Further Waves Of COVID-19 Imminent In Zimbabwe Unless We Become Serious About Prevention

NATURALLY as human beings, we get tired of unpleasant situations that drag for protracted periods of time. It is therefore not surprising that we have become largely complacent about COVID-19 prevention protocols.

By Dr Grant Murewanhema

Recently, I went into a fast-food outlet, and was surprised that the attendants and their customers had no masks on, and hand-sanitizing on entry is no longer taking place. I quickly reminded the supervisors about the need to enforce these protocols. They are good not just for COVID-19, but even for other respiratory illnesses, especially as the cold spell begins in Zimbabwe.

Several factors may be contributing to the current complacent behaviour; but anecdotally I can quickly point to a few, including pandemic fatigue, lack of accurate information and knowledge, lack of direction from leadership, lack of enforcement from reliable authorities, or just simply not caring.

Pandemic fatigue is a well-known phenomenon, and is not unexpected as this pandemic has dragged on for over a year now. People are tired of wearing facemasks, washing hands frequently, or keeping physical distances. People are also tired of staying in confined places. Human beings are social beings, and by nature, we want to mix and mingle. Hence, despite limits in the number of people allowable at social gatherings such as funerals, church services and weddings, people have really started going out in huge numbers.

The population is deprived of accurate knowledge and statistics, there is a reduced drive to talk about COVID-19 on mainstream media and on social media, and COVID-19 prevention messages have drastically been scaled down. People have also become tired of following these messages, including our social media pages. Despite almost a hundred thousand followers, less than a 1000 individuals consistently follow us now.

Whilst staying away from COVID-19 is good for the mind, especially as some are suffering from post-traumatic stress disorder, panic attacks and anxiety from events of the past few months, being closed totally to what’s happening can negatively impact preventive efforts. The political leadership also lacks commitment to the COVID-19 prevention agenda and are involved in many potentially super spreader avoidable activities such as opening small projects where they go out in large numbers, and the population follows suit. Decisive leadership is a critical element of success for any public health programmes.

Some people simply don’t care about COVID-19 anymore, and the lack of reliable income or jobs forces people to go out and carry out their pre-COVID-19 economic activities. Bread and butter issues are at the bottom of Abraham Maslow’s hierachy of needs, and in a population with over 90% formal unemployment, it’s not surprising at all that people have gone back to their traditional hustles.

We live in a country where people live from hand-to-mouth, with no reasonable savings at all, so yes people have to work. There is no social support or any social insurance. One only needs to pass through Magaba in Mbare to witness what I am talking about. Recently I talked to a couple of guys in that area about COVID-19 and their response was simple: ‘Makuruwani, how do we survive, pay rent or send our kids to school if we don’t work. You know the economic situation in our country.’

I am usually quick to remind people about the scramble for oxygen and hospital beds that happened between December and February, and the usual answer is, ‘we will cross the bridge when we get there’. People have genuine socioeconomic concerns, concerns that need to be addressed, but there simply is nobody to address them.

Our vaccination roll-out has been extremely slow, with less than 600 000 people having received their first dose to date, and an even smaller proportion having been fully vaccinated. Drivers of this slow vaccine rollout are multiple but also include a lack of drive from the responsible authorities, and widespread vaccination hesitancy which has not been appropriately addressed. One can speculate that lack of accurate information, perceived adverse events, unaddressed safety concerns and unfortunate utterances by prominent religious leaders may be some of the drivers of vaccination hesitancy.

Unfortunately, vaccination is such an important primary prevention modality that has the capacity to reduce new infections, reduce disease severity and reduce mortality from infectious diseases. Population wide benefits of vaccination will only be realised once we have vaccinated sufficient numbers to achieve herd immunity, of which we are still way off target for now.

India has suffered massively from the current wave, and they are paying a huge price for complacency. Some provinces in South Africa have officially announced that they could be in a third wave now. Zimbabwe is not yet in a third wave, our epicurve remains flat for now, but we continue to see spikes in incident cases from time to time. We also have received reports of cases of returnees from India, though we don’t know which variant they tested positive for. Early genotyping is important, unfortunately we have limited capacity locally, and it usually takes several months before we get to know the variants we are dealing with.

As we get into winter, a third wave of COVID-19, with further waves in the future, is imminent, unless we become serious about preventive efforts. Without strict lockdowns, we should just enforce our prevention efforts ourselves, including wearing our masks appropriately, correctly and religiously while  maintaining physical distancing and hand hygiene, and avoiding large scale gatherings.

For religious leaders, the urge to call for large scale gatherings is strong, but it’s a behaviour we must desist from. Additionally, we must ensure strict compliance with prevention protocols in schools and workplaces. Let’s accelerate vaccination, and ensure the vulnerable portions of our population are protected before we get into winter.

The responsibility and power to prevent further waves of COVID-19 and their devastating psychological and socioeconomic consequences lies really within our hands as citizens, and it is time to step up our prevention efforts, fight complacency and stop further waves. Even without governments pronouncements, let’s be responsible citizens.

(Dr Grant Murewanhema, MB.ChB, MPH, IPFPH, is an independent epidemiologist and public and global health practitioner and a registrar in Obstetrics and Gynaecology. All the opinions expressed herein represent his personal opinions).

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