organization and is now an Associate Dean in the Faculty of Medicine at the University of Auckland.

“These places don’t have robust health systems,” he says. “They are small, they are fragile, many have no fans. If an epidemic happened, it would decimate the population. “

And, he says, many Pacific Islanders are already in poor health.

“Many of these places have high rates of diabetes, heart disease and chest conditions – all of these conditions [are linked to] a more severe form of the virus. “

If there was a serious epidemic in one of the small Pacific countries, they would have to send their patients abroad. But it’s easier said than done when countries lock their borders.

So, says Dr. Tukuitonga, their best bet is to stay at zero for as long as possible.

“The very isolation of small populations across a large ocean – which has always been a problem for them – has become a protection,” he said.

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Media captionMeasures the NHS says you should take to protect yourself from Covid-19

Although most countries without Covid-19 cases are islands, some have land borders.

Malawi, a landlocked country of 18 million people in East Africa, is also awaiting its first case. But he’s not sitting on his hands.

The country declared a “disaster”, closed schools and canceled all visas issued before March 20. It’s also about “stepping up the tests,” says Dr. Peter MacPherson, a public health expert from the Liverpool School of Tropical Medicine, whose work is funded by the Wellcome Trust and is based in Malawi.

He says that the “extra week or two that we had to prepare” has been precious, and he is “quietly confident” that Malawi will do well when Covid-19 arrives.

“We have been very affected by the HIV epidemic for the past 30 years and also by the tuberculosis pandemic,” he said.

“Much of this very effective response has been basic but effective public health – programs that work well at the district level, doing the basics, but doing them very, very well.” “

Despite this, it is a question of when, and not if, the country deals with its first case. The evidence indicates that this will happen in all countries, says Dr. MacPherson.

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Media captionWhy staying at home is a matter of life and death

If not Malawi, where could be the last place in the world to catch Covid-19?

“These are probably these very remote South Pacific islands, I would put my money on them,” said Andy Tatem, professor of spatial demography and epidemiology at the University of Southampton.

“But in our global economy, I’m not sure there is a place to escape such an infectious disease. “

Blockages – like those in Nauru – can work, he says, but they can’t last forever.

“Most of these countries depend on some sort of import from abroad – be it food or goods or tourism – or export their own goods. They may be able to lock completely, but it will be detrimental – and they will have to open eventually. “

And, he warns, the number of cases is far from peaking.

“We have all these blockages, so it does not burn the population, and we still have a very large proportion [of people] don’t get it.

“It’s great for health systems, but it means we have a lot of sensitive people around the world. We are going to have to live with this virus for a while. “

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