The president of the Republic of Ghana addressed the nation for the third time on Saturday 21st March, 2020. The main highlight of this update was the closure of the borders of Ghana by sea, land and air effective 00:00 22nd March, 2020. People entering the country before then were to be put under mandatory quarantine and tested for the virus.
On 24th March 2020, Ghana recorded a hooping 26 cases raising the number of positive cases from 27 on 22nd March to 53 in one day. At press briefing by the ministry of information, the minister of health disclosed that 25 of the newly recorded cases were confirmed among the 1030 people who are under mandatory quarantine in the country after arriving at Kotoka International airport hours to the deadline for the closure of the country’s borders. Out of 185 results received, 25 of those quarantined tested positive to the COVID 19 virus. He also stated that psychologists had been assigned to those in quarantine to chat with them and those tested positive would be handed over to the case management teams set up as they had started taking them to the isolation centers for case management. As at 25th March 2020, the number of confirmed cases had risen to 68 with 38 of them coming from the people under mandatory quarantine.
In the wake of this global pandemic, there have been many measures put in place by the Government to see to the containment of the spread of the virus. While at this, one important conversation that has been ongoing is how not to reach the community infection stage. Records of recently confirmed cases however have shown that our worst fears might be coming true as it is supposed that this might have started already. There have been confirmed cases that are unable to trace their source as in their best of knowledge have not been in close contact with anyone that recently traveled and no history of travel themselves over the past few months since the start of this coronavirus pandemic.
The WHO in a recent briefing stated that new research now indicates that the virus could be airborne, indicating the spread will be rather very easy, a reason for which the social distancing rule emphasizes a 2m distance between people’, especially with infected individuals. In a case like ours where we do not have mass testing available, it is essential that everyone is treated as a potential infected person and keep the appropriate distance. Dr. Michael Owusu, the Executive Director of Centre for Health Systems Strengthening (CfHSS) and also a Virologist at KCCR implores that the use of nose masks be limited and left for the frontline health workers as people scrambling for it to use precociously may be left with none when needed as they are mostly at risk. He says appropriate social distancing may just be enough. However, people with the virus are advised to use masks so that through their coughing and sneezing do not release the virus into the atmosphere.
On the issue of testing he stated that, at this rate, we have no choice as a nation than to decentralize the testing. With six community cases recorded, it has become important that the testing is decentralized. He said that, the country may have control over the imported cases and their contact tracing but the community cases might be rather difficult as the rate of confirmed cases may begin to increase in an exponential rate as the virus has a reproductive number of two to three; meaning at any unit time a person with the virus will be able to transmit it to 3 other people and each one of those three will be able to transmit it to another three in one hour and the numbers will keep increasing from there. So if the primary cases are not found, it could be predicted that in the weeks to come, the number of infections will shoot up.
In a community phase, KCCR and NMIMR may not be enough for testing. To reverse community transmissions, testing will be the only key and it will therefore be essential to have other facilities and centers where testing can be done for COVID-19. Dr. Owusu has also commented that, we could adopt what countries like Singapore and South Korea did to beat down the surge of their COVID-19 cases. He stated that, these countries adopted what is called the community enhanced testing. In this case, they went into the cities and sought for those exhibiting the symptoms of the disease, got all of them tested and isolated the positive cases, removing them from the community to prevent any more spread.
In Ghana, considering the situation of overcrowding in most of the cities, a community outbreak will have dire repercussions on the people, frontline health workers and the nation at large. As extensive education is ongoing to create awareness on the virus, it has also become imperative that community transmission is averted. Below is a link to the interview.