02.04.2020 Corona

Today I would like to take some time to reflect on the situation with Covid-19 and how it affects us here in Madagascar. We have a complete airport closure that began on March 19 and is expected to continue until April 20. It has been strange to hear absolutely no air traffic these last weeks. About a week after airport closure the movement via landroute has also been curtailed. Travel to and from the region Antananarivo (in which we live) as well as Tamatave (main harbor city on the east coast) is closed. That means we are not able to leave the city/rural area around the city in which we live. There is a big police and military presence on the roads, controlling all cars. Medical convoys are excempted We actually recently left town with the Ambulance to pick up stranded midwives in the bush so at least all of our staff is back! All essential stores and food markets are open only until noon. This means we have had to adjust our food shopping trips, these now take place during regular work hours so we take turns doing the shopping for all the volunteers. At the hospital patients are being screening in the morning on the field outside for symptoms and treated there if possible in case there is a suspicion of Corona. So far nobody has come here with respiratory distress, if so we would need to transport them to the responsible Corona hospital some kilometers away. The only patient we truly suspected was the patient that had a c-section here last week, which we operated with minimum staff and then kept in our quarantine ambulance post-partum. She and her baby did fine, by discharge day we suspected it was probably more a case of pneumonia then Covid-19. The general doctors gave her antibiotics and she was rapidly doing better.

Our staff wears masks at work and gloves. We keep our distance too. Official numbers are now around 60 cases of Covid-19 as well as a handful of recovered patients. Truth is there are so many more things deadlier in this country that there is a good chance to die of those things before any respiratory complication can do the job. Tuberculosis is still very common here so if someone with exacerbated Tuberculosis contracts Covid-19 it would be hard to differentiate what really was the cause of death in the end. Keep in mind that life expectancy here is 47 so we barely have the older population with weaker immune systems. Those that made it to that high age probably have pretty good immunity to have made it that far and may be better able to survive an infection with Covid-19. So due to lack of older people, most of the Covid-19 patients will be younger with pre-existing conditions which in turn will likely be the cause of death officially. That in combination with lack of testing may explain why the official number to date is around 60.

Interestingly though, all of the people who arrived by plane 2 weeks prior to airport closure were recruited to be tested. Patrick was part of this group and thankfully he tested negative. He even got an official document certifying this! At this testing event there was even some publicity with the president making an appearance. The people being tested at the time had been in the country (mostly in home quarantine) already 14 days. There was a good chance that many of these being tested positive would be lower as the 14 days had already passed. Was this testing for good publicity?

Anyways there are not too many pictures to describe the above situation except people wearing masks and gloves but I figured you see enough of that so here some pictures of beautiful flowers in bloom around here: