Managing Covid-19 and Related Pandemics

It is another Friday and after some time of being absent from this platform I am finally back to commit to bringing weekly articles having cleared the obstacles that were in the way. In my last article before the break, I had invited writers from across the readership to volunteer their services to ensure that we all had articles as I went about with my endeavors. A few promised to feed us but did not actually come through, but finally here we are.

There is only one thing that the world is talking about and that is the Covid-19 outbreak. Before I went absent, I managed to provide basic details of what the disease is all about. A lot has changed between then and now as we have now registered confirmed cases in the country. The coming in of the new cases and the updates on the outbreak in the country is bringing in a lot of reactions and the result has been the outright increase in epidemics that we have to deal with on top of the Covid-19 pandemic; misinformation, poverty, stupidity, blind politics and the other epidemics you can add to the list.

By the time I am drafting this, there are more than 2.6 million coronavirus infections and the same has claimed more than 184, 000 deaths. The numbers will be more than what I have reported by the time you read this and while the situation is resolving in other countries, the natural trajectory of the pandemic entails that things might get worse before they get better in our country. This point is very important to note because we do not need to be caught unaware and to be spreading misinformation and propaganda over something that others knew would happen months before it happened. That brings us to the other epidemics that we will have to struggle with amid this Covid-19 crisis and these are happening at state, community and individual level.

Weeks before we registered the first case in Malawi, there was a lot of talk on the diagnostic capacity and hiding of cases. I will get into that later but some people took it to the social media to celebrate that Malawi had not yet registered a case despite our neighbors having some. I quickly dismissed the joy as premature and my reason was simple; as a nation, we did not utilize the honeymoon phase in which we did not have cases to prepare for this time when this pandemic has knocked on our doors. We have seen the effect of this lack of state-level preparedness as we are yet to see the authorities get to be decisive about the public health measures we are going to use to curb the disease as a country. This is one side epidemic that has been and will continue to cost us; lack of preparedness.

As Malawians, we have always been heavily political and these coronaviruses could not have hit at a worse time considering our political mess. Close to a year has gone after going to the polls but we are yet to get over the May 2019 election for reasons everyone who can click the link to this blog knows. The combination of the political situation and the global pandemic has led to the politicization of the response to the pandemic both at all levels from the state to the individual to an extent that there are some who are of the belief that the government is inflating the number of cases to ensure that we do not have the fresh elections that the Constitutional Court demanded on earlier this year. I am aware of the ruling party’s abilities, but I beg to differ on this one. My argument is simple. If we are to look at the surrounding countries, they are registering comparable numbers of cases and I do not think that they have elections that the ruling elite want to avoid over there. That is the other pandemic; politicization of the pandemic.

In line with the politicization of the cases, the mainstream social media have been awash with allegations and propaganda relating to various aspects of the disease from diagnostics through statistics to treatment. Those of us who are health workers have had to answer a lot of “is it true” questions preceded by the most ridiculous of rumors and assertions. Worse still, some health workers have joined in the bandwagon of those who are spreading false rumors about the pandemic. Misinformation, then has become the other pandemic that we need to fight as some of the messages are leading people into unnecessary panic and fear while on the other extreme end some misinformation is leading people into believing that Covid-19 is less of a danger than it actually is. There is only one way this would go if these waves of misinformation are to be left unchecked and that is an increase in the transmission.

I was trying to avoid mentioning the other serious accessory epidemics, but I would like to think that there is lack of leadership in the response to Covid-19. In the west, we saw Boris Johnson, the British Prime Minister and Donald Trump leading the way in giving information about Covid-19 to the people they lead. In these information sessions, they were flanked by experts who took questions about different issues relating to the pandemic response. Closer to home, presidents in countries like Uganda and  South Africa have been addressing the populace on the measures that their governments are taking to curb the spread of the virus and to help the citizenry in the wake of the economic hardships brought about by the virus. The story has been different here because while we have seen our leader address us on the pandemic on a couple of times (well, maybe one), the job of updating the country has been left in the hands of the cabinet committee tasked to respond to the outbreak. I would have had no issues with that, ideally but truth be told I am not convinced that our men in the cabinet are handling this well. Lack of decisiveness is nicely twinning with lack of leadership to counter the efforts to prevent the rapid spread of the disease.

I will skip the issue of those who itch to share misinformation and the issues we will have due to what I call the 21^st century, money-driven and click-bait sort of journalism. This I might attack the next time I get to make time to write, but to make misinformation on social media worse, the mainstream print, television and media houses could do better in the coverage of the pandemic.

I will not go in detail on how to tackle each of those accessory epidemics but I will address them in general terms. We have heard about the general measures of avoiding crowds, washing hands and avoiding touching of the face. We got the numbers to call to seek help and to ask for information. Perhaps if we start to go by that, some of these issues would go.

While I understand the volatility of our political situation, it is important to remember that not everything revolves around politics. The management of Covid-19 and the public health measures instituted are not meant to target a certain political grouping and as such they need to be viewed soberly. Media houses should do their part in extinguishing rumors that may potentially fuel carelessness and neutralize control efforts.

The government needs to rise to the occasion. As a nation we have been sleeping on this pandemic but I am glad that some strides are being made towards the right direction. Experts need to be roped in to guide public health interventions and treatment efforts by the government to ensure that the already ailing health system is not overwhelmed by the virus at some point. We also need to learn from countries that have done well and adapt the measures they have taken to our context. The fact that there is a hard lock down in South Africa does not mean that we should also institute a lock down; the fact that the governor of the New York metropolitan area is pestering his president for ventilators does not mean that we also need ventilators and the fact that South Korea went to the polls in the midst of this global pandemic does not mean that we should do the same. The copying and pasting of interventions might prove costly because there is no universally applicable playbook for the prevention of the spread of Covid-19. At a time when Malawi and the world at large are plagued by this pandemic, we need the leadership to step up and coordinate this response; epidemiologists, health workers, scientists, faith leaders, innovators, economists, law enforcement and all other relevant professionals need to sit on one table and figure out a way of preventing the spread of this outbreak and to ensure that preventive measures for the disease do not worsen the living conditions of the masses.

Covid-19 related strikes and demonstrations? Masks and gloves in the streets? Why don’t we talk about those in subsequent pieces.

Have a lovely weekend. Remember. Covid-19 is real. And oh. Kuvota tivota. Koma mochedwa.

Thoughts on the Covid-19

Greetings all. It is a rather unusual Friday and for some reason I have taken a break from my writing break to add a voice (hopefully of reason) to the (social) media buzz about the Covid-19.

We might want to begin with the obvious. Covid-19 is caused by a new strain of coronaviruses. Worth noting is that these viruses have always been there and they cause respiratory illnesses that affect people in many ways. The new strain, however, has been known to spread rapidly with now over 200, 000 confirmed cases and over 8700 deaths globally. When you tune in to the mainstream media, major global news channels are spending over 90 percent of their time reporting on the effects of the pandemic and the social media is awash with both updates and mistruths about the disease. Perhaps we from Richie Online, could add a voice of reason to this whole noise, I thought.

While the virus originated from China, recent surveillance reports have shown that China has been able to contain the virus with no new local infections reported as of March 18. The epicenter of the disease is now Europe where countries like Italy and France are reaching their peak incidences of the infection and numbers of deaths registered. We are also seeing a spread of cases into Africa with some countries reporting deaths.

Those who have been following might have come across statements like “Africa is 4 to 6 weeks behind Europe in the Epidemic”. While this might have been a technical statement, others have taken it as if the people who said such had a death wish over us. To think about such a statement, we would have the following to consider. In a pandemic situation like this, an outbreak would have a source, in this case China. With globalization, the disease would inevitably spread to other countries at different time points. At the moment, people have predicted (using mathematical models and what have you) that Africa would be as many weeks behind Europe which means the stage of starting of the detection of cases and reaching the maximum number of cases will take about 4 to 6 weeks. Worth noting is also that at some point the number of cases begins to decrease and in the same way we are behind Europe in having the disease, we will be behind them with clearing it.

Recently, we have had reported cases in the neighboring Zambia and Tanzania with no deaths reported in the countries. The fact that our neighbors have reported having had confirmed cases is drawing mixed feelings among the populace. While some on the conservative extreme of the spectrum feel like there is need for a lockdown, social distancing and other measures, there are some on the liberal side who have their arguments against the introduction of such.

The fear of the disease and its spread is driven by a number of factors. On the objective side, there is the rapid spread of the disease in the wake of globalization and the fact that our health system may not be able to cope. Our neighboring countries are registering cases and  measures like quarantining people or placing the country on a lockdown my not effectively work here for different reasons that I would not like to get into now. Then there is the mainstream and social media. Most global media houses are spending most of their time reporting on the disease and sometimes rather irresponsibly.

Closer to home, there is a bunch of Homo sapiens that find pride in being the first to share news with little attention paid to whether it may be true and how it may impact others. There is mass hysteria among the people to an extent that some have concluded that what may kill us is the panic and not the pandemic itself.

On the other hand, some would argue against the institution of extreme measures like putting the country on a lockdown before we actually register a case. Then there are the arguments that cite the recovery rates that are upwards of 70 percent and the death rates that roam around 3.4 percent. This is small if you compare the numbers of deaths attributed to diseases that are endemic in this part of the world like malaria, tuberculosis and HIV/AIDS. And then there are those that cite the fact that the disease is mostly affecting the elderly and those that already have issues with their immunity. Two extremes.

Despite people holding the two views, there are some who are lamenting the lack of political leadership in the preparedness for the emergence of the outbreak in Malawi. While we know for sure that there are some efforts to screen people who are coming from high risk countries by the Ministry of Health and the College of Medicine and its affiliates, we have not seen symmetry in the preparedness from our leaders. One could take exampled from the United Kingdom and the United States of America where leaders are giving daily updates on the outbreak and sensitizing people. Closer to home, presidents in Zambia, Uganda, Tanzania and more recently have taken it to their people and addressed them about the coronavirus outbreak.

If I were to be asked as to which side I am on between the liberals and the conservatives, I would say that I am standing in the middle and here is what I mean. The coronavirus may not be in the country yet, but I think it is important for people to be aware of it. The reason is simple; this virus will hit us at one point or the other. It is not a matter of if, but a matter of when and as such we need to sensitize people on what is coming for them. On top of that, the government and other partners in the health sector should use this honeymoon phase to prepare along the lines of diagnostics and treatment while the rest of us should be working on getting used to behavioral changes that will limit transmission.

To the liberals… The coronavirus is real. While most of the affected have been white people and the elderly, audits have shown that the disease can also affect people of color and young people so we are not immune. While the disease may not be that infectious and have a low death rate, we should look beyond the numbers and realize that the 8000 people who died are individuals and some of them were healthy as we were. In other words, it is not good to be blinded into being laid back about the pandemic by statistics. You or someone you know could be in the statistics of the infected or affected if you do not stay safe.

To the conservatives, I would commend you for being cautious. There is a looming danger and something needs to be done about it. On the other hand, the current situation may (underline MAY) not warrant the introduction of the measures that have been instituted in other countries. I have seen a few people walking around with masks in places outside of medical facilities. Perhaps we might want to hold off the mask and use it when we need the most.

So… What do we do now? In my view, this time should be about preparing because like I pointed out, it is just a matter of time. While we are in the honeymoon period before the announcement of any confirmed case, I think it is good to invest in getting all the relevant and accurate information about the disease. Some of us that have been privileged to have the internet can visit relevant websites like that of the World Health Organization to look for reports and tips on how to prevent. There is also a provision of  some WhatsApp contacts from which you can ask for information from the WHO and the Society of Medical Doctors, Malawi (SMD). There is a danger with believing in things that are in circulation over the internet, based on what is happening elsewhere and that is why consulting local experts like the SMD Malawi might be very important.

Other than the specific information and the guidelines that we would get from the Ministry of Health, it is important to maintain the basics of what we may have heard. Frequent hand washing with soap or hand sanitizer is encouraged as it reduces the risk. We should avoid touching the face especially the nose, mouth and eyes as these provide entry points for the virus into our bodies. We should avoid unnecessary contact with people who are sick and are showing symptoms of the disease (fever, dry cough, shortness of breath) and we should avoid being in huge crowds where the risk of contracting the virus may be huge. The virus may not be here, but it is good for us to get used to preventive habits in readiness for the time that it will come into our borders. Then there are the other health habits like having a balanced diet, exercising and getting enough sleep that generally improve one’s health and immunity, but prevention comes first.

Other than these biological and preventive measures we have mentioned, it is worth mentioning that we should not get into rumor and panic-mongering in issues to do with the virus. While it is good to stay cautious and safe, it is also good to be calm and to avoid inciting unwarranted fears.

I hope that this helps.

The Society of Medical Doctors is taking questions on the Coronavirus through text and WhatsApp on +265 884 286 991.

You can also find the English and Chichewa information pamphlets on the disease on the following links:

Coronavirus English Pamphlet

Coronavirus Chichewa Pamphlet