Covid 19 Fight in Ghana: Addressing the Major Challenges

Background
The battle is on as Ghana and the rest of the world continue unrelentingly to contain, eradicate and finally gain freedom from the deadly Covid-19 pandemic.

Various interventions have been put in place by the government of Ghana after the unwelcoming arrival of the coronavirus in the country. After the first two positive cases were recorded on March 12, 2020, schools, churches, mosques and other public places have been closed down. Other physical distancing protocols such as being at least a metre away from other people and avoidance of crowded places have been encouraged to slow down the spread. Partial lockdowns were at a point in time enforced and the regular washing of hands and the use of alcohol based hand sanitizers and face masks seem to have been embraced by Ghanaians without any problem.

The above measures aimed towards reducing the spread of the virus have somewhat achieved results. What Ghanaians need to be worried about, are two main challenges inhibiting the progress of the Covid-19 fight; testing of suspected people and reporting of new cases.

Testing of Suspected People
The availability of few testing centres for Covid -19 in Ghana poses a great challenge to the fight against Covid -19. Until quite recently, there existed only two testing centres; Noguchi Memorial Institute for Medical Research and the Kumasi Centre for Collaborative Research. These two centres could not test more than 2000 samples daily, creating a test backlog and subsequent delay in the test results.

The aggressive testing and contact tracing by government is a commendable and worth emulating measure of chasing and fighting the virus. However, if Ghana's Covid -19 case count standing currently at 2,169 has led to the tracing and testing of more than a 100,000 contacts, then one can estimate the number of contacts needed to be tested should Ghana's case count hit 5,000 and above. The more contacts are traced and tested, the more results of tests are delayed because our testing centres do not have the capacity to test large samples within a day.

The activation of three other testing centres by government (National Public Health Reference Lab, Korle Bu, the Veterinary Service Department and Council for Industrial Research) comes as a good news, but more need to be added. Test centres should be extended to the doorsteps of Ghanaians because should Ghana reach the peak period of this pandemic (peak because we prepare for the worst as we hope for the best), these testing centres would be overwhelmingly inundated with test samples.

As indicated earlier, the absence of more testing centres have accounted for the delay in test results. Currently, it takes two to three weeks to receive test results of samples. This has a devastating impact on the fight against Covid -19 as patients who eventually test positive would have developed severe symptoms of the disease, making their recovery a mirage of impossibility. This has resulted in the current surge in Covid -19 deaths. Two weeks ago, a patient died at the Bawku Presbyterian Hospital before his result was out after almost three weeks after being tested, which eventually and sadly proved positive.

There is the urgent need for government to expedite the setting up and activation of Covid -19 test centres so the test results can be delivered the same day after testing without having to queue up for days. The ability to release test results within the shortest possible time after testing (preferably on that same day) would make patients remain asymptomatic, making their cure and recovery easier, and subsequently reducing the fatality rate of the disease.

Reporting of Positive Cases
Since Ghana hit over 600 Covid -19 cases, the Minister of Information, Hon. Kwadwo Oppong Nkrumah, did indicate that the then, and subsequent surge in number of positive cases are the results of backlog of tests made. Is it not interestingly ridiculous how Ghana continues to owe arrears of workers and is now owing arrears of Covid -19 test results? None the less, assuming Ghana's test centres have a testing capacity of 2,000 samples per day, teat results for these samples should be made available within 6 hours after testing. Why then, can't the Ghana Health Service (GHS) give Ghanaians a daily update on the number of new cases but instead keep the cards to their chests until six to seven days?

This cumulative release of information on new cases by the GHS makes it difficult for Ghanaians and other researchers to follow the actual daily infection curve and make projections into the future. It looks scary and intensifies the fear of Ghanaians when the GHS wait for a week before updating us with a rise of say 300 new cases. Daily update of new infections from daily tests would help researchers to assess the success or otherwise of the interventions put in place by government.

Conclusion
Ghana's efforts in combatting the Covid -19 pandemic is on the right trajectory. What seem to be thwarting Ghana's efforts is the delay in releasing teat results owing to inadequate test centres and the selective cumulative reporting of new cases (the backlog syndrome), leading to the inability to see with clarity, the footprints of the viral movements.

We shall be out of the woods if government enhances our testing capacities through the activation of more test centres for early diagnosis and treatment. For sure, this too, shall pass.

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