Considering the rate at which the Coronavirus is spreading around the world, it is not a question of “if” but “when” a case of this virus will be detected in Zambia. COVID 19 is a highly infectious disease with a mortality rate of about two per cent in countries with advanced health care systems. Mortality will be significantly higher in countries with weak and dysfunctional health systems like Zambia.
The elephant in the room is how prepared are we as a country for the COVID 19 outbreak? If you asked this question to the Minister of Health, Dr Chilalu Chilufya, he will probably tell you that his ministry, under the guidance of the able leadership “Dr” Edgar Chagwa Lungu is more than prepared. This would be a sick joke of the century. The PF government is not ready at all, perhaps the alleged corruption charges are distracting the Minister. Going by the response to the last Cholera outbreak, this country is far from being prepared for COVID 19. The transmission dynamics of this respiratory virus are much more complex than the oral-facial route of the cholera transmission.
We have been told that the National Public Health Institute (NPHI) will lead the prevention efforts; the same Agency that could not contain the cholera outbreak 2 years ago primarily for two reasons, no expertise and no financial resources. Three months into the epidemic, the NPHI has no protocol to guide frontline health workers on how to proceed should they have a case of suspected COVID 19. Just go to Nakonde, Kasumbalesa or indeed any other border town and check if health workers have been guided on what to do. Nothing has been done. Zambia has no quarantine facilities save for Lusaka where a facility has been designated in Chilanga, but how many patients can it take? The most probable point of entry for a COVID 19 case in Lusaka is at the International Airport.
The question that comes to mind is why the authorities would find it fit to transport suspected cases of this deadly virus all the way from International Airport to Chilanga. How many people would inadvertently be exposed in this long transit? What happens if the transit ambulance breaks down? Unlike restrictions that many countries have imposed on arrivals, people from any country are arriving at our borders and Lusaka International Airport as if we are the most organized country in the world that can detect and combat Coronavirus. This is a seriously pathetic situation. Epidemic preparedness requires planning for the worst. Has the Ministry of Health trained its health workers adequately and how many countrywide? Does the Ministry of Health have in place all the protective uniforms that health workers need countrywide? There is no sensible information that the Ministry of Health is releasing to the public, other than that they have an isolation facility in Chilanga. Zambians in urban areas are learning more about Coronavirus from BBC, CNN than from our Government, but what about those in the rural areas?
All this gross incompetence is immoral bordering on criminality and taking the lives of
Zambians for granted. This is disregard for the sanctity of human life.
According to experts, the definitive diagnosis for COVID 19 is by polymerase chain reaction (PCR) and we are told that the WHO has built capacity for the Virology Lab at UTH making it the only lab in the country able to confirm a COVID 19 case. To put this into context, cholera can be confirmed at pretty much any lab in Zambia. It is going to be very hard to confirm COVID cases in Zambia. The NPHI has no capacity to courier samples from suspected cases to Lusaka. What will Government do when cases are detected in Nakonde or any other remote areas? COVID 19 is a very infectious virus. The estimated reproductive rate (Ro) is 2.5, meaning each infected person is expected to infect another 2.5 people. At this rate of transmission, the probable number of new cases from a single source for the next 10 days would gradually increase, and the estimated cumulative cases would reach about 1600 in just 10 days.
In the absence of expertise at the NPHI (MoH), the next course of action is a massive health promotions campaign in all our languages both on radio, television and print media. This requires reaching out to all citizens by any means possible and educating them on how COVID 19 is transmitted and what are the symptoms. Simple messages such as avoiding handshakes, crowded places and frequent hand washing would go a long way in preventing a COVID 19 outbreak. The government through the Ministry of Health really needs to step up and raise the epidemic preparedness to red alert. They should immediately provide frontline health workers with necessary information and protective clothing. Quarantine places and referral protocols should be instituted at all district levels. The enforcement of the Public Health Act should be in full force and all relevant government agencies like the Ministries of Finance, Education and Local Government should be brought on board in a very well-coordinated manner.