The extreme social-distancing or lockdown seems to be an intervention available to help individuals stay healthy, break the chain of transmission and give more vulnerable populations a fighting chance of surviving the COVID-19.
As a precaution to counter the spread of COVID-19, the President of Ghana placed a suspension ban on all public gatherings such as festivals, rallies, church activities, weddings, and funerals for four weeks. Also, basic schools, Senior High Schools and Universities, both Public and Private have been closed.
On 21 March 2020, the president updated the nation on the status of the measures put in place to help minimise the possibility of further novel coronavirus infestation. He also placed additional stringent restrictions on travel by ordering the closure of Ghana's land, sea, and air borders to human traffic effective midnight, 22 March 2020.
A substantial number of detected cases in Ghana are from among some of the persons who were mandatorily quarantined by the government after arriving in the country hours to the closure of the country's air, sea and land ports. The number of vertical transmissions or imported cases recorded gives credence to the closure of Ghana's borders.
The exponential growth of the number of cases in Ghana has compelled some associations and individuals to appeal to the President for additional social-distancing or lockdown measures.
The Ghana Medical Association (GMA) called on the President to immediately lock down the nation with the exception of essential services, to prevent any further spread of the novel coronavirus. According to the GMA, the lockdown is a proven option backed by science.
The Graduate Physician Assistants Association of Ghana has also called for the immediate lockdown of towns and cities with the most confirmed cases of the coronavirus in the country. According to them, the government should either conduct mass testing of all towns and cities with most cases immediately or immediately lockdown the towns and cities with most cases.
The President has said his administration is currently discussing and giving consideration to the issue of a nationwide lockdown proposed by the Trade Unions Congress (TUC) in a recent letter to him.
Starting 23rd January 2020, the Chinese government locked down Hubei Province, including Wuhan, the city of 11 million where the outbreak started. They halted transportation in and out and barred tens of millions of people from working or going to school and closed all shops except those selling food or medicine. In some areas, residents were even forced to limit trips to the store or order supplies for delivery. This unprecedented lockdown of tens of millions of people was considered a vast experiment, but it may have worked. Following the lockdown, cases began to slow.
There is a need to examine the consequences of a similar lockdown in Ghana. We hope that the government will critically look at public health concerns, social and economic implications before any decisions are made.
Ghana is predominantly an informal economy. A large number of the population, over 80% are employed in the informal sector. None of the regions of Ghana has up to 20% of businesses or non-household establishments being formal. Most of them are largely self-employed persons like farmers, artisans and craft-workers, traders, food processors, and others. When it comes to the development of Ghana's economy, the informal sector plays a vital role.
Most informal sector workers are caught up in poverty since they earn a low income. They are mostly people who are self-employed; operating small businesses that are not registered. The informal economy will suffer from the lockdown because of loss of daily sales and income.
At least 80% of families go to farms and normal markets before they are able to feed their families. The majority of families cannot buy bulk food and even then such bulk local food items cannot last for a week without rotting. So locking down an informal economy may starve some people.
Ghana has a housing deficit of over 1.5 million. There are some people in Ghana who don't even have a place to get locked inside. With lockdown, the government must advance plans to shelter them.
What will be the faith of households who go out for sanitary services; toilets and water every day? Total lockdown will minimize the contagion effect of the pandemic but uncollected waste, failing water supplies and intermittent power could prove as dangerous as the virus. The problem is that, as soon as the end of the lockdown, the infections and deaths will soar again.
In other countries where lockdowns are accompanied by bailouts, the leaders know that these can only offer short-term fixes. They have one eye squarely on the calendar and are trying to calculate when they are going to have to tell people to get back to work. The coronavirus lockdown cannot go on too long or the consequences of economic breakdown could be even more deadly than the disease.
Epidemiologists and doctors believe even the most radical social-distancing measures like lockdowns in Italy, Spain, Belgium, and other EU countries can only provide temporary respite. China has chosen to give up on the most radical forms of containment and prioritize economic growth in the coming months.
If Ghana decides to go for a total lockdown, a stimulus package must be given in terms of tax rebates, financial reliefs, refunds, and social assistance to affected businesses and individuals to cushion the economy from the effects. We have to introduce mitigating conditions to strike a balance between health and socio-economic considerations.
Some additional social-distancing measures or restrictions may be needed to halt the further spread of COVID-19 in our communities but must be done incrementally on selected economic activities especially in towns and cities with the most confirmed cases of the coronavirus in the country.