MDC Alliance Weekly Health Alert (6th Edition)
Welcome to yet another edition of the Weekly Health Alert by MDC Alliance Health portfolio in conjunction with the Communications department. This week we are looking at the lockdown and the way forward for Zimbabwe.
Covid-19 Lockdown – Whither to Zimbabwe?
We have been on level 4 lockdown in this second COVID-19 wave since January the 5th, initially for four weeks, but extended twice by two weeks at a time, to March 2021. With the strict lockdown comes many socio-economic challenges, which the government has up until now been unable to mitigate. Business is at a standstill, the cost of doing business has skyrocketed, especially with the current requirement that to reopen your small business you need COVID-19 certificates for your workforce, at own expense. The restrictions on informal traders has plunged many families into abject poverty and outright starvation in some cases, with no bailout from government.
We cannot be in perpetual lockdown, especially in a country where there are no social safety nets, but the decision to lift the lockdown must be based on data and science, not on political considerations. Weaponisation of the lockdown is a tragedy, and many in Zimbabwe feel the lockdown is being used as a political weapon. As President Chamisa said before, the government should be working with local authorities and health care departments to come out with a more scientific targeted approach based on numbers and hotspots.
Constant surveillance through testing and isolation throughout the country is necessary. Let’s remember the WHO’s admonition: “You can’t replace the lockdown with nothing”. Measures must be put in place to ensure a smooth transition to normalcy with adequate control mechanisms. We need a well-informed and committed population, with persistent long-term behavior change as part of our new normal. COVID-19 safe behaviours must be observed at all times.
Vaccines bring with them a new hope of permanent relief, but only if we get it right, and we establish and maintain the highest levels of transparency regarding the vaccine attributes of efficacy, safety, cost, and procurement decisions. Arrogance on the part of government will derail the program. Every citizen has a right to be heard, and all concerns must be addressed with empathy, knowing that we are all born equal under the law of Zimbabwe, and in the eyes of God Almighty.
Dissemination of correct information is key to the acceptance of any particular vaccine by the people, in our case the Sinopharm vaccine, at least for now. The current low uptake is due to lack of information, which buttresses all the conspiracy theories. Coercion and intimidation will work against the program. The government must make it abundantly clear that taking the vaccine is a completely voluntary exercise, and informed consent is necessary for administration of the jab. As the people watch the early recipients of the vaccine, and as real time data on safety and efficacy is rolled out by the government, more people will volunteer to take the vaccine. The recent command and control intimidatory diatribe we heard from high offices threatening to limit liberties to use Zupco buses and to bar people from getting employment if not vaccinated are both extremely unfortunate and mortally retrogressive to the program.
But is the vaccination program adequate on its own to ensure the safe lifting of lockdown measures? The answer for now is no, until we have vaccinated enough people to protect the whole population. There is no magical figure to achieve herd immunity, but if 60-80% of the population is vaccinated, we will enjoy reasonable protection as a nation. This is a medium to long-term aspiration, considering that all we have now is 200 000 donated doses of Sinopharm vaccine, which will cover 100000 people out of the projected minimum target of ten million recipients. There is hard work and difficult decisions ahead of us. We implore the government to collect quality data that will inform future steps.
What shall we do now to be able to lift the lockdown without courting a third wave backlash? The World Health Organisation (WHO) suggests six conditions that must be met before lifting the lockdown:
1. Disease transmission must be under control. We have seen a reduction in the number of new cases and of deaths over the past month. We are not there yet, but we are making progress. On this score alone, controlled relaxation of lockdown measures is feasible.
2. Health systems are able to “detect, test, isolate and treat every case and trace every contact”. This condition is the weakest link in our fight against covid-19. Government has never been able to supply enough testing kits to meet demand, and we continue to grope in the dark.
3. Hot spot risks are minimized in vulnerable places, such as nursing homes. In our case, its super-spreader events like ZUPCO buses, funerals, parties, shebeens, prisons and Zanu PF rallies. There is need to liberalise the transport sector to reduce unnecessary congestion. I do not consider church services to have super spreader potential if all things are done in an orderly manner and necessary precautions are taken, including social distancing, temperature checks, controlled numbers and masking up.
4. Schools, workplaces and other essential places have established preventive measures. We must at this stage take heed of what the teachers’ unions are saying about re-opening schools. To quote PTUZ, “…opening of schools is not an event, but a process that must be preceded by broad planning and engagement of teacher unions, parents, prioritization of health and safety of teachers, pupils, and ancillary staff”.
5. The risk of importing new cases “can be managed”. We need to manage our boarders and test all immigrants, with a view to isolating for an appropriate period those found positive. Remember, our nasty second wave was due to relaxation of the boarders, failure to quarantine and test all immigrants, failure to follow up new comers in the community, and the presence of illegal crossing points. These must be remedied as a necessary precondition to lifting lockdown measures.
6. Communities are fully educated, engaged and empowered to live under a new normal. A new culture must emerge. Social distancing, not shaking hands or hugging, masking up, limiting size of gatherings, banning cultural practices like eating at funerals, frequent hand washing with soap and water, use of sanitisers, must become the new normal for the foreseeable future.
Health workers must continue to wear PPEs as before until the pandemic is over. Investment in COVID-19 clinical management infrastructure and PPE must continue. Health worker continuing professional education must intensify. The law must be applied evenly across the political divide, religious affiliation, race, colour & creed.
Lifting the lockdown situation has become a necessity to save the people from suffering and starvation, and a sector-by-sector consideration must be done, with the necessary stakeholder consultation and a targeted geographical approach. New and much cheaper vaccines like the J&J that has been used in South Africa must be procured and introduced in Zimbabwe. Measures as outlined above must be taken to ensure we do not gravitate into an even nastier third wave.
Now is the time to move and alleviate the people’s suffering, while keeping the pandemic under control.
Dr Henry Madzorera
Secretary for Health and Child welfare