Diary of the Covid-19 pandemic: Morocco


● REGIONAL UPDATES
Latest developments, plus graphs and statistics relating to Covid-19 in the Middle East and North Africa.

● COUNTRY NARRATIVES
Reports on developments, sorted according to country:
Algeria | Bahrain | Egypt | Iraq | Israel | Jordan | Kuwait | Lebanon | Libya | Morocco | Oman | Palestine | Qatar | Saudi Arabia | Sudan | Syria | Tunisia | UAE | Yemen

● SPREADSHEET
Daily statistics of cases and deaths across the region


Country narrative: Morocco

March 4

Morocco reported its first coronavirus case on Tuesday – a Moroccan citizen who arrived from Italy.

March 5

Morocco reported its second case on Thursday morning – a Moroccan woman who lives in Italy. She is reported to have arrived in Morocco on Wednesday, so it's likely her case was detected as she entered the country.

March 10

Morocco reported its third case on Monday – a 52-year-old French tourist who arrived in Marrakech on Saturday and presented himself at a hospital on Sunday after developing a temperature and respiratory problems.

March 11

Morocco reported its first coronavirus-related death – an 89-year old woman in Casablanca who had chronic health problems.

March 14

A French woman who arrived in Taroudant on March 2 from France is Morocco's eighth confirmed case. She is being treated in hospital in Agadir.

March 15

Transport minister Abdelkader Amara has tested positive after returning from a trip to Europe.

March 17

Morocco reported nine new cases, bringing the total to 37. The new cases were widely distributed – in Marrakech, Fez, Rabat, Meknes, Agadir and Casablanca – which is not a good sign.

March 18

The second reported coronavirus death was that of a 75-year-old Moroccan citizen from Salé.

March 19

Various posts on Twitter show that Britons in Morocco are struggling to get flights to take them home.

March 23

Morocco: The authorities are investigating a doctor in Tetouan who tested positive after returning from abroad but resumed medical work instead of staying in quarantine.

April 22

More than 60 cases of Covid-19 have been detected at a prison in Morocco. This is the third outbreak in the country's jails which altogether hold about 80,000 prisoners.

On April 8, a staff member staff at the vast Loudaya prison in the desert near Marrakesh was taken ill with the virus and, following tests, three other staff were found to be infected.

At Ksar el Kebir prison, in north-west Morocco, four more cases were detected among staff. Four female prisoners who had been in close contact with them were also checked. Two have since tested positive.

The latest outbreak – at the local prison in Ouarzazate, southern Morocco – looks far more serious because almost half of its 126 staff have tested positive for Covid-19, along with the prison's governor.

As a precaution against spreading infection, the staff had been divided into two teams, rotating at two-week intervals. Both teams were being checked at the end of each rotation and again before starting a new one.

However, this didn't prevent both teams from becoming infected. Testing has revealed 36 Covid-19 cases in one team and 24 in the other. At least six prisoners have also been confirmed as having the virus and the authorities say everyone held in the jail is being tested. According to one report 730 tests have so far been carried out and the results are expected later today.

The rotation system was one of several measures adopted in Morocco last month to reduce the risk in prisons, including a release of more than 5,000 prisoners.

Prison populations are seen as especially vulnerable to infections and the World Health Organisation has issued guidelines for dealing with the situation in the light of the Covid-19 pandemic.

May 1

Police in Morocco have arrested more than 80,000 people during the last six weeks for violating the coronavirus lockdown, according to official figures from the Direction Générale de la Sûreté Nationale (DGSN). On Wednesday alone, 4,582 were arrested – the highest daily total so far.

Other countries have also faced problems with non-compliance but enforcement of the preventive measures in Morocco has been especially strict. When the state of emergency began on March 20 the public prosecutor gave orders to "ensure rigorous application" of its provisions. Penalties for violators – including those who fail to wear a face mask in public – range up to three months in jail and a fine of 1,300 dinars ($130). It's likely that about half of those arrested will eventually be prosecuted.

Fortunately for the police, they don't have to spend so much time on routine work at the moment. Crime in general has fallen substantially during the lockdown in comparison with the same period last year, Morocco World News reports:

"Crimes related to theft under the threat of a weapon decreased by 52%, reported sexual assault and rape cases decreased by 41%, premeditated homicide cases went down 67%, and reported economic and financial crimes fell by 23%, in addition to decreases in other categories of crime."

Restrictions on movement have also brought a huge reduction in deaths and injuries caused by road accidents.

However, there's bad news from Morocco's prisons. Covid-19 outbreaks have been reported in three of them – initially among prison staff. Further testing has since revealed that more than 200 prisoners at a jail in Ouarzazate have also been infected.

The state of emergency is due to last until May 20 and the Moroccan authorities are hopeful that by then they can start lifting the restrictions. There's a reasonable prospect they will be in a position to do so. Official figures show that while the virus is still spreading the rate of increase has slowed considerably.

The total of confirmed cases has risen by 20% over the past week – well below the regional average. "Active" cases (after deducting recoveries and deaths) have risen by only 11% week on week.

May 28

Moroccan health minister Khalid Aït Taleb says use of chloroquine leads to faster recovery

Health authorities in Algeria and Morocco say they intend to continue treating Covid-19 patients with anti-malaria drugs despite safety concerns raised by the World Health Organisation (WHO).

Algeria claims to have had "great success" using hydroxychloroquine in combination with antibiotics and says it has "not noted any adverse reactions" among several thousand patients who have been given this treatment.

Hydroxychloroquine and the related drug chloroquine are mainly used for malaria but there have been claims they can speed up the recovery of coronavirus patients. Last week, however, WHO suspended medical trials of hydroxychloroquine amid fears that it can increase the risk of death.

WHO was also worried that people might be tempted to self-medicate with the drug after Donald Trump revealed that he was taking it in the belief it would protect him from Covid-19.

study in the medical journal The Lancet found "no evidence of benefit of hydroxychloroquine or chloroquine when used either alone or with a macrolide [antiobitic]." It suggested there was "not only an absence of therapeutic benefit" but also a possibility of patients being harmed.

Algeria's decision to use chloroquine/hydroxychloroquine was questioned two months ago, in the early stages of the outbreak, but health minister Abderrahmane Benbouzid defended by saying the country had "no other choice".

Several Algerian doctors have claimed the treatment is very effective. Because of the possible side-effects some patients are reportedly given alternative medication in the form of anti-viral drugs normally used for HIV.

Morocco also pinned its hopes on anti-malaria drugs around the same time as Algeria and the government requisitioned all the available stock.

Morocco has been treating Covid-19 patients with chloroquine since April 8 and, like Algeria, appears to have no intention of stopping.

According to health minister Khalid Aït Taleb, chloroquine has antiviral properties that lead to a faster recovery and save some patients from the need for intensive care.

Egypt has also been using anti-malaria drugs (as well as HIV drugs) to treat Covid-19, though it has warned the public not to self-medicate with them.

Tunisia was initially enthusiastic too, and even started manufacturing its own hydroxychloroquine. Yesterday, though, it announced that the treatment has been halted in all the country's hospitals following the statement from WHO.

These four North African countries appear to have been using chloroquine-based treatments in very similar ways – but with wildly differing results.

If we look at the number of cases that are now closed (as a result of recovery or death), the official statistics show the percentage ending in death was as follows:

Egypt: 13.6%
Algeria: 10.8%
Tunisia: 4.9%
Morocco: 3.9%

Based on that, use of chloroquine does not guarantee a low death rate and the variations between these countries suggest other factors have a bigger role in determining how many people die.

June 2

Face masks are compulsory when outdoors in Morocco. Photo: Xinhua

By world standards, Morocco's Covid-19 epidemic was never very large and it's steadily getting smaller.

At the peak in April, new cases were averaging more than 200 a day but the average during the past week has been only 43 a day.

Between May 10 and the beginning of June, the number of active cases – people currently infected – has almost halved, from 3,321 to 1,735. The rate of recovery from Covid-19 is now significantly higher than the rate of infection.

This raises the prospect that Morocco's lockdown, which began on March 20 and is due to end on June 10, will not be extended – at least, not in the same form.

The focus now is on how to safely extract the country from its lockdown, and the government appears to have recognised that it can't do that all by itself.

Prime minister Saad Eddine El Othmani has been saying that a successful transition – and revival of the economy – will depend on cooperation from civil society, all political parties and trade unions.

To that end, he has been having discussions by video link with the country's political parties, including some that are not represented in parliament.

Another preparation for ending the lockdown was the official launch, on June 1, of a contact-tracking app known as Wiqayatna ("Our Safeguard").

Use of the app is not compulsory but it forms part of a broader campaign under the slogan "Stay vigilant, protect each other" aimed at encouraging people to continue taking precautions when the lockdown ends.

Cooperation from the public could be jeopardised if people thought the country's future had been placed in the hands of American consultants and the BCG's Casablanca office issued a swift denial (of sorts). Prime minister Othmani said in April that Morocco's emergence from lockdown would follow a "well-studied strategy" and a news report around the same time claimed that a US-based firm, Boston Consulting Group (BCG), had been commissioned to develop it.

In a statement reported by Morocco World News, the company said it had "not been directly mandated to prepare an official strategy to lift the lockdown" but was working closely with the health ministry and other government departments.

It was said to be "providing data and analysis on recent international experiences, free of charge, to maintain a strict framework of national solidarity".

New Covid-19 cases reported in Morocco. Seven-day average, day by day during the past two months

June 22

The Moroccan army has set up an emergency field hospital to care for hundreds of strawberry packers who have tested positive for coronavirus over the last few days.

The outbreak in Kenitra province, north of the capital, Rabat, is the biggest so far recorded in Morocco which has seen only 10,000 cases since the pandemic began. It comes as restrictions are about to be eased in most parts of the country.

The Kenitra outbreak began with a trickle of cases in rural villages which prompted the authorities to carry out widespread testing at factories and other workplaces. As a result, 700 people were found to be infected – including 457 at a strawberry-packing plant run by a Spanish company, Frigodar, at 103 at Natberry, a similar plant run by another Spanish company.

Most of the cases are said to be mild but the field hospital is needed because Morocco has a policy of hospitalising everyone who tests positive, in order to prevent further transmission of the virus.

According to the Spanish news agency EFE, the field hospital is "in existing military installations" at Sidi Yahya el Gharb. A reporter observed "movement of ambulances, fire trucks and military vehicles" but no photographs were allowed. Previously-published photos of Moroccan field hospitals show lines of dark green tents.

A Moroccan army field hospital

The soft fruit industry employs about 25,000 people in the Kenitra area – almost all of them women – and is a major part of the local economy. It normally generates exports worth $500 million a year but has now come to a standstill.

Morocco's interior minister has ordered an inquiry amid claims that local officials mindful of the industry's economic importance were reluctant to enforce safety precautions that would have been costly for employers.

Jerónimo Díaz, manager of Frigodar, told EFE news agency that his company had introduced various precautionary measures, including separation screens, compulsory face masks and temperature checking. A photo taken inside the plant shows workers in protective clothing separated by screens.Mohammed al-Amouri, head of the Red Fruits Inter-Professional Federation, maintains that the industry followed government instructions and blames the health ministry for not carrying out more tests when the first few Covid-19 cases were detected among strawberry packers in May.

However, EFE also quotes Abdelali El Karkri, head of the region's Network of Development Associations as saying women at the packing plants gather together for meal breaks where they don't observe social distancing.

Another problem, highlighted by both Karkri and Diaz, is the minibuses that transport women from their villages to the packing plants. During the epidemic they are supposed to operate at 50% of seating capacity but according to Karkri, at the height of the strawberry season drivers remove the seats – which allows them to cram in as many as 40 passengers.

New Covid-19 cases in Morocco. Seven-day rolling average, day by day over past three months