Africa: What’s next after coronavirus lockdown?
AS Covid-19 spread through mainland US in March, I wondered about the situation back home in Zimbabwe. The pandemic had swept through Asia and Europe, with Italy becoming the centre of global attention after an explosion of deaths. At that point, coverage on Africa was virtually non-existent.
Yet, the absence of news felt like good news. When I spoke with my mother, I learned that the pandemic was receiving news coverage although there was no official case count locally.
My spine tingled when she mentioned plans to deliver a church sermon end of month. What if Covid-19 was already there? It did not take long to get an answer. A prominent Zimbabwean television host was confirmed as the first local Covid-19 death after returning from New York City. It is something of a miracle that Africa was spared in the early days of the pandemic, considering the significant volume of travel between China and African nations.
Various explanations have been offered including random chance, lack of surveillance and warmer weather. Regardless, Africa finds itself with the opportunity to make decisive actions to curtail the impact of Covid-19. The president of South Africa announced a 21-day lockdown starting on March 26, which was later extended by two weeks.
When the Zimbabwean Government announced its own 21-day lockdown, albeit with fewer cases documented, I felt immense relief. I no longer had to worry about my mother’s exposure risk. While a lockdown will blunt the spread of Covid-19 and result in fewer deaths, some have argued that this is not the right call for Africa.
They say Africa’s population is significantly younger than that of other places where morbidity and mortality has been concentrated among the elderly. Additionally, given the high unemployment rate, a general lockdown imposes food insecurity on many people.
Other endemic issues including crowded housing and gender inequality make lockdowns even less favourable. Necessary or not, a lockdown cannot be indefinite. The next phase of crisis management must soon replace it. In this vital phase key stakeholders including governments, international partners and business leaders must expeditiously mobilise resources to execute a four-pillar strategy.
Amplify public education about Covid-19
A public education campaign would comprise information sharing through public and private channels, and social media platforms. Typical information includes common symptoms, preventive measures such as handwashing and physical distancing, criteria for self-quarantine, when to seek medical care, considerations for special situations like pregnancy, and myth-busters to counter misinformation. Translating content into multiple languages will allow for the broadest reach. An example would the Covid-19 Fact Sheets that I helped to review on behalf of a group of Zimbabwean professionals and researchers who translated key information into Shona and Ndebele.
Provide enough testing capacity to capture all suspect cases
Widespread testing of symptomatic individuals and their contacts is essential to inform tactics such as quarantine and contact tracing.
In hospitals, test results enable the appropriate use of resources such as personal protective equipment (PPE), isolation wards, and dedicated staff. Later on the epidemic serologic testing can help to identify individuals who have recovered and are theoretically safe to resume “normal life” without being at risk to self or others. Serologic testing also offers a window into the degree of “herd immunity”. South Korea and Singapore have demonstrated the impact of widespread testing. In Africa, Ghana has led the way with over 35 000 tests conducted as of April 11.
Equip healthcare workers for acute care and community outreach
Given the high occupational risk due to Covid-19, it is critical to protect and equip healthcare workers through provision of PPEs and knowledge sharing. Additionally, mobilisation of healthcare workers for community outreach can facilitate the delivery of public education and close monitoring of patients whose trajectory may warrant early intervention. Germany’s “corona taxi” service is an example of innovating on outreach.
Address infrastructural gaps, including ventilator shortage
Recently the demand for ventilators was estimated to be 10 times the global availability as countries scramble to meet the needs of critically ill patients. In Zimbabwe a prominent couple recently donated 45 ventilators to augment the country’s supply. At the same time an inspiring team of volunteers is helping to build and test open source ventilators under the registered trust Kufema Zimbabwe. However, the impact of increasing the number of ventilators is subject to infrastructural limitations that must be addressed including technical expertise, electricity, running water and oxygen supply.
Infrastructure preparedness will also determine capacity for broad distribution of evidence-based therapies and vaccines as they become available.
Random chance or not, Africa’s advantage of having lead time for Covid-19 preparation presents an opportunity that must not be squandered. Lockdowns may be efficacious in the early phases of the pandemic but in the later phases it is more beneficial to strategically execute on the four key areas outlined in order to save as many lives as possible.
Wishing friends, family and all Zimbabbweans health and safety during this time.
◆ Tafadzwa Muguwe studied global health science and immunology at Oxford as a Rhodes Scholar. He lives in Boston where he works in strategy and hospital medicine.