Lockdown & its Aftermath in Accra, Ghana, By Teddy Totimeh

Coronavirus Covid-19 Disease Control Ghana Global Pandemic National Public Health Emergency Public health Policy Public safety SARS-CoV-2 society and health Uncategorized

Lock down ends. The streets are already beginning to fill again. There is a new item of color on the landscape of faces now: masks. I am learning to recognize people by the pattern on the masks they wear. It is a different world now. I don’t think things will ever be the same again. This virus has ravaged through the very fabric of our societies. We are living through historic times. This is a transition nobody could have seen coming. The syllabus for life’s textbook has undergone a major revision.

The weather is also beginning to change. The rampaging sunshine of the past month is submitting slowly to the gathering rain clouds. The next two weeks will have to be taken one long day at a time, as epidemiologists hold their breath, and hope that the three week lock down did the trick. It was a constant battle during lock down, between need and pestilence. It seems like need won, but my prayer is that we won some ground against the pestilence too.

The emergency rooms will become busy again. The motorbikes and cars are back to share the roads with the pedestrians. The collisions will start again. It’s just that now the hospital is not what it used to be. COVID has no symptoms initially. And one never knows what one carries into the clinical spaces. The capacity of any hospital at this time is stretched, even before a real surge starts, because so much has gone into fighting an enemy one can not see. And so much is needed to ensure that the health care worker who sees one patient, will be there to see the next one.

We cannot afford a surge in cases. Our capacity to take care of more than a few critically ill people is limited. And as the lock down ends, and economic life restarts, we must all bear this in mind. We must protect posterity, with our attitudes today. We have to socially distance, we have to protect each other. The lock down has been an eye opener to how simple life can actually be. How much we can do from home. How little we can really thrive on. In this new chapter of life, we need as many of those lessons as possible, to secure the future.

In the long run, it’s a numbers game. Hopefully, staying indoors for 3 weeks has kept the most infectious individuals away from the susceptible. Hopefully the quiet streets allowed hospitals to receive as much reinforcement of their supplies as possible. Hopefully the enhanced movement of health workers made them as available to help the infected as possible, and get them home, to become bearers of the COVID testimony, and remind people that this disease is real.

It is estimated that 30% of health care workers in the UK may be infected already. The UK has more than 75000 doctors. Ghana has less than 10000 doctors. We cannot afford to lose staff. We cannot afford to let this virus bounce out of control from person to person until our few ICU beds are overwhelmed. The number of staff trained to handle critically ill patients in Ghana is small. They work long hours in difficult conditions. They are the ones most exposed to the infected patients. And if we do not invest into the consumables and equipment that protect them, we will lose them to fatigue and disease.

The countries that have thrived against COVID19, tested quickly, isolated completely and treated aggressively. The mortality of COVID19 has so far been tagged to the degree of testing. South Korea was testing 12000 a day. The more tests there are, the lower the mortality there is, when there is a surge. Testing more than 5000 people per million, is the critical point for lowering mortality. In Ghana we are just around 2000 tests per million. We have got some way to go. Our target of 100000 tests in total, is UK’s target per day by end April.

For now we cannot afford to forget the habits we have acquired on masking, social distancing and hand hygiene. The lock down may have ended, but we still have to keep the disease locked down. Vaccine testing has started. But this virus is already showing that it can reinfect. There is no cure yet. And this disease is not just a flu. The mortality rate for influenza virus is 0.16%. COVID19 mortality ranges between 2 and 5%. But in the early days in some hospitals in China, before strict protocols, it was 16%.

This virus does not play games

Dr. Teddy Totimeh is a Pediatric Neurosurgeon who practices at the Greater Accra Regional Hospital in Ghana

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