Spike in COVID-19 cases: What might have gone wrong?

COVID-19 continues to tear the world apart, but the talk about it seems to be fading away as each day passes. Many people have been forced to think that the virus is now history which is a serious misconception that Brazil, Mexico, Russia will regret to hear.

The virus is still a menace in United States of America where an average of 1 000 people die every day and the total death now surpasses 102 000 people. South Africa today has more than 25 937 cases with 552 COVID-19-related deaths. Zimbabwe is a landlocked country that has South Africa on the south and Zambia with 1 057 cases, on the north while Botswana lies on the western side with just 35 cases.

While we appreciate the divine favour in cases of prevalence and incidence, we should also bear in mind that the low numbers that we have in Zimbabwe may be attributed to our low testing.

However, we have not witnessed increased cases of suspicious deaths in our country which may be a signal that we may be doing quite alright and the direction has clear routes.

Lately, our cases have been recorded from returnees in the quarantine camps and Wednesday was the darkest day since the beginning of the year when a total of 76 cases were recorded in just one day.

How calamitous is that! We were basking in the sunshine as a nation when we were walloped by lightning from nowhere and the consequences can be easily envisaged. We cannot deny our people back as some of them are just victims of silent xenophobia from where they are coming from.

Government did very well by putting them in quarantine centres and Beitbridge has been using the magnificent NSSA Hotel to accommodate our fellow sons and daughters of the soil. The returnees from South Africa seem to be the greatest risk to our country at the moment.

If 76 people can test positive in one day and assuming that the virus was directly imported from South Africa, then the whole road to the border is now full of coronavirus.

Is it imported cases that have hastened degrees of local transmission in the quarantine centres? If the country is to move in the right direction in terms of COVID-19 control, we have to have answer to the following questions:

 Were these infections purely imported or they were acquired in the quarantine centres?

 Are quarantine centres the new hotspots for COVID-19 transmission?

 Are we doing the prerequisite testing at day 1, 8 and 21 in the quarantine centres?

 If then it is local transmission in quarantine centres, what are we doing wrongly to allow transmission of such magnitude?

Quarantine means a state, period or place of isolation in which people or animals that have arrived from elsewhere or have been exposed or are suspected to have been exposed to infectious or contagious disease are placed. Yes, our brothers and sisters are feared to have been exposed in South Africa so we need to be sure they remain safe to everyone. So what are the minimal public health practices that should be practised in the quarantine centres? Putting people in designated centres without observing the right public health measures may not only be woeful but pathetic. Ideally, the following should be done in quarantine centres:

 It may be suicidal for returnees to share amenities. It is prudent for occupants to have their own room, toilet and bathroom.

 Meals should be served preferably in their own rooms and sharing dining rooms should follow social distancing, sanitization of surfaces like tables. Number of people served should be very minimal to allow for easy disinfection of the places. This is not the case at one of the quarantine centres in central Harare. The returnees are crowded at meal times, some even play games as groups. We are doomed!

 Wearing of masks should be done if there are chances of some occupants meeting.

 Caretakers should be taught about basic principles of public health because they may be the sources of infection.

 Facilities for handwashing with clean water and soap should be readily available, including the provision of sanitisers.

 There must be separation of cohorts by the countries they come from or the time they came into the quarantine centres. Those coming from highrisk places or countries should be separated from those coming from low-risk areas. Handle highly suspicious cases with extra medical care.

 Testing should be prompt and results should be availed as soon, preferably within 24 hours as delaying with results may give a false sense of health security to some returnees who may start to mingle around. We have heard of sex escapades in quarantine centres with condoms running out of supplies. Serious quarantine should see little of this as social distancing should be number one priority.

Are those things I mentioned above being followed in quarantine centres then?

It is quite astounding that so many of the returnees are now illegally crossing the border from South Africa to Zimbabwe via Chiqualaquala, Chikombedzi and Gezani, thus evading the mandatory quarantine.

How annoying to hear that 118 returnees have escaped from quarantine centres, putting the lives of everyone at risk?

We ought to remain vigilant as a nation. Border patrols should thus be strengthened with security agents being deployed with speed to curtail the detonation of the time bomb that threatens you and me. The border is now the greatest threat to humanity in terms of the COVID-19 war. Together, we will win.  Johannes Marisa is a medical practitioner, educationist and public health practitioner who writes in his capacity. He can be accessed on doctormarisa@gmail.com