Following on from the Press Conference on Sunday afternoon 15th March, attended by all the bosses of Health care in Ghana and under the auspices of the Minister of Information, it was revealed, that Ghana has 6 confirmed cases and have of the order of 180 contacts undergoing tracing.
At this stage we must assume that there are community infections and plan for it. No one can assure all Ghanaians that all contacts can be traced particularly after they have entered the community for days with a highly transmissible virus that infects during the period of no symptoms. The transmissibility must be the overarching concern.
The advise given on the COVID-19 must be strictly adhered to; washing of hands with soap under running water, use of 70% alcohol sanitisers, disinfecting all surfaces and hand held knobs, keep 2 metres between people and cover mouth when coughing and sneezing using easily discarded tissues or elbow but not hands, touching of face and picking of nose which unfortunately is very common in Ghana.
We must also assume that many of the 180 contacts have themselves contacted others some of whom with the best intention in the world, may not remember and therefore may start the in-community infections. We must act with dispatch and flatten the curve as soon as possible. The next two weeks will be very critical as and when some of the contacts begin to fall ill and report to our facilities and get tested.
The President has announced travel bans from countries with more than 200 cases but why 200 and not countries with evidence of community infection and has asked for Ghanaians from such countries coming into Ghana without symptoms, to self isolate. How I wish I could trust Ghanaians who have travelled down with gifts and parcels from fellow Ghanaians to family members to self quarantine. We must be bold and take very drastic measures taking cue from good old Dr. Anthony Fauci, Director of National Council for Infectious Diseases of USA, who believes that such times require bold initiatives, national lockdowns, that can reduce human contacts and reduce infection and not make them voluntary. Are we worried about the cost of official quarantine?
We must begin to discuss ways of reducing human contacts in Ghana.
Where more than 10 persons must meet such should be postponed.
It must be announced that funerals, church services, Friday prayers, outdourings, traditional marriages and weddings must all be postponed till we are certain that the infections are flattening. Our public transport system, stations and markets are potential major sources of transmission. What are we doing? Do we just pay lip service and think the explosions will not occur. Prayers and Bishops and Angels oils will not work. Only pragmatic decisions are needed.
We must close schools, basic, secondary and tertiary and where possible apply e-learning. It is amazing how we talk about e-learning and yet do not follow through and implement. If one child, one computer had indeed been implemented, our children could all be given homework to be submitted electronically but no, it was political propaganda. Outpatient attendances for reviews and non emergencies must be reduced significantly.
Interestingly His Excellency the President has been bold to announce some far reaching decisions which have come into effect but there is more that needs to be done.
Since the virus causes respiratory disease, we must take inventory of the number of intensive care beds and ventilators we have in our country and the availability of oxygen and such information shared at least within the medical community. How many Pulmonologists do we have in country and are they being used to update all doctors in the intervening period before a possible explosion? I wonder whether the isolation wards in Tema and Ridge and Regional hospitals and the Doctors, Nurses and other health professionals have the critical training and all the necessary logistics. How come Ghana’s so-called quaternary hospital grossly underused is not put on notice to assist in the country’s hour of need.
Globally, children and young persons have been spared serious illness since it is the elderly with co-morbidity that are commonly affected. In Ghana about 33% of children under five years have some form of undernutrition and have compromised immunity and may if infected create different problems for all of us. Patients living with HIV and Tuberculosis also present challenges.
We must not wait to identify community infections before we take some if not all the drastic measures and the next two weeks will be critical. Let the discussions start and plans laid out and implementation commenced. Countries that took drastic actions early were able to flatten the curve and reduce infections and are the better for it. We do not have enough tests and therefore we will never be able to quantify our denominator properly to assess fatality rate and also be able to identify how many infections including the mild forms took place in Ghana.
We must be in an emergency mode from now till end of April by which time we would have appreciated the disease outcome. If the Vatican has taken actions that will impact on Easter celebrations then we must, knowing we are protecting our population and also protecting our health staff who are always over stretched and under rewarded.
We must take this opportunity to begin to produce face masks, sanitisers, protective clothing, ventilators and we must be producing rapid tests kits and vaccines in Ghana. None of this is beyond the capacity and capabilities of Ghanaians but as usual we lie in wait for others to produce for our use. Let us put the $100 million pledged by the President to work and make Ghana a COVID-19 free or virus subdued country.
We must establish our own Centre for Disease Control in Ghana because this will not be the last of viruses crossing from animals to humans. In the last three decades we have seen H1NI, H5N1, EBOLA, SARS, MERS, and now COVID-19. So long as we cohabit with small and big animals more crossovers will occur.
The Central Bank must also prop up the economy. In anticipation of the fall out, interest rates must be reduced considerably, business rates must come down and there must be infusion of interest free loans to pharmaceutical and electrical/electronic companies keen to begin production if some of the much needed appliances or gadgets listed above.
We must be prepared at all times as a country.
By: Prof. Agyeman Badu Akosa, a former Director General of Ghana Health Service.