On Monday 30th March 2020), once-bustling cities in Ghana (Accra, Kumasi, Tema, n Kasoa) turned into ghost towns as these cities go on a partial lockdown for the next two weeks. The government has ordered these cities to stay at home for two weeks except for essential reasons in order to slow the spread of the virus. The move comes as the death toll in Ghana reaches five (5) and the recorded cases hit 152.
I also would like to commend the president for the swift response. I believe anything that is done that increase social distancing can help decrease the spread of the virus. Epidemic grows for a simple reason- how often people mix.
But whether the lockdown will succeed in stemming the spread of the virus is a matter of debate. I am very skeptical about the great impact of this partial lockdown n may be backfired if other urgent measures are not implemented to augment this partial lockdown of some selected cities in Ghana.
I was in Accra last Saturday and was overwhelmed by the huge number of travelers leaving Accra to their respective hometowns. I believe this unwarranted movement of people will put people in other regions at risks especially from people who have already been infected with the virus but not showing any symptoms as at the moment
All the same, if we do the right thing we will have a positive result. We must not go to sleep and think that the lockdown will do the magic for us. Some countries such as Italy are on total lockdown but recorded case and death rate continues to surge.
Managing the lockdown
We can’t fight this pandemic blindfolded. If the lockdown measures are implemented, that alone isn’t enough to stop the spread of the virus although that has been the plan B in previous epidemics worldwide. Many nations including China have chalked some success by halting the spread using the lockdown measure. But that is no guarantee that Ghana’s version of the lockdown will automatically lead to similar results. Achieving the desire success will depend on other measures the government put in place to augment the imposed restrictions.
1. Speed up Testing
Rigorous containment measures such as mass testing should be adopted. We must test test test and test people as many as possible to find as many cases as possible, isolate those infected to stop the chain of transmission. The testing must cover the entire nation and should also include At Risk Population, health workers (including herbal practioners) who are exposed to the virus per the job they do. We must try hard to find every single infection through mass testing and follow up on every potential exposure and break every possible chain of transmission. Countries like South Korea have beaten back the virus through mass testing program. They didn’t even go on lockdown. Majority of its citizen got the chance to be tested. The Chinese government deployed a team of 1500 epidemiologist, 5 in a team to every locality in Wuhan to trace, and isolate people who get infected by the virus and their contacts.
2. Speed up Contract Tracing
The country’s virus containment system needs to be improved during this partial lockdown. The risk of slow contact tracing is that by the time someone is called because they are close contact of an infected person they might already feel feverish, and have passed the virus to another person(s). At Risk population are close contacts and if employing additional public health staff or epidemiologists we should in other to speed up contact tracing. We need to use this period to build up our ability on those cases and contacts, and also make sure we are addressing any blind spots we have in our ability to identify cases. We must at this time reduce the number of days used in tracing contacts.
3. Empower Health workers
We must do all we can to empower local health department, Clinics and community health workers including herbal practitioners who on daily basis come into contact with people. By this, health workers will able to scale up rapidly to trace contacts of those infected by the virus. We should maintain a trained workforce and up-to date infrastructure in various clinics and hospitals until we fix this crisis.
4. Increase public sensitization
The citizenry matters in all of these. We must engage the public more actively. I think the president has been doing that more often with his frequent broadcast to the nation. Infected people if properly educated will isolate themselves and even not relent in asking their recent contacts to test also. We must empower n educate the population to be able to help them take matter into their hands. We should learn from countries like South Korea which uses location data to customize mass messages sent to cell phones, notifying every resident when and where a nearby case is confirmed.
5. Enforce the law with human face
The efficacy of the lockdown will also depend on the extent to which people comply with the rules. The length of time the rules will be lifted can have vast social and economic cost. Many Ghanaians and those quarantined who are not used to such restrictions may go through mental health issues arising from the emotional toll of weeks being locked in small places unable to see friends and family or engage in their regular businesses.
The government, of course, has the right to ensure its policy, but there is a countervailing duty that is obligated to perform. That duty is to ensure that the lockdown does not, in its operation violate the fundamental rights of people. The right to earn a livelihood is a fundamental right.
Post Lockdown Tracking
The partial lockdown will not accomplish it aim of halting the spread if other measures including some that I have enumerated above are ignored. A boomerang effect could occur. Again how we manage post lockdown will also go a long way in curbing this pandemic. Countries like China, Taiwan, Singapore and South Korea which seem to be at the tail end of their outbreak are seeing new cases emerging even though they are being imported. A small number of Ghanaians who were under lockdown might still have the virus as the lockdown expires but not know they are sick. These people could spread it, starting a new wave of infection. Internal tracking if not controlled or monitored, travelers could bring back the virus into the country. We should not go to sleep after the lockdown.
In conclusion, the advantage of Ghana having a system with a quick turnaround of lab testing, fast contact tracing and dealing with post lockdown issues will save all of us this unprecedented situation we find ourselves.
Jerry Kweku Asomaning
A Public Health Advocate and a student of history and politics