A Distressful Experience with the Covid-19 Management/Containment System of Ghana: Implications for Fighting/Containing the Pandemic in the Country

On 12th July, 2021, my wife (Mrs. Yvonne Ayelazuno) and I went to a certified Covid-19 testing laboratory, the Public Health Laboratory in Tamale, and got a test for travelling purposes. A staff of the laboratory called us on 13th July and relayed bad news: both of us have tested positive for COVID-19 (see the results of the test attached). The rest of this statement covers this experience and its implications for the fight and containment of the pandemic in Ghana.

Zero, naught, no action by the Ghana Health Service (GHS)

It is exactly ten (10) days since my wife and I tested positive – taking seriously the results of our test by the Public Health Laboratory in Tamale. Yet, as of the time of writing and releasing this statement, no action has been taken by the Ghana Health Service to, at the very least, stop the spread of the pandemic; by managing what my wife and I may do (or not do) relative to the observance of the protocols by people infected by Covid-19. Except the advice of an official of the laboratory to us to self-quarantine, no any other official of the GHS has contacted us with information regarding managing and containing the spread of the pandemic. Note that our concern is not even about treating us for the disease, but preventing us from infecting other people.

The inaction of the GHS should be situated in the context of Ghana’s official policy for managing and containing Covid-19 in the country, for which it has been highly commended.^{^[1]} For example, the International Monetary Fund (IMF) praised Ghana for its “proactive response to the pandemic which mitigated its economic impact” on the country.^{^[2]}

Since March 2020 when Ghana recorded its first cases of Covid-19, the government stated five objectives it seeks to achieve in the fight and containment of the pandemic: 1) limit and stop the importation of the virus; 2) contain its spread; 3) provide adequate care for the sick; 4) limit the impact of the virus on social and economic life; and 5) expand the domestic capability and deepen the self-reliance of the country in dealing with the pandemic. The motto driving Ghana’s system of management and containment of the pandemic is the ‘3T’s’ (i.e., Tracing, Testing, and Treatment).^{^[3]}

Ghana’s strategy for fighting and containing the pandemic was recently elaborated in a press statement issued and read by the Director-General of the Ghana Health Service on 20th July 2021.The statement was issued after a two-day high level strategic meeting on Covid-19, organised by the GHS in Kumasi.^{^[4]} In this press statement, the GHS expressed grave concern over the recent upsurge of Covid-19 cases in the country; that is the 3^rd wave, driven by the new and infectious Delta variant of the virus. The GHS attributed the upsurge to some challenges: total disregard of Covid-19 prevention protocols by the public; limited access to testing for Covid-19, contact-tracing challenges, vaccine hesitancy and misinformation, etc. To counteract these challenges, the GHS said it was taking the following measures: it will embark on educational and attitudinal change communication on the safety protocols of Covid-19; scale up testing capacity; use antigen testing as part of its rapid response strategy to outbreaks of the disease at specific places; it will strengthen contact tracing, quarantine and isolation; it will strengthen case management capacity, etc.

Implications of our case for the fight and containment of Covid-19 in Ghana

Our experience after testing positive for Covid-19 shows that the system/strategies designed by the Ghanaian state to fight and contain the pandemic do not work, and this has many serious implications for Ghanaians, as they try to deal with the pandemic in challenging circumstances. These implications include the following:

First, the inaction of the GHS after my wife and I tested positive illustrate the widespread inefficiencies that have bedeviled Ghana’s public service, a situation that has led to the poor delivery of essential services to Ghanaians; services such as quality education at all levels, water, electricity, health and sanitation – to mention but just a few examples.

Second, and redolent with the gap between good policies and implementation – which, I dare say pervades the public service of Ghana – our experience demonstrates that Ghana’s Covid-19 fighting and containment policies may be the best in the world, but they remain so only on paper. The political class and top public servants are good at shouting these good policies/strategies from the rooftop – mainly to promote their selfish political

and class interests – but do little or nothing to implement them. The corollary of this attitude is that, Ghana is a country with many good policies and institutions on paper, but they are useless, if probed with the delivery of the services they have been designed for. For example, the much-touted ‘3T’s’ (i.e., Tracing, Testing, and Treatment) are empty rhetoric, at least, from our experience.

Third, our experience calls to question the credibility of the national Covid-19 data compiled and released by the GHS. For example, the GHS reports on its website that, as of 18^th July 2021, the confirmed cases of Covid-19 in Ghana are as follows:

Routine surveillance – 34, 978 cases;
Enhanced contacting tracing – 62,950 cases;
International travellers – 2,046 cases;
Total number of cases – 99,874 cases.^{^[5]}

The GHS reports that, 95,538 of the above total number of infected people recovered from the disease or were discharged; 26 people were in severe condition; 15 people were in critical condition; 818 people died from the disease; and 3,618 are active cases. Having been tested positive on the 13^th July, my wife and I will constitute part of Ghana’s total number of cases. However, and considering that the GHS has not contacted us, it cannot capture our cases in any of the above categories (recovered/discharged, severe condition, critical condition, dead, and active cases). If this assumption is plausible, then where do we belong? Of course, we are not dead, but it is impossible for the GHS to know this since they have not contacted us. Some of the data churned out by the GHS may be, at best, inaccurate, and at worst, spurious.

Last – and this is the upshot of this press statement – our experience shows that ordinary Ghanaians are on their own when they are infected by Covid-19. It is most likely that they would not get any help from the state – never mind the elaborate measures it has designed on paper to trace, test, and treat people for Covid-19. This means that all Ghanaians must try to follow the safety protocols to protect themselves from getting infected, if they are to have a 50-50 chance of living through the pandemic. This is critical, considering the low vaccination capacity of the Ghanaian state. Of course, some of these protocols require some resources to adhere to them. For example, running water is needed to comply with washing hands regularly; hand sanitizers are needed to sanitize hands; face masks are needed to cover the face/nose/mouth, etc. All of these require some financial resources that the poor classes may not have. Nonetheless, the takehome message of this press statement still remains the same and is worth re-echoing: Ghanaians, try as much as possible to protect yourself from infection, because you would be on your own when you are infected with the deadly disease.

Stay safe! Thank you!

[1] Sibiri, H., Prah, D., & Zankawah, S. M. (2021). Containing the impact of COVID-19: Review of Ghana's response approach. Health policy and technology 10: 13-15.

[2] Graphic.com.gh (2021). IMF commends govt for COVID-19 response, stable cedi.

https://www.graphic.com.gh/business/business -news/imf -commends -govt -for -covid -19 -response -stable cedi.html .