In Elechi Amadi’s exemplary 1969 novel “The Great Ponds”, the dibia or healer comes to terms with what everyone was later to realize, was the stark arrival of the 1918 influenza pandemic to the people of the Niger delta in Nigeria. Resigned to what was to come, the dibia observed “they were all going to die anyway. It was only a matter of time “, for he realized, there was no cure.
Time indeed is the currency and how well it is used will determine our national outcome. We hope that the current COVID-19 pandemic does not take the same relative toll on the world as the 1918 influenza pandemic did. In January, when this began to unfold, everyone thought it was a Chinese problem.
However, in this widely interconnected global village, that we call our world, there is nothing like a local problem. Soon enough, the virus, transported by people traveling to and from China, spread rapidly across the globe. Every day, we observed the morbid league table of cases in different countries and the rate at which the epidemic was transforming itself into a global pandemic. Thankfully, in Ghana, entry through our largest international airport includes thermal screening which has been present since the Ebola epidemic in West Africa. It is a good place to start but clearly is not enough because this virus seems to have a rapid mechanism of transmission with an incubation period of 5-14 days during which spread continues. It also has a high infectivity rate.
Before long, many countries between latitude 35 N. and 45 N. began to manifest a high density of cases. Places like South Korea, Iran, Italy, Spain, New York state (US) and Washington state (US) manifested what the world could look like in the coming weeks. This is very different from other coronaviruses we have been familiar with. Influenza, SARS and MERS appeared less lethal than this new kid on the block. We have learned a lot in a very short space of time. The presence of flu-like symptoms should lead one to a healthcare provider to be sure whether Covid- 19 is responsible for the symptoms or not. If not, isolate yourself as much as possible. For many, it is experienced as a moderate flu-like illness but for the elderly and the already medically compromised, it can be rapidly fatal.
It is unclear how the illness manifests in children and young adults but they seem for now, to be relatively more resilient than other population groups. They could however be vectors or carriers, making all the people around them ill. So, will keeping schools open help create herd immunity or will closing schools help with limiting the spread Covid-19? Within our Ghanaian context a number of things are very important. Public health crises of this nature must be approached with a military mindset.
Just as President Xi of China referred to their approach in Wuhan as “The People’s War “. The primary goal of our approach is should be to reduce the rate of community spread so as not to overwhelm our already under resourced and overstretched healthcare system. The war must be won in the community to prevent this from overwhelming our healthcare capacity. The key to achieving this is to become very un-Ghanaian. We are very social beings but to survive this new reality, we must observe social distancing with a high degree of discipline. I know that our undeclared national motto is “long live the dead “.
We must however begin to care more about the living for the next few months. Large funeral gatherings must be done away with promptly. Technology can be used to express our sympathies by paying our “Nsawa” by Momo. Funerals must become a more private affair, if they are not to become hotspots for seeding and spreading this virus. Not shaking hands at funerals is not enough. Large celebrations like weddings and indeed regular church services need to be curtailed in the short term for the sake of the greater good. Again, many may have to worship by their laptops and Internet connections. God will understand, even if pastors don’t. There is a complacency that comes with having just a few confirmed cases of Covid-19.
The current models suggest that many thousands could be asymptomatic and will spread the condition, if strict social distancing is not enforced. It is believed that, once cases are established, whether verified by testing or not, the number of live cases doubles every six days. The US with 2000 confirmed yesterday, has 3000 today and is projected to have 1.3 million cases by the end of April. Indeed, enforcement is the key. We have not had a good history with enforcing anything but this time, our very lives might depend on this.
The press must rise to the level of providing clear and transparent information that is vetted by our public health authorities. Though we have freedom of the press and indeed free expression in our society, one must carefully weigh printing and disseminating false information, such as false cures, raising false hope by numerous so-called men of God and charlatans. This situation presents a good opportunity to reinforce known standards of good hygiene, which can be embedded in the society and useful to all of us long after this crisis passes. When the Catholic Church closes all churches in Rome and even private worship, the epitome of social distancing is not allowed, you know that God will understand if you do not go to church. Not even the Sack of Rome in 1527 led to the closure of churches. Only necessary travel in multi-passenger vehicles should be considered.
There will be economic hardship and other social considerations but these will be superseded by the number of deaths, when and not, if they begin to occur. Spain and Italy are essentially on national lockdowns because the tough decisions were not enforced early enough. This situation is a test for transparent and bold leadership and it is our hope that our government will take the very difficult, likely unpopular and hard decisions that are necessary to keep all Ghanaians alive. If we are to avoid having to build field hospitals, buy ventilators and spend a great deal protecting health workers, we must not politicize this war.
All communication must be provided ideally, by public health leadership and all Ghanaian experts, irrespective of perceived political leanings must be at the leadership of the war against Covid-19. There are of course, regional imperatives to consider as well, to keep all of West Africa safe. All government and Norwegian officials who may have been exposed in Norway must be monitored, tested and isolated as necessary. No exceptions! Prayer is not enough. We have to adapt rapidly and change our social behavior to meet this new reality.
T. P. Manus Ulzen is Professor of Psychiatry and Behavioral Medicine at the University of Alabama, Annual Visiting Professor at the University of Cape Coast School of Medical Sciences and author of “Java Hill: An African Journey” – A historiography of Ghana [email protected]