Mongolia pins hopes on vaccine, containment after its first coronavirus death


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Mongolia reported its first Covid-19 death over the weekend, sending a clear signal that even in one of Asia’s best-performing countries when it comes to pandemic control, the coronavirus shows no signs of abating. And while Mongolia has not made a final decision on its choice of vaccines, some analysts say that those from one of its closest neighbours, China, do not appear to be high on its wish list.
Before the death of a 76-year old woman from Covid-19 on Saturday, the country of 3.4 million had reported no fatalities from the disease since its first Covid-19 case was discovered in March. The woman was said to have other prior health complications, including high blood pressure, diabetes and hepatitis C, reported national news agency Montsame.
On Monday, the country reported 16 new cases, bringing the total number of cases to 1,098, with 711 recoveries. But as recently as early November, there had been no local transmissions and only 346 imported cases before a surge occurred.
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Some analysts attributed the low infection rates to the fact that Mongolia is one of the most sparsely populated countries in the world. However, many also credited the government for closing its border to China on January 22, and to the rest of the world in March.
In a November 2 report, the World Health Organization (WHO) praised Mongolia’s emergency preparedness system, which involved setting up a multisectoral management team of 70 officials from 21 agencies covering areas such as health, transport, border control, law enforcement, state administration and emergency management. “The foundations of the shared strategy were solidarity, early preventive measures, multisectoral partnership and a culture of continuous improvement,” the WHO said at the time.
But the surge in the country in early November, including the first locally transmitted case, prompted authorities to announce a curfew in the capital, Ulaanbaatar, where residents were asked to stay home and leave only to buy food and essentials. All businesses, except for essential services, were also closed.
The first case of community spread was said to be connected to a freight truck driver who entered from Russia, leading to further outbreaks among employees of the Ulaanbaatar Railway, or the Trans-Mongolian Railroad, which connects Mongolia with Russia, said Marissa Smith, an associate researcher at the University of California, Berkeley.
“At that time, Buryatia, the region bordering Mongolia to the north and through which most of transport passes, was one of the hardest-hit parts of Russia,” said Smith, who also sits on the board of directors of the American Centre for Mongolian Studies.
“The Mongolian government is taking strong measures that are warranted,” she told This Week in Asia on Monday. “It is remarkable there was no community spread earlier.”
Even so, by the first week of December the number of infections had risen to 812, forcing authorities to announce a second curfew from December 23 to January 6 – mainly due to a cluster of patients from a district hospital in Ulaanbaatar, said Anandsaikhan Nyamdavaa, an independent consultant based in the capital.
Mendee Jargalsaikhan, deputy director of Mongolia’s Institute of Defence Studies, said the government was now trying to contain community spread by restricting internal travel and movements between the capital city and provinces.
Nyamdavaa said being able to postpone large-scale infections and deaths for almost 10 months had given Mongolia “a big boost”, as authorities were able to upgrade and purchase new PCR testing equipment, including mobile laboratories, that was able to help stem infections in the countryside.
The government has also purchased 400 ventilators, trained health practitioners and designated additional testing places, such as stadiums, to prepare for a larger surge in cases.
“Most of the preparations have been done with the lessons learned from different countries,” Nyamdavaa said, adding that Mongolia has now tested half a million people after having no prior experience in mass testing.
He said one of the biggest positive stories to come out of the pandemic was the authorities’ insistence on transparency.
“To keep the public updated and stamp out any conspiracy stories, the Ministry of Health has instituted daily briefings that are watched by the whole country,” Nyamdavaa said, adding that this has turned some government officials into public figures.
Even though the government’s preparedness level had been widely acknowledged, there had also been some “highly embarrassing failures” it had readily admitted to, he said. These included cases of people who returned from overseas but who did not observe proper quarantine measures, the mixing up of PCR test results, and the failure of people to practise social-distancing measures as they waited to get tested.
“The Mongolian government is not always transparent and open so this was really a breath of fresh air,” Nyamdavaa said.
In mid-November, Mongolia announced that it had applied to purchase vaccines with the US$50.6 million in funding it received from the World Bank when it joined the Covax Facility, a global initiative that brings together governments and manufacturers to ensure that vaccines will reach developing countries in need.
Nyamdavaa said Russia and China – Mongolia’s two closest neighbours – had officially expressed willingness to supply their vaccines to Mongolia.
“Both the countries could supply their vaccines in a short period if we request them today,” he said, adding that Mongolia is, however, likely to receive vaccines through the Covax Facility in the first quarter of 2021.
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Jargalsaikhan, of the Institute of Defence Studies, said Mongolia’s Ministry of Finance and the State Emergency Commission had been looking into all vaccine options, including those from China.
However, he said, “one principle the commission has to stick to is the approval from WHO, since Mongolia has been collaborating with the WHO very closely”.
As of now, China’s Sinovac vaccine, which has only been approved for emergency use and which has claimed promising results, has yet to be approved by the global health body.
Mongolian health authorities also have another prerequisite – that the country should have the capacity to store the vaccines. At least one – the Pfizer-BioNTech vaccine – requires minus 70 degrees Celsius (minus 94 degrees Fahrenheit) storage facilities, which Mongolia does not possess.
Additionally, Nyamdavaa said, there has been “some reluctance to accept the vaccines from China”.
In an online poll conducted by Nyamdavaa over the weekend, 298 Mongolians said they would rather not receive any Chinese vaccines, versus only 15 who said they would.
The same question on Russian vaccines resulted in 62 people saying they would not mind being inoculated with them versus 21 who said they would reject them.
“Even though this is not a scientific poll, it, in my opinion, accurately portrays people’s opinion on the vaccines,” he said.
Smith, of the University of California, Berkeley, agreed that China was likely “not the preferred source”, but noted that Mongolian officials had not explicitly turned down Beijing’s offer of vaccines.
In August, China’s ambassador to Mongolia, Chai Wenrui, said his country would send its vaccines to Mongolia once the WHO gives its approval.
This article originally appeared on the South China Morning Post (www.scmp.com), the leading news media reporting on China and Asia.
Copyright (c) 2020. South China Morning Post Publishers Ltd. All rights reserved.
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