Ghana hailed as a global leader in coronavirus response

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Ghana’s COVID-19 response since the WHO declared it a global pandemic in March continues to attract international recognition and applause.

The WHO, the TIME magazine, the New York Times and other renowned publication’s have commended Ghana’s COVID-19 response efforts.

Latest to do that is international blogger Indi Samarajiva, who has been researching into countries’ response to the pandemic and how effective their measures have significantly reduced the impact of the virus on their citizens.

Writing in his series of articles for medium.com, an international blogging site, Samarajiva presents to his global audience the effectiveness of Ghana’s COVID-19 response through what he describes as intelligent leadership by President Akufo-Addo in the time of crisis.

He also praises the efforts of Ghana’s frontline workers, including the staff at Noguchi and other testing centres.

Below is the full article

COVID Underdogs: Ghana

Ghana has led the world in pandemic leadership. While Western leaders were telling people to drink bleach, this West African nation offered sober, intelligent leadership to its people and — if we’d been listening — to us. It’s not too late to listen now.

I know white women are supposed to save the world, but we’re sleeping on the Black Star of Africa. This is their story. It’s a story of leadership, in a world that desperately needs it.

Wait, Africa?

Yes, Africa. As The Lancet wrote last week, ‘according to WHO, Africa is the least affected region globally, with 1.5% of the world’s reported COVID-19 cases and 0.1% of the world’s deaths.’

This is not just luck. Yes, the continent has some advantages (youth, being under a de-facto travel ban), but those advantages only buy you time. COVID-19 is so novel and so infectious that it will spread everywhere eventually, left unchecked.

The main advantage Africa had was African people that used their time wisely.

In February 2020, while many other countries were still dismissing the emerging outbreak, the African Union acted swiftly, endorsing a joint continental strategy in conjunction with WHO. (The Lancet, May 30)

Within the African Union, Ghana stands out. People can claim a lack of testing or data to explain away other nations, but not Ghana. At the start of its outbreak, Ghana tested at a higher rate than even South Korea. They deployed innovative solutions like drones to reach the last mile. More than anything, their leader spoke words that made sense and saved lives.

That’s all we really have against COVID-19. We just have our brains and our ability to cooperate. We have no cure. That’s why leadership matters.

Let’s have a look. Ghanaians operate in English, so you can watch all the speeches yourself, which I highly recommend. It’s amazing to watch a leader that just does their job.

How to face a pandemic

The President’s shirt game is on point.
The number one predictive factor in surviving a COVID-19 seems to be simply believing in it. This is horror movie 101. YES THE HOUSE IS HAUNTED GET OUT.

On March 11th, the WHO declared a pandemic. The same day, President Nano Akufo-Addo told everyone that it was a pandemic, and acted accordingly. I’ll go on but that’s basically it. 90% of pandemic response is just showing up.

During a pandemic, a leader has one job. They just need to marshal public support for public health. Public health tools are all we have, but they don’t work without public support. Contact tracers can’t trace, quarantine centers can’t quarantine, social distancing doesn’t happen. Without leadership, things fall apart.
Akufo-Addo did this one job well.
Listen for yourself:

“It is imperative that we step up our preparedness to ensure that, beyond these initial satisfactory measures, we adopt a whole of Ghana approach in adequately preparing for a possible hit within our borders. This fight cannot be that of government alone. It is for all of us”.

To be completely honest, it was mind-blowing for me to just hear these words in English. That language has been used to spout such bu****** and lies that to just hear the obvious truth told by a politician was very disorienting. I consume western media and I’m used to hearing about Africa as this place needing help, but it’s obviously not true. We need Africa’s help. We should have been listening to them.

Ghana has had airport temperature scans for years and was screening for COVID-19 from January. Ghana reacted when there were just a few cases in neighbouring Burkina Faso, Togo, and Cote D’Ivoire. S*** was hitting the fan in Italy, with a large Ghanaian population, so Ghana prepared its airports to screen everyone. Everyone could have done this.

Ghana prepared its research institutions for testing and had tested the first 57 suspected cases at this point (all negative). If they could do it, any country could have been ramping up testing in March. As you’ll see, they went even further.

Their Minister of Finance released $100 million to expand infrastructure, purchase PPE, and educate the public. Ghana is not a rich country. Most countries could have done this.

Most importantly, they communicated all of this clearly to the public. While western leaders were walking WhatsApp forwards, Akufo-Addo just took the standard scientific information and communicated it well. That’s literally all you have to do, listen to the scientists, get them what they need, and tell people what is going on.

The Ministry of Information is leading a nationwide public education campaign on preventive measures that we must all observe to ensure that we’re able to control the spread of infections should we record any infection in the country which, mercifully, so far, we have not. But which, by the law of averages, we shall.

People have praised Angela Merkel for speaking clearly to people, but she was objectively awful. Merkel spoke too late, did too little, and got over 8,500 people killed (!). Do you know how many people have been killed in Ghana, out of 30 million?

38.

That’s leadership.

At a time when the UK’s Boris Johnson was bragging about shaking hands with COVID-19 patients, this is what Ghana’s leader said:

As the Ministry of Health has advised, we have to revisit our custom of shaking hands and stop doing so completely. This fight, fellow Ghanaians cannot be that of government alone. It is for all of us.

These seems like political boilerplate, but it is so important to have someone trusted and competent just say these words. There is no public health without the public. They have to be informed and, most importantly, motivated to work together. This what Ghana did exceedingly well.
Please watch for yourself. It cleared some of the cobwebs out of my brain.

How to fight a Pandemic

My least favorite shirt. I feel like the President knows it.
Throughout just the speeches I’ve watched, Akufo-Addo is constantly repeating himself and sticking to the same themes. It’s a masterclass in crisis communication. He is constantly reassuring people, and he does it through language.
For example, this seems like a standard phrase:

I have come into your homes, again, this evening to provide an update, as I promised, on the measures taken by Government to combat the Coronavirus pandemic.

The power is in repetition. He does this every speech. Akufo-Addo promises to come back, and he does. This is how you build trust. I learned that from the song ‘grown-ups come back’ in Daniel Tiger. If children trust that you’ll come back, they won’t go crazy when you leave. I guess it also works for adults. What Akufo-Addo is doing through simple language is building trust, the currency of public health.

Without trust in public institutions, public health falls apart. People will lie to contact tracers. They won’t self-quarantine. They’ll panic and hoard. Building and maintaining this trust is a leader’s main job during a pandemic. If a leader does their job, public health officials can do theirs.

Losing this trust in the middle of a pandemic is like breaking ranks in front of an enemy. A leader doesn’t need to fight, they just need to keep the damn flag aloft and hold the line. In linguistic terms, that means a lot of repetition.
Another thing that Akufo-Addo constantly repeats is the plan. Everything he says connects to five simple points.

As I have said before, all that Government is doing is intended to achieve five key objectives —
1. limit and stop the importation of the virus;
2. contain its spread;
3. provide adequate care for the sick;
4. limit the impact of the virus on social and economic life;
5. inspire the expansion of our domestic capability and deepen our self-reliance.

Bad leaders make up new strategies all the time, which is not a strategy at all, just tactics. This confuses people. Akufo-Addo has one clear strategy which he just keeps repeating. And it’s not some dumb advertising slogan like CONTROL THE VIRUS — SAVE LIVES. Like, with what? Jedi mind tricks? Ghana’s plan consisted of actual actions that actually happened.

#1 was limiting importation, which is why he talked about airports before. Now they’re onto #2, which is how he brings up lockdowns. The important thing is that it’s not out of nowhere, it’s part of a plan.

Prevailing circumstances mean that stricter measures have to be put in place to contain and halt the spread of the virus within our country…

Then he lists all the cities getting locked down. This is all fine, but how do you get people to really stay home? This is another neat linguistic trick Akufo-Addo has. He is always talking about why.
Like children, people are always asking why?Why should I stay home? Why should I listen? Without a why we simply won’t do anything. So he always answers that question.

Why are we preparing? — Law of averages.
Why are we locking down? — To halt the spread.
As the Merovingian says in The Matrix:

“Why” is the only real source of power. Without it, you are powerless.
Why is what launched a thousand ships to Troy, or a thousand apes to Lanka. It doesn’t even matter if what you’re doing makes sense, as long as the why does. The same is true for public health. During a pandemic, public health officials know what to do. A leader’s job is to tell people why.

Akufo-Addo can put this in a really simple way:

“The frontline of the fight against Coronavirus is your front door. If you cross it, you and your family will likely be infected”.

Hell, the Dancing Ghanaian Pallbearers put it in a way that spread across the world (#StayHomeOrDanceWithUs). Communication seems to be something Ghana is good at. This is what leadership looks like. It looks simple but obviously not, the world is led by idiots.
Again, watch the whole speech, or read the transcript here. I’m a political junkie and this is as close as we get to poetry.

How to outwit a pandemic

Wait a minute… these shirts are all the same. Just different colours.
Epidemic response has not changed that much for centuries. The Prophet Muhammed (PBUH) spoke about isolating cities. Ancient Chinese even had crude smallpox vaccines. In truth, the only modern innovation is PCR testing, discovered in the 80s. Most of the world is still doing the same old stuff, which is fine as long as you do it well.

Ghana, however, went beyond.
As Nana said earlier (can I call him that?):

“There is no one-size-fits-all approach to this pandemic. We have a unique situation in our country, and we must take it into account in dealing with the disease, whilst meeting all the six (6) key WHO guidelines on the most effective ways of combating the pandemic”.

What he mentions is important. You have to follow the basic guidelines because innovating with the core of public health will get people killed. You can, however, tinker around the edges. Ghana did, and amazingly, it worked. The most powerful thing was a little trick called pooled testing.

PCR is really sensitive. You can test for COVID-19 in municipal poop water, even at that high dilution it works. The insight Ghana had was to use PCR testing to test multiple people at once. That would tell you if someone had the disease, and then you could narrow it down. Here’s an example.

Contact tracing leads you to an office of 20 people. You jab them in the nose-hole, get back to the lab, but test kits are running low. What do you do? Normally you’d need 20 kits, but if you use math you can test everyone with 9.

Here’s how

First, put ten people together in one tube and ten in another. One tube is clear, so those chaps are clear, you send them home. Then you take the ten potential patients and divide them five and five. Then another test is clear and you send five people home.

Now you run five individual tests and find the infected person. All in all, you’ve only done nine tests. It’s a bit more work, but in epidemiological terms, it’s magic. You’ve just doubled your testing capacity with the same amount of kits. And it works because you can stretch a single sample this far. Much respect to the Noguchi Institute.

This obviously breaks down if you have a lot of positive cases, but used wisely, pooling dramatically expands your testing capability. Ghana is one of the few places to do this on a mass scale, which takes a lot of smarts.

It was also a game-changer. Look at Ghana’s test numbers compared to the Trap God of testing, South Korea, and the local god, South Africa.

Confirmed tests per capita, starting from the same point in their epidemics
Early in its epidemic, Ghana tested at a higher rate than South Korea. This is like having a fire extinguisher earlier in a fire, it’s obviously better. Again, this is coming out of Africa. Y’all been sleeping on Africa. And that’s not all Ghana did.

Drones

Zipline used drones to rapidly get rural samples to testing centers in cities
While America uses drones to murder people, Ghana used them to save lives. Zipline, a private company operating in Ghana, popped rural samples in drones and shot them to central laboratories in half-an-hour.

This A) gets people test results way faster and B) makes tests more reliable because the samples haven’t been cooking on bumpy roads for hours. This isn’t as much of a game-changer as much as pooled testing, but it’s still cool.
VC fuckbois have been talking about drone delivery for years, but Ghana really did it.
Basically, Ghana innovated hard. They used veterinary labs to conduct tests. They used tuberculosis labs. Any lab they could find, they slapped a PCR machine and some trained technicians in there. And they did it fast.

Note that I haven’t talked about the President at all here. That’s what good leadership does. It gets out of the way. Because Nana did his job, Ghana’s scientists and businesses were able to go above and beyond.
They droned COVID-19.

I’ll stop here

OK, I’ll stop. There are a lot more speeches but you’ve been here a while. My honest advice to you — go watch or read them yourself. It’s amazing how someone not being stupid just makes you feel better. I’m honestly enraged most days because I follow American and British news, but this is like a sorbet of competence. It’ll clear your mind.

This is how leaders are supposed to talk. This is how people are supposed to be. Does Ghana have problems? For sure. Journalists have gotten beaten by soldiers. Nana addressed this, but it’s not right. Bright Simons has some detailed criticism of Ghana’s data and transparency.

They could have shut down borders earlier, like Mongolia, and perhaps avoided transmission entirely. There’s an election in December and the opposition obviously has their criticisms as well.

Finally, we must remember that the virus is relentless and Ghana’s epidemic is not over. They must continue fighting and cannot let up.

I comment here only as an outsider. Do I understan Ghana’s President? For sure. I think he’s an excellent speaker and he lowers my blood pressure.

But I’m not saying vote for him. I have no idea and a President has other jobs. Frankly, this is the minimum we should expect from our leaders.

No matter what party we vote for, they should not get us killed. They should just tell us what’s going on, translate the science, and let everyone get on with their jobs.

Unfortunately, this isn’t the world we live in. Hundreds of thousands of people have died for nothing more than the stupidity and the arrogance of their leaders. It’s so, so sad. We live in a world desperate for leadership, and covered by a media that only sees white.

But it’s been there all the time. It’s been there in style. The global leader in COVID leadership is Ghana.

I’ll leave you with one last quote, which I found quite inspiring. It completely slays the false division between human life and the human economy.

It tells us all what to do.
I assure you that we know what to do to bring back our economy back to life. What we do not know how to do is to bring people back to life.

We will, therefore, protect people’s lives, then their livelihoods.
Forget the West. Real leadership is coming from the Black Star of Africa.

I’ve researched this by using data from OurWorldInData, watching and reading many of the President’s speeches, and following some Ghanaian news, bloggers like Ato-Kwamena Dadzie and thinkers like Bright Simons. I have tried to link to or quote any assertions of fact but please tell me if I missed anything.

I have also run this by a Ghanaian to see if I’m a complete idiot, but if you have any more information or feedback or disputes please comment (which I check infrequently) or email me at indi@indi.ca.

I’m looking for more COVID Underdogs, so if your country has any stories let me know.

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