10 cases, 10 recovered: How the world’s most densely-populated region fought off the coronavirus

March 15, 2020, 11:30 AM UTC

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This story is one in a three-part series on how Greater China regions—Taiwan, Hong Kong, and Macau—have responded to the coronavirus outbreak.

Macau is the world’s most densely-populated region, with 680,000 people living on a landmass 26-times smaller than Singapore, and it’s just a stone’s throw away from mainland China. Yet, remarkably, the Special Administrative Region of China, a gambling mecca, has only reported 10 cases of coronavirus and, as of March 6, all 10 of those patients had recovered. With no new cases reported since Feb. 4, but with roughly 230 still under observation, Macau can tentatively claim to be free of Covid-19.

“Macau’s response to the outbreak has been very strict but very effective. They have restricted movement heavily, both at the border and within Macau, and the communication with the public was also very good,” says Edwin Cheung, a professor of health science at the University of Macau.

Macau’s new chief executive Ho Iat-seng has driven that firm response, having taken office just 11 days before China notified the World Health Organization of the coronavirus outbreak on Dec. 31.

Ieong Meng-U, a professor of political science at the University of Macau, says the change in leadership was timely since it meant Ho was looking for a way to prove himself and rose to the occasion. “I must say in this case at least Ho appears to have done a good job and has impressed the society,” Ieong says.

Macau’s early response

Immediately after confirming the first infection within Macau on Jan. 22, Ho’s administration stopped all travel between Wuhan, the outbreak’s epicenter in China, and the territory and ordered all tour operators to report where tourists from Wuhan were staying. Days later, police task forces began rounding up tourists from Hubei province for deportation or mandatory two-week quarantine, expelling 150 Hubei residents on Jan. 27.

Ho’s government also implemented widespread shutdowns of public places, ordering cinemas, theaters, nightclubs and spas to close and canceling Lunar New Year celebrations, too. Schools have been closed indefinitely as of Jan. 24. Then on Feb. 4, with most gathering points under lockdown already, the government took the monumental step of closing Macau’s 41 casinos. 

“This is not a holiday. It’s not for you to go out, go to gatherings, go jogging or do exercises, it’s not for this, but for people to stay at home,” Ho said as he announced the closure, urging the local populace to “do their civic duty” and stay off the streets so as to not “cause harm to others.”

Macau’s economic aid

Macau’s casinos generate $37.6 billion in revenue a year while gaming taxes constitute up to 50% of government coffers. During the mandatory 15-day closure, the casinos lost an estimated $2.24 billion. The Macau government, however, runs a huge surplus and can afford to support aid for the local economy. 

Concern In Macau As The Wuhan Coronavirus Spreads
A man wearing protective mask walks across a street in front of the Grand Lisboa Hotel in a residential district on February 5, 2020 in Macau, China. The Macau government announced it would close casinos for two weeks after a hotel worker was infected.
Anthony Kwan—Getty Images

Similar to Hong Kong, Macau has released over $1 billion in stimulus packages, including loans, tax breaks and direct payments. Over $270 million in vouchers were issued to the general public to encourage spending. Unlike Hong Kong, however, Macau also managed to secure a supply of face masks for its population, launching a scheme that distributed ten masks to residents every ten days.

Meanwhile, Ho’s government continues to pile travel restrictions on other regions where the virus has taken hold. As of March 11, arrivals from South Korea, Italy, Iran, Germany, France, Spain, Japan or Norway are required to undergo a 14-day quarantine.

Targeting mainland visitors

Those restrictions came on top of a rule enacted on Feb. 20 that targeted visitors from mainland China, who numbered 2 million in January alone. The rule forced visitors from Beijing, Chongqing, Guangdong, Henan, Shanghai, and Zhejiang province to submit to a medical examination before gaining entry.

The tiny territory’s border with mainland China—which includes several pedestrian crossings, an airport, ferry piers and a motorway—remains open despite the restrictions on specific countries and Chinese regions. The local economy relies heavily on workers commuting across from neighboring Zhuhai, Guangdong province, which is connected to the Macanese headland.

Foreign workers crossing from mainland China are subject to a 14-day quarantine, however, so some casinos and construction sites are offering mainland Chinese employees temporary accommodation within Macau to alleviate the quarantine burden.

“With the fact that we’ve had no new infections for over a month I think there’s a sense of normality returning to Macau,” said Ben Lee, managing partner at Macau-based gaming consultancy IGamix. “The streets are full of people again.”

More coronavirus coverage from Fortune:

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—A Q&A with WHO special envoy David Nabarro on COVID-19
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—After SXSW cancellation, Austin hotels and restaurants are bracing for a rough road
—While canceling mass gatherings, the U.K. is still aiming for deliberate “herd immunity”
—Walmart, Target, CVS, and Walgreens will loan space for coronavirus test centers
—Let’s remember what we learned in WWII, as well as in 2008

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