Dr Omane Boamah writes ... Coronavirus Disease on A crowded Planet
The Coronavirus scare is real! Ghana has so far confirmed nineteen (19) cases – comprising both imported and community level infections. The global figures are mind-blowing!
The disease inspires fear in most Ghanaians who get to know not only about its rapid spread but also its socio-economic ramifications. Patients come to doctors terrified at the slightest cough, cold or sneeze.
I have managed a few of such cases and having convinced myself – clinically – that they do not meet the case definition criteria counselled and reassured them to self-isolate and revert for review.
Although the World Health Organisation encourages testing and testing, the harsh reality is that for now, there are not enough test kits for everyone. As a result, there are restrictions on who gets tested.
Following the release of the genomic code for the virus (which is the blueprint for creating tests and vaccines) in January after the first few cases, different countries showed variable responses to it and to the development of test kits for diagnosis.
At the moment, nations who were swift and had appropriate local backing, are currently able to churn out a good number of test kits which helps to contain the disease.
In Ghana, a few health workers have already been forced to avoid assisting suspected cases of Coronavirus disease, not out of wickedness, but due to lack of Personal Protective Equipment (PPE). Bottom line, both clients and caregivers must be supported to overcome the conquering Coronavirus disease – COVID-19.
What is in a Name?
The virus which causes the disease is named: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-COV-2). It is not the “Chinese virus”. SARS-COV-2 is new. But Coronavirus itself is not novel. Call this dreaded virus a ‘close family member’ of the already known Coronavirus, and you will not be wrong. Needless to state, Coronavirus disease (COVID-19) is the disease caused by this new virus.
This difference between the name of the virus and the disease itself is not unusual – and must not cause any confusion. A similarity can be gleaned from Acquired Immune Deficiency Syndrome (AIDS), which is caused by the Lentivirus, Human Immunodeficiency Virus (HIV 1 & 2). HIV belongs to the retrovirus ‘clan’.
Instead of creating confusion based on fiction, untruths, half-truths, mischief and junk research about the appropriate name to use and unverified coping mechanisms, I entreat you to focus on identifying the core symptoms (fever; cough; sneezing; and difficulty in breathing) very early.
If you do, do not panic! Seek medical attention.
The assurance is, before this novel Coronavirus disease, there was: fever, cough, and sneezing so you may – just maybe – not be a victim of the ongoing pandemic. Yours could be a common illness with known treatment. On the other hand if you test positive for the virus, subject yourself to medical management because the survival rates with efficient care are encouraging.
What Is Happening In Our “Crowded Planet”? Any hope?
The concept of a “crowded planet” was introduced to us by the Quetelet Professor, Jeffery D. Sachs at Yale University, Connecticut – U.S.A in April 2008 during a Unite for Sight Global Health Conference.
Why a crowded planet? Is our planet, earth, not too vast and rich in resources for humanity? Jeffery Sachs answered these nagging and gnawing questions about the linkages between economics (including human activities) and the environment.
He said brilliantly, “…We are, in short, in one another’s faces as never before, crowded in an interconnected society of global trade, migration and ideas, but also risks of pandemic diseases,…and conflict.” Sadly, twelve (12) years on, we are witnessing one of such pandemics unfold in the form of COVID-19.
We are truly “in one another’s faces as never before” because we live in: ghettos, “compound houses”, condominiums, bungalows and gated communities.
Even if we live with our families in isolated walled houses, we interact with others at work, school etc. And after the day’s hard work, we return home to share common places and items with our families.
Another interesting concept which explains the novel COVID-19 is, “The Changing nature of infectious diseases.” There is emergence and re-emergence of new diseases such as SARS and HIV; ancient diseases including diphtheria; and novel diseases (e.g. COVID-19).
In recent times, we have witnessed Zika virus infections in Brazil, which nearly undermined the Rio Olympic Games in 2016 just as COVID-19 is threatening Tokyo 2020 scheduled between 24th July and 9th August. Also, the Ebola virus virulently invaded West Africa and spread to other parts of the world.
Coker, Sim, Pomerleau and McKee (2011) suggest, “The human race originated in the tropical climate of Africa and was affected by the same parasites as other primates in these areas. As these early hunters migrated into more temperate zones, then the infectious agents they were exposed to changed.”
They further suggested that agriculture replaced hunting and led to domestication of animals; the closer interaction between domestic animals and humans created the opportunities for zoonotic (animal) infections to spread to humans. The overall effect is that, person-to-person spread of infectious micro-organisms increased.
Flowing from the foregoing, is there any wonder that conspirators have theorised, albeit without evidence, that the source of the disease confirms China’s culinary low threshold for some organisms? It is fair, also, to state that China has suspected a biological attack on them.
What is not in doubt is, over the years, humanity has domesticated more animals and there is emergence and re-emergence of infectious diseases.
This phenomenon, according to experts, is due to, demographic changes and human behaviour, microbial adaptation, technological and economic development, breakdown of public health policy and health infrastructure, warfare, terrorism and conflict, and last but not least climate change.
These anthropogenic causes of infectious diseases may develop into global self-destruct buttons, if we do not act and care as individuals, as governments and as a global community sharing a crowded planet. The time to save the planet is now or never! Let’s save humanity for sustainable development now!
Impact of COVID-19
There has been a massive and negative impact of COVID-19 on Ghanaians and the world as a whole. In Ghana, among others, schools and churches have ended physical sessions; funerals and major events have been postponed indefinitely and recreation has been badly hit.
In the U.S.A. Psychologists are raising issues about the effects of COVID-19 on mental health. Such was to be expected, particularly social distancing is considered a significant control measure against the spread of the virus.
Italy is still counting the dead, cutting their losses and welcoming medical aid from China; as China begins to count their victories over Coronavirus disease.
As the world and Ghana grapples with these challenges without enough test kits and inadequate personal protective equipment, health human resource and infrastructure, we must act collectively, while keeping a social distance to survive.
What Can We Do?
1. Prevention! We must keep it simple: thorough handwashing with soap under running water. Where running water is unavailable, authorities should provide Veronica buckets (a Ghanaian invention) and tippy taps.
2. We must report early to health care providers when we develop fever, cough or difficulty in breathing.
3. We must not shake hands.
4. If you already have hypertension, diabetes mellitus, cancer, long-standing respiratory disease such as asthma, you stand a higher chance of contracting coronavirus disease. Same can be said for the elderly above 60 years. Therefore, greater precautions must be exercised.
5. Also, do not refuse to be quarantined or self-isolate if need be – you can read, listen to music, watch television and participate in group video chats but stay away from gatherings, gyms, sleepovers and concerts for fourteen (14) days.
6. Social distancing really helps. We must also limit contact between people to reduce the spread of infections. So, limit being in large groups; Government should strongly consider implementing a lockdown to prevent horizontal spread of the infection.
7. Governments. Governments must act fast and decisively to nip the pandemic in the bud and build resilient health systems. I urge the President of Ghana to release money from the Heritage Fund – even if that is the last resort – to bend the arc of infections urgently and immediately before it is too late for Ghanaians.
8. Furthermore, the required infrastructure and logistics are disproportionately scanty in Ghana. I do not expect mushrooming of new infrastructure overnight. We ought to be realistic. The ministers for Health and Local Government and Rural Development should engage all Regional Directors of Health to identify facilities in the sixteen regions of Ghana as possible quarantine centres. It will be impossible to transfer coronavirus patients from the hinterlands to the capital, Accra.
9. The United Nations, African Union, ECOWAS, CSOs, NGOs, Pharmaceutical Companies, researchers, public health and policy experts including health workers must accept our common but differentiated responsibilities and work to save our crowded planet to ensure sustainable growth and development.
10. Finally, I urge you to stop peddling rumours and myths about coronavirus disease. Help save everyone, including yourself.
I agree that Coronavirus disease is thriving because our planet is crowded and the overcrowding and human activities are leading to the changing nature – emergence and re-emergence – of infectious diseases, we are witnessing today. Zika, Ebola and SARS-COV-2 viral infections are enough warning signals; so let us act decisively now!
Dr. Edward Kofi Omane Boamah
A Frontline Health Worker In Ghana
Former Minister for Communications
21st March, 2020