Rwanda has declared a blockade, no movement allowed
Uganda closed its borders, banned public transport and imposed a curfew.
South Africa has declared a lockdown, no movement allowed
Nigeria has imposed lockdowns in key urban areas, Lagos
Kenya imposes curfew and restrictions between populated areas
Little is known about the consequences of coronavirus infection for other people with malaria or malnutrition.
On the other hand, the African population is young.
One of the reasons given for Italy’s high mortality rates is that a large proportion of older people (23% of the population is over 65) are at higher risk if they contract the disease.
By contrast, less than 2% of Africa’s population is over 65. For this reason alone, the virus’ mortality rate may be lower on the continent.
It is clear that each African country will have to design its own response, suitable for its own need.
Governments have the knowledge and models to make accurate predictions through experts, and they will obtain them temporarily.
But there is a better, tried-and-true method: talking to communities. Clinicians and epidemiologists can provide medical data, communities can provide the main contextual points and wisdom about what has worked for them in the past.
China, Europe, and North America have followed much the same thing to control the epidemic: lockdowns.
African governments have followed suit, but overall, lockdowns may simply prove unfeasible on the continent. Only a few African countries, such as Rwanda and South Africa, have the capacity to manage a centralized strategy.
For others who live paycheck to paycheck and rely on the money they earn in the market to buy food, a few days of lockdown mean the difference between poverty and hunger.
For others who are already suffering due to unemployment, drought or a locust invasion, social assistance is provided through relatives. If confinement severs those social ties, adversity turns into misery.
Lockdowns also threaten to disrupt supply chains for medicines to treat tuberculosis, HIV and other diseases.
For any form of containment to work, emergency relief measures are needed.
This includes helping those who have lost their jobs or the money they earned from their families in Europe and the United States keep food and fuel supply chains open.
Some countries, such as Uganda and Rwanda, are distributing food in bulk. Ghana has announced a flexible supply of electricity and water, as well as a tax exemption. But African governments simply don’t have the budget for such measures without foreign help.
If fundamental livelihoods are secured, a total blockade is impractical. The handicapped will prefer the lottery of infection to the certainty of starvation.
During the Ebola outbreak, when the Liberian government ordered the military to impose isolation at West Point in the capital, Monrovia, in 2014, it discovered within days that the lockdown was so unpopular that it was unworkable and did not prevent transmission.
Very quickly the government shifted to a policy of asking community leaders to design and enforce their own control policies.
The lesson that public fitness works through consent was also learned in Sierra Leone. Communities took the initiative to design their own quarantine measures, which were then followed through foreign agencies.
The key lessons for epidemic response are to act fast but act locally. That is what African countries should be doing.
Africa’s health systems are already overstretched. Covid-19 demands an emergency response at scale and that begins with governments.
African hospitals need testing kits, basic materials for hygiene, personal protective equipment for the professional health workers, and equipment for assisted breathing.
There is a global shortage of all those products and an embarrassing struggle between evolved countries, relegating Africa to the back of the queue.
But as foreign backlash gathers momentum, African governments are coordinating their testing and wish-procurement.
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How Coronavirus Is a Gang Truce in South Africa
An urgent need is to set up box-type hospitals to deal with the surge in cases that may reach the peak of the outbreak, which appears to be happening about eight weeks after network transmission becomes apparent.
These will necessarily have to be very simple: tents on the school grounds or even thatched sheds in the bush.
There simply will not be enough respirators or intensive care units. The modest aim is to ensure that family members can nurse patients with Covid-19 without disabling local hospitals or health centres.
Keeping fitness facilities open for teams such as mums and babies, safe from cross-infection with Covid-19, is another key goal; Otherwise, the accumulation of illness and death for other reasons can overwhelm the virus itself.
Communities can help by locating sites, building camps, and caring for patients according to a home care protocol for the virus, under the supervision of a remote medical professional.
An even bigger challenge will be keeping economies functional and stopping a slide into destitution and hunger.
African countries cannot close their new markets for agricultural products, otherwise other people will starve. But market visitors can easily find strategies to reduce the risk of transmission, through measures such as increased hygiene, crowd control and physical barriers. such as polyethylene sheets at the point of sale.
Another proposal is for the family to designate only one user to buy food, and for the market government to provide that user with an identifier, such as a colored wristband. The designated client would then be isolated from other family members when they return home. Markets may temporarily relocate to safer locations.
In some countries, it would possibly be feasible to switch to cashless mobile transactions; In others, companies sending remittances to their countries may be used.
The best is not a list of clever ideas, but a genuine debate with traders, customers, market authorities, chefs and local authorities. They are the ones who will know what is best for them and how it can be controlled and applied.
Lockdowns have the potential to create a serious social crisis. This not only creates poverty, hunger and resentment, but also jeopardizes the implementation of effective epidemic measures.
Today, public fitness experts have not presented themselves to a total lockdown.
They explored local variants of isolation, movement restrictions, tactile tracing, and quarantine. This is because they have still asked local communities for their proposals.
There is no time to waste and network consultations will need to start now.
The experience of managing epidemics such as HIV and Ebola is an encouraging lesson. Ordinary people are not the problem, they are the solution.
The news is that communities can be temporarily informed to think like epidemiologists, as long as epidemiologists are willing to think like communities.
Alex de Waal is the director of the World Peace Foundation, Tufts University, and author of Aids and Power: Why there is no political crisis – yet. Paul Richards is an anthropologist, and author of Ebola: How a people’s science helped end an epidemic
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