FOR almost nine months now, Zimbabwe has been battling the COVID-19 outbreak, which unfortunately has brought unprecedented changes to our way of life. As a country, Zimbabwe has by and large been spared of major epidemics in the past, and the COVID-19 pandemic presents the first real challenge to the country.
By Dr Grant Murewanhema
The previous SARS and MERS outbreaks relatively spared most of Africa, Zimbabwe included, and the Ebola Viral Disease outbreaks of West Africa also spared Southern Africa. Not surprisingly, the idea of quarantine, isolation and lockdowns is quite foreign to most of us.
It has been assuring that a pandemic that ravaged advanced nations has so far been very mild in most of Sub-Saharan Africa, and the projected trajectory has not manifested. For example, scholarly mathematical projections by a team of researchers at the London School of Hygiene and Tropical Medicine had projected that Zimbabwe would have a cumulative case burden of 1000 by mid-April 2020, but by the end of June 2020, we were still at less than 60% of that projection.
Why we have been spared has been baffling for many scientists, but it has definitely worked in our favour. With a very vulnerable to non-existent public health sector, Zimbabwe would not have coped with a massive case burden.
As of 5 September 2020, Zimbabwe had reported a cumulative total of 6977 cases, which includes 5360 recoveries, 1410 cases and 207 deaths. Harare Province bears the greatest burden of COVID-19 in the country. Reassuringly, the national recovery rate approximates 80%, and the majority of cases have been asymptomatic or moderate and have not required any hospitalisation or specialised medical treatment. For a country with a total ICU capacity to date of less than 100 beds, this is really awesome news. Healthcare practitioners have been on strike for almost 2 months and patients have had nowhere to turn to for treatment.
The past 2 weeks have seen a marked decline in the number of reported cases, and except for the past two days, less than 100 cases were being reported per day. But clearly, this is misleading. The national situation reports indicate that Harare had a huge backlog of samples to be tested; testing has remained the biggest challenge and threat to control of the outbreak in Zimbabwe so far. Once testing is upscaled, more cases are reported.
Of course, there are still many unverified reports and rumours of people dying in communities as they fail to access testing and treatment in both the public and private health sectors. In the past few weeks I have received an increased number of calls from diasporan friends with concerns that some of their family members were exhibiting symptoms suggestive of COVID-19 and failing to access testing. Of those we have successfully referred for testing, a good number have tested positive.
This brings the question of where we are with the COVID-19 pandemic in Zimbabwe, and where we are going. Whats evident from the increased number of local cases is there is widespread community transmission. Of the 140 cases confirmed in the past 24 hours, 100% were local, 135 being from Harare Province. Mashonaland West Province has also seen a marked increase in the number of local cases in the past 2 weeks. It is safer to say the true burden of COVID-19 in Zimbabwe remains largely unknown, and efforts to establish this are dampened by critical challenges in resource availability including testing, personal protective equipment, human resources and logistical challenges.
Unfortunately, and naturally as humans, signs of fatigue and complacency have begun to manifest. People have started going on about their usual routines without adequate infection prevention and control practices. The numbers of people practising physical distancing and hand hygiene is declining drastically, and many have started forgetting their face masks.
Control at road checkpoints has been loosened by and large. Reports of parties at night have started coming, and disturbing videos of people partying without face masks, being intimate and not practicing any form of physical distancing have been circulated.
Zimbabwe has good chances of controlling the pandemic and keeping the numbers low, but the relaxed attitude and the complacency presents the biggest enemy to a successful fight. The population once again needs strong reminders thats its not yet over. The youthful urban and ‘elite’ population presents the biggest challenge to control, and tighter regulations aimed at this population may be necessary. The youthful population of the high density areas, who survive on informal trade and vending also present another big threat.
Without adequate social support and without any significant savings, people have to go back to finding their livelihoods once again, in this hyperinflationary environment. Churches and other religious groups also present another huge challenge to our control; this group of people tends to quickly forget and relax as they surrender all unto the Almighty. We don’t question or oppose people’s religious convictions, but we advise caution as people embark on the activities they believe in. The re-opening of schools remains contentious; its something I believe has to be done but that the right environments protective to scholars and educators must be created.
Whilst it is reasonable that people return to their economic activities, infection prevention and control in the workplace becomes the next major challenge. This starts with appropriate information dissemination, especially letting people know that its not yet over. A useful reminder to the youthful must always be that whilst they can withstand the disease, they could be the vectors to their vulnerable elderly parents and grandparents, and if not for themselves, they should practice infection prevention and control for the sake of the community.
As we move forward, complacency is our next biggest enemy in the fight against COVID-19, and we have to focus and remind ourselves once again that the war is still on. COVID-19 is not a hoax; its real and it has claimed the lives of many of our beloved ones.