A lockdown is an emergency protocol that prevents people from leaving a given area. A full lockdown will mean you must stay where you are and not exit or enter a building or the given area.
This scenario usually allows for essential supplies, grocery stores, pharmacies and banks to continue to serve the people. All non-essential activities remain shut for the entire period.
What are essential activities?
Essential activities include picking up groceries and medical supplies, going to doctor and going on a walk provided you are following social distancing. If you work for an essential service, you will not need to adhere to these restrictions.
Can Ghana afford to experiment with a different way to deal with the Covid19 pandemic? The Wall Street Journal urges, in an editorial, a rethink of prolonged lockdown as the strategy to counter the pandemic in the US, given the economic loss it entails, including the loss of livelihoods. Is there an alternative strategy?
The Spanish Flu of 1918 killed off 18 million Indians, about 6-7% of the population. About 7% of Iran’s population was wiped out, about 5% of Mexico’s. Since estimates of the total victims of the flu range from 50 million to 100 million, it is difficult to say what the mortality rate was. The rate varied across the world, but the average is supposed to be 2.5%.
Suffice it to say the Spanish flu epidemic gives us an idea of how much an infection of the kind can spread when not checked with the kind of measures in place now across the world.
If social distancing remains protracted, large parts of the economy would shut down. There would be a huge cost. To avoid this cost, should Ghana as a nation try another strategy? Take the risk of allowing the epidemic to spread and treating those who fall ill? After all, only about a fifth of those who fall ill require hospitalisation and about 5% of those who catch the infection develop symptoms severe enough to require care in an Intensive Care Unit. We allow diarrhoea and pneumonia to claim over a lot of lives every year. Annually, road accidents kill 5,000. Another over 10,000 die of malaria. So is a Covid19 toll a bearable risk for Ghana?
Can Ghana afford to take the route of avoiding economic lockdown and treating those who get affected? Let us assume that unlike the Spanish Flu, Covid19 would afflict only about 10% of the population without tough social distancing measures that involve protracted lockdowns of towns and severe disruption of the economy. That would mean 0.5% of the population would require ICU care.
Ghana’s population is upwards of 30 million. The number of ICU beds that Covid19 would claim would be 150,000. Assume a patient has to stay in for two weeks and the epidemic would stretch out over eight fortnights. Ghana would still require over 10,000 ICU beds, just to treat Covid19 patients. Ghana currently has fewer than such beds (the latest figure I could spot was 23,829). For Ghana to attempt any strategy other than to suppress and contain the disease is to let at least 1.5 million people die.
The Spanish flu was unique in that it was most deadly for the young, aged 20-40. Conventional flu poses the biggest threat to the elderly and the very young. Covid19 tends to spare children, yield to youthful vigour and settle for the elderly and those with underlying conditions. The median age for Italy’s Covid19 victims is over 80.
Ghana is full of people with underlying conditions. About 5% of the population is diabetic, which means all their organs are less than robust. A large proportion of children are malnourished and even women in affluent families are anaemic. The death rate in Ghana could be higher than in other parts of the world. It could be higher than even 0.5 million.
The US currently has 70,000 ICU beds, for a population of 330 million, reportedly with a third lying empty at any given point of time. If 5% of the population fall ill without severe restrictions that would squeeze economic activity, the Americans would need a little over 100,000 ICU beds to treat Covid19 patients alone. So, if they double their existing number of ICU beds, the Americans could actually afford to adopt a strategy that focuses on treatment rather than suppression and containment of the disease via lockdowns that cripple the economy.
The Wall Street Journal is not entirely callous to discuss such a policy
Things are a bit different in Ghana. Unless we are willing to countenance mass culling of the poor and the elderly — the rich would have access to ICUs, the elderly are the most vulnerable — there is no alternative to containing and mitigating the disease with severe measures even if these constrict the economy. It would be morally reprehensible and politically suicidal to make a tradeoff between avoiding economic damage, on the one hand, and millions of lives, on the other, in favour of money. Far better to spend some money to assuage the hurt caused to the economy.
The proponents of no lockdown have argued that people will struggle to survive when there is a lockdown. It must be noted that whether we do it now or later, there shall be a lockdown eventually. The cost of a late lockdown to the economy and the population shall be very hurting and shall take centuries to resolve.
It is said that, where there is a will, there is a way. With regards to the challenge of washrooms, under the regime of curfew, necessity is the mother invention and therefore people living in community could be controlled to still Make use of the public places.
A lockdown will equally lead to reduction in the demand for PPES and a result will be available to the frontline healthcare workers and also reduce the astronomical prices at which they are being sold.
if Ghana fails to manage the next 21 days, it could be set back by 21 years. As a country we failed to be proactive in putting in place travel restrictions and now have to do retrospective testing of international travelers who have already mingled with their various community and may have spread the disease. It is said that if a bird does not fly, it goes to bird hungry. These are interesting times and require drastic action to curtail the spread and not to play with politics.
But Ghana needs to prepare for future pandemics. That means building up capacity to treat patients by the million. Hospitals with the flexibility to convert normal wards into ICUs — seal off sections, selectively allow for continuous replacement of the air, put in place the additional equipment. Invest in raising immunity levels, through good diets, discouragement of gluttony, especially in relation to starchy foods, public health engineering involving sanitation and safe drinking water, and promotion of an active lifestyle, distinct from active watching of live sports on TV.
Source: Dennis Emmanuel Dorbu-Amedzeame, Senior Regulatory Officer, Food and Drugs Authority
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