Is Zambia Ready to Cope with And Contain a Coronavirus Outbreak?
By Parkie Mbozi
THIS IS the question on the lips of any concerned Zambian. Going by the limited information coming from our Ministry of Health on measures being put in place to combat the epidemic, one is bound to believe that an outbreak of the Coronavirus would have catastrophic consequences for the country. The world has now come to know that the Coronavirus (code-named COVID-19) is very infectious and spreading fast.
My analysis of the country’s preparedness for COVID-19 potential outbreak is at three main levels: 1. Prevention of an outbreak; 2. Treatment of patients and, 3. containment from further spread in the event of an outbreak. All in all as citizens of this country we should be concerned about the capacity of the health systems to respond to the epidemic. We should also be concerned that we are dealing with a viral disease, which currently has no vaccine and just a handful drugs to suppress it in patients. Experts (for instance the Centre for Disease Control of the United States of America) have said the earliest a vaccine for COVID-19 Virus could be available is 18 months away (June 2021).
Just to put the disease into perspective so that we all know why we should be concerned about the country’s preparedness or lack it, here are a few facts. The COVID-19 virus first broke out in December 2019 in the city of Wuhan, Hubei province, mainland China. Wuhan is home to 11 million people (three times the size of Lusaka district) and has been under lockdown since 23 January. Lockdown means that the residents are kept in quarantine (in their homes) with transport links into and out of the city closed.
Within weeks of its discovery, the numbers of new cases of infection and deaths from COVID-19 Virus in China and now across seven continents have been rising at breakneck speed especially since January. By 26 February, the World Health Organization (WHO) reported a cumulative global total of 81,155 cases of infections (77,150 in China alone) and 2,750 deaths (2,592 in China alone). The Chinese National Health Commission reported 150 new confirmed coronavirus deaths on Sunday alone, up from 97 the previous day.
The COVID-19 Virus has thus been described as a fastest-spreading respiratory infection whose global death toll of 2,750 within two months is more than the 774 killed by SARS – Severe Acute Respiratory Syndrome – and 8,100 infections over eight months in 2003. Experts say COVID-19 is currently spreading at a rate 10 times higher than SARS and its mortality is 2% compared to 1% of SARS. While the WHO is yet to declare it a pandemic, its director general Tedros Adhanom Ghebreyesus told reporters in Geneva on Sunday that “the world should be working harder to contain the spread of the deadly new coronavirus, and should be preparing for a “potential pandemic”.’ The COVID-19 outbreak remains an international emergency, a spokesman for WHO said.
“The sudden increase of cases in Italy, the Islamic Republic of Iran and the Republic of Korea are deeply concerning,” Ghebreyesus said. WHO’s concern stems from the fact that despite the various measures put in place by China to halt transmission, such as shutting down transport, quarantining entire cities, and enforcing the use of face masks, the disease has spread like wildfires to countries and region’s beyond China and Asia.
To illustrate: When I started working on this article on 25 February, the disease was reported to have spread to about 30 countries in Asia, North America, Middle East, Australasia and Europe. By the time I was sending it to the media on 27 February, the disease had spread to 61 countries. New cases had just been reported in three new countries and continents: one case Brazil in South America and Algeria and Egypt in Africa (with one case each) after. As of the morning of today, 27 February, the disease has spread to all continents apart from the Antarctica.
Impact on economy and international trade
Within two months the impact of the COVID-19 outbreak on the global economy has been profound and yet to be fully felt. This week alone markets across the world have been sent tumbling by the disease. In the US the Dow Jones plunged by 1,910 within two days. Shares and currencies across Asia have slumped sharply. Italian Prime Minister Giuseppe Conte said the impact of the coronavirus outbreak on the economy could be “very strong”. “The economic impact could be very strong. At this moment we can calculate that there will be a negative economic impact, we are not yet in a position to forecast what will happen,” he told reporters.
Affected countries have stimulated a wide range of measures to prevent and contain the outbreak. Most of the measures have had economic ramifications. They include: travel bans, (for flights, train, buses, etc), closing border crossing, suspends air links, quarantines, ‘complete ban’ on wildlife trade (China), postpones of major events, including sports, and shutting trade links. A number of US companies (Goldman and Sach) have already announced Zero profits in 2020 because of the coronavirus.
Concerns for Zambia
For starters Michael Yao of the WHO Africa region told Cable News Network (CNN) that Zambia is one of the 13 African countries most vulnerable to COVID-19 outbreak due to strong trade links with China. The disease proffers a number of political, institutional, social, environmental, technological and pathogen-related challenges. Across the globe assessments of how countries are prepared and preparing to deal with the disease are being made from these perspectives. First. politically citizens have to ask what programmes and strategies are being put in place by their government to prevent and contain the disease? How much money is being set aside for the eventuality of an outbreak?
Second, according to the WHO, the incubation period – between infection and showing symptoms – lasts up to 14 days. However, some researchers say it may be as long as 24 days. Further, Chinese scientists say some people may be infectious even before their symptoms appear. These dynamics raise prospects of undetected transboundary and community level transmission of the virus, as noted by Anthony Fauchi of the National Institute of Allergy and Infectious Diseases of the US. It also raises questions about the efficacy and effectiveness of our testing (if/where at all) at major points of entry, especially for travelers from affected countries, such as China.
Many countries have taken infection prevention measures, even beyond what is recommended by WHO. Top of the list is testing and quarantining (for at least 14 days) of people from affected countries, regions and (especially) cities. For instance, Diamond Princess cruise ship has been quarantined off the coast of Japan since 3rd February with 3700 passengers, 900 of whom tested positive. The United Kingdom now requests individuals who have recently visited Italy to self-isolate. Here in Africa early this week
Mauritius blocked some Italian visitors over coronavirus concerns.
Third, from an institutional perspective, can we say with confidence that our health care systems are prepared to respond to an outbreak of this scale? China was able to build a hospital for affected patients in two weeks. Does Zambia have the capacity to mobilise resources and trained manpower at such speed, especially that COVID-19 patients need to be kept in intensive care unit. As in all outbreaks, there is an urgent need to develop effective diagnostics and therapeutics capacities. So far we have not heard enough about the preparedness of the country’s health systems at various levels and points to screen, isolate and treat patients and perform contact tracing.
As one expert observed that, “While health systems in high-income countries would be stretched by the outbreak, the most devastating effects would be in countries with weak health systems, ongoing conflicts, or existing infectious disease epidemics. In these countries, it is imperative to rapidly detect and contain the virus at points of entry to prevent community transmission and health systems from being overwhelmed.”
Finally, serious questions should be asked about measures being been put in place to increase public awareness about the disease. How much does the public know about the disease? In 2003 some governments in the region reacted rapidly to the outbreak of SARS by training journalists and producing IEC (information, education and communication) materials, even before a single case was reported. None of that has happened so far despite the complication of the need for language translations in order to cover the whole country. The COVID-19 outbreak is headline news across all major international media outlets but is largely obscure or poorly reported among Zambian media.
From the above analyses, Zambia is not ready to deal with an outbreak of COVID-19 should it (God forbid) happen. As Anne Schumchat of CDC said during Trump’s press conference last night, “Time to prepare is now”.
The author is a media and communication researcher and scholar with the University of Zambia. He is reachable on [email protected]