03.04.2020 Feature Article

Do we stand a chance in Ghana with the global pandemic of the coronavirus? (part two)

Some of the challenges faced in Ghana with the ongoing coronavirus pandemic.
Dr Marian Manso (PhD)Dr Marian Manso (PhD)
03.04.2020 LISTEN

It will be very presumptuous to say yes outright when asked whether there are indeed just about +/-200 people infected with the coronavirus in Ghana. Or even in any other country when these number of cases are reported. Considering the rate of spread, it is normal to assume that when the reports says that there are +/- 200 confirmed cases, this figure can be doubled especially in Ghana. Why am I saying this? Few factors need to be considered:

As we already know, everyone can be infected by the coronavirus however, people at certain age generally have stronger immune system (unless they are immune compromised). This means that they are able to recover quickly before the corona symptom manifest. If they are able to recover sooner than symptoms are shown, then please understand that there are people walking amongst us that are infected but they do not realize it themselves and are able to freely pass on the virus to both younger and older people. So if the reports says that there is about +/- 200 confirm cases, these are people that have either shown symptoms and have taken the initiative to seek medical help. Or these are people that have flown in from a different country and have tested positive for COVID-19. To make the story short, there are people walking amongst us who are infected and are not even aware of it so naturally, people around them will come in contact with the virus and when they become infected, they also will pass it on. So please don’t be too comfortable to rely solely on the number of reported cases by the government.

Now let’s say you are not one of the lucky ones and you do indeed develop mild symptoms. Your financial situation will determine whether you do seek medical help or not. Now let’s be honest, how many people in Ghana or even in a developed country develop a common cough and immediately seek medical attention? I know I don’t. Firstly, a middle class or lower class income (which is about 70% of the people in Ghana) Ghanaian citizen will not pay 250 Ghana cedis consultation fee just to see a doctor. This consultation fee does not include transportation back and forth to the hospital, medicine that could be prescribed, or even a repeated visit fee to the hospital. Also, the thought of, what if I get admitted, how much will it cost me, how will I go to work and feed my family, after all, this 250 Ghana cedis can feed us for almost a week, will cross their mind. So imagine that about 70% of 300 (hypothetical figure) coronavirus infected individuals have the same thought and still are going about their businesses and coming in contact with other people, that is 210 people that will not seek medical help and will be casually infecting other people. Whiles this article is not meant to instigate fear, it is still important to understand the numbers when they are reported in the media. Moreover, from an epidemiology point of view, projection of coronavirus infected number is important to do a proper risk assessment and recommend the necessary precaution that need to be implemented.

Thirdly, not only are we dealing with financial situation, but we are also dealing with people who are simply unaware, illiteracy, or are simply being fed the wrong information. Let me focus on the misinformation about the high weather temperature. It is very understandable that people will assume that the coronavirus is not able to stand heat. Now I will hope that this assumption is somehow based on a scientific research but if it isn’t, let me explain briefly how scientifically, heat may be a factor in the coronavirus. After the outbreak of SARS CoV in the early 2000s, scientist investigated the stability of the virus. Chan et al., 2011 Investigated SAR CoV virus stability at different temperatures and relative humidity on smooth surfaces and they concluded the following: The virus on smooth surfaces retained its viability for over 5 days at temperatures of 22–25°C and relative humidity of 40–50%, that is, typical air-conditioned environments. However, virus viability was rapidly lost at higher temperatures and higher relative humidity (e.g., 38°C, and relative humidity of >95%). Chan et al (2011) further concluded that, the better stability of SARS coronavirus at low temperature and low humidity environment may facilitate its transmission in community in subtropical area (such as Hong Kong) during the spring and in air-conditioned environments. It may also explain why some Asian countries in tropical area (such as Malaysia, Indonesia or Thailand) with high temperature and high relative humidity environment did not have major community outbreaks of SARS. Because of these scientific reports on the previous SAR CoV, the outcome of these data have now been applied to this novel COVID-19 virus as its genetic material shows that both viruses are from the same family. Because of this, many Ghanaian citizens believe that the virus will not survive in Ghana and are therefore not abiding by the precautionary measures suggested by the health authorities and government. Whiles treading in this line of thought that heat destroys the coronavirus, we need to be careful and understand that this new coronavirus, although similar to the previous coronavirus, is still different and our knowledge on the virus is still limited. We are currently unaware whether mutation may have caused the virus to retain a good ability to be stable for longer period of time in hot temperatures. Also, whiles the study reported that 38°C causes the SAR-CoV to lose its stability, the stability of the virus in temperatures ranging from 28°C to 33°C (range of temperature in Ghana generally) was not reported. Therefore these presumptions do not aid in the fight against the new coronavirus. Moreover, reports on this current SARS-CoV-2 shows that RNA has been identified on a variety of surfaces in cabins of infected passengers up to 17 days after cabins were vacated on the Diamond Princess ship suggesting that this SARS-CoV-2 could possible stay stable for a prolonged period of time. Whiles secretly, I am hoping that the high weather temperature in Ghana may indeed contribute in shielding us from the rapid spread of the novel coronavirus, it is still of high importance to take the necessary precautions instructed by the government and other health authorities such as WHO and CDC, until more research has been done on this virus and we can make an informed decision.

To sum up this chapter, In Ghana, although the number of infected people are being updated continuously, it does not reflect the actual reality of the people infected with the virus. Financial difficulties will strongly influence the spread of the virus in the country. In addition, illiteracy, misinformation also contribute to the spread of the virus. Whiles heat is shown to reduce the viability of the previously identified virus, this does not mean that COVID-19 react to heat in a similar manner.

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