Summary

Unlike other regions of France, which are showing a decline in epidemiological indicators of SARS-CoV-2 circulation, Mayotte continues its climb toward the epidemic peak. Two months after the first case of COVID-19 was identified in Mayotte (March 13), the virus is actively circulating throughout the department, and the epidemic is gaining in intensity and severity.

As of May 14, 2020, 1,210 cases of COVID-19 have been biologically confirmed by the laboratory at the Mayotte Hospital Center and the island’s sole private laboratory. They are capable of performing up to 200 tests per day. To date, more than 5,000 tests have been conducted over two months, corresponding to 4,540 individuals who underwent a biological test for SARS-CoV-2.

Several surveillance systems have been implemented by Santé publique France (SpF) in collaboration with its partners to generate epidemiological data to inform decision-making regarding management measures. The collected data enable monitoring of the epidemic’s progression and assessment of its severity (severe cases and mortality). Today, the primary objective is to mitigate the scale and impact of the epidemic wave.

As of May 14, each case is subject to a telephone or in-home investigation. For each case, the individual’s ability to self-isolate in order to protect those around them is assessed. Subject to the patient’s cooperation, contact tracing is conducted. This contact tracing has two main objectives:

• To identify vulnerable individuals: the elderly, people with chronic conditions (diabetes, hypertension, kidney, heart, or liver disease), immunocompromised patients, cancer patients, and obese individuals.

• To break transmission chains around as many cases as possible.

Investigations highlight factors useful for guiding COVID-19 prevention policy in Mayotte: lack of awareness about the disease, difficulties in perceiving its contagiousness, particularly in cases of pauci- or asymptomatic carriers. Finally, some cases are unable to self-isolate to protect those around them, highlighting the importance of maintaining accommodation options to ensure these individuals can complete their 14-day quarantine.

To inform and raise awareness among the population about COVID-19, community outreach events have been organized by the ARS in recent weeks. Key information necessary for understanding the epidemic is covered during these events. To be effective, these efforts must be sustained over time. Their impact will be all the greater when they are led, explained, and promoted by leaders from various communities. Indeed, these valuable partners are fully aware of the potential barriers to implementing preventive measures; they provide significant support in helping the public internalize the messages.

Furthermore, in some cases, individual interventions involving home visits have been conducted. These visits allow for informing confirmed cases and their contacts, as well as disseminating prevention recommendations, reminding people of protective measures, and continuing epidemiological investigations. They also provide insight into living conditions (access to water) and the feasibility of quarantine/isolation (number of household members, overcrowding). If necessary, teams provide supplies to facilitate hygiene at home and limit the spread of the virus (masks, soap, jerry cans).

Today, there is an increase in the number of people requiring support to combat the disease. The investigations and interventions carried out by the ARS and SpF can only be effective with the essential support of local stakeholders. The goal is to strengthen the strategy to combat the epidemic by facilitating access to a water source and encouraging mask-wearing in situations conducive to the spread of the virus.