During the year I’ve been tracking which countries are doing better, worse, or are in complete crisis with COVID-19. Most of those doing the best have been island nations, which makes sense since air and boat arrivals are bottlenecks, and it’s easy to test incoming people. Land borders tend to be porous and it’s easier to spread.
Not all landlocked or bordered countries are doing poorly. Four Southeast Asian countries, Thailand, Cambodia, Laos and Vietnam are all doing well despite bordering countries in crisis. But (to me) the most notable exception has been Mongolia, landlocked between Russia and China. There are few more than 300 cases, 12 active, and zero deaths as of today.
Just because Mongolia has 8000km of border with the two neighbors doesn’t mean it’s easy to get in. Much of it is mountainous or through the Gobi Desert. Driving into Mongolia can be as dangerous as it is distant, so most travel in and out is either by rail or by plane. Mongolia cut rail travel to Russia and China in February and as of June still blocked most air travel in and out.
As said above, airports are bottlenecks and so are train stations, making detection and monitoring a lot easier. Starting in March, Mongolia began disinfecting trains every two hours and test passengers. With more than 8000 passengers per day of domestic travel, it’s a reasonable measure. They have also been disinfecting public spaces with sprays. Thus far, they report only one local transmission, from a French national to another person.
Two of the main reasons Mongolia’s government took immediate action are its inadequate medical system and population centres. A quarter of the population live in the capital, Ulan Bataar, which is also where most of the rail and air traffic pass through. Many live in Soviet-era apartment buildings, poverty and cardiovascular conditions are common, so COVID-19 could spread like wildfire if it got into the population.
Fortunately the Soviet era paid dividend with a high literacy rate (approx. 95%) and with most having cellphones (many have smartphones), the dissemination of accurate public health information was as effective as it was here in Taiwan. The Lancet has a good writeup on Mongolia’s success.
Davaadorj Rendoo, an epidemiologist at the National Center for Public Health in Ulaanbaatar, explains Mongolia’s national strategy.
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.
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.
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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.
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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.
Dr. Rendoo may not be very confident in his country’s ability to cope with the disease, but credit to them for not wasting time and doing everything right. Cheap prevention wasn’t hard.
The UN, in typical fashion, is more concerned about “the economy” and “debt”. If their concern were Mongolia’s (and other countries’) long term well being, they would be calling on creditor nations and the World Bank to forego servicing of debt. Instead, like most others, their focus seems to be on “reopening”. This is likely because, like Bolivia in South America, Mongolia has large quantities of mineral resources that other countries want. Mongolia has a flawed democracy, mostly free but heavily weighted toward one party, making corruption a problem, both internal and external. They had national elections in June 2020.