Co-operation, transparency and much more testing: Covid-19 is “a scary disease”, but with the right measures Zanzibar will push through, says Dr. Ghirmay Redae Andemichael, liaison officer of the World Health Organisation (WHO) in Zanzibar.
Dr. Andemichael, we are several months into the epidemic in Zanzibar, which started here on 18 March. How worried are you still about the coronavirus?
It’s a scary disease, but I am hopeful. Zanzibar has dealt with emergencies before, cholera outbreaks for instance. It has established institutions to deal with such a crisis like the disaster risk management commission in the Second Vice President Office, Rapid Response Teams and an emergency operations center at the Ministry of Health. This enables Zanzibar to activate a multi-sectoral response.
Sounds impressive. But the public often doesn’t get figures and facts.
We have said it over and over again: The WHO advocates for transparency and release of data for effective response and containment of the pandemic. We are still seeing only the tip of the iceberg. 80% of those infected with the coronavirus show no symptoms or minor symptoms. 20% display moderate or serious symptoms and of those 3-5% may require critical care. The majority will not feel sick but potentially transmitting the disease.
Meaning?
Consider everyone as infected. Practise social distancing, hand-washing and other hygienic precautions. If you do have symptoms, stay at home, call authorities to investigate you, don’t go to the market or to work.
Zanzibar is opening up to tourism again. From a WHO standpoint, when will holidaymakers be back?
The comeback of tourism will be dictated by global events. Not because Zanzibar wants it, but when people are ready to travel again. The global way of doing things might change in travel, tourism, hospitality industry and others. It can be a wake-up call. Hopefully next year the virus will either fade through natural immunity or through vaccines and medicines. WHO and member states are engaged in research collaborations for this purpose.
Let’s get to the medical bottom of this. Why is not more testing being done?
It would obviously be good to test as many people as possible, also suspected groups, but Zanzibar does not have the resources neither do several other countries in the world. Even richer countries in North America and Europe did not do sufficient tests. It is good that new testing facilities were being installed in Unguja and Pemba.
It seems the pandemic was or is still growing slower in Africa than elsewhere. In Europe, after a slow start, the second month brought exploding numbers, here not. Is Africa probably not that endangered?
It might be that a different demographic, a much younger population, heat and humidity, outdoor socialising, different immune responses and other factors play a role in the lesser acceleration of COVID-19. But complacency is not an option. No, not all! We have to be very vigilant, especially in June, July, August when the southern hemisphere will be cooler. The pandemic could still be exploding. We simply don’t know.
What role does the World Health Organisation (WHO) play in Zanzibar?
We advise the government on evidence based public health measures and work together for their implementation. We have deployed five full time experts for example for surveillance and infection prevention, we have brought personal protective equipment for health care workers to both Unguja and Pemba before the pandemic reached Zanzibar, we recently shipped in more hand-held thermo-scanners and other equipment for doctors and nurses worth $60,000. We have trained more than 220 district teams, including rapid response teams. We say: Health emergencies are becoming a norm rather than an exception, Don’t run after emergencies. Use the crisis to build up the system.
Some people say, a one-fits-all strategy cannot work for Africa, and poverty may kill more people than the coronavirus?
If you are not healthy you are not productive. Each country has its own strategies to deal with the situation. But the general truth is: Health should be at the centre of the development agenda. All member states follow WHO’s guidance on dealing with the pandemic. In Africa, Corona is an additional burden to other diseases such as malaria, HIV/Aids, non-communicable diseases and malnutrition among others. Exactly because this pandemic might exacerbate poverty, we need to redouble our efforts to curb this menace.
But how? Public places and markets such as the Darajani market, for example, are full of vendors and customers…
Be assured, everybody has been working on these issues, from the municipality to various ministers. Corona prevention is everybody’s business - without forgetting the other diseases and the socio-economic impact of this menace. Darajani market was cordoned of, watchmen controled the wearing of masks. A lockdown might not be an option in a place where economy depends on daily transactions among people. However, this could be a last resort to go to if need arises.
Amidst all rumours there is one daring theory: Could Corona have hit Zanzibar earlier - practically unnoticed? In December/January many people are said to have been seriously ill.
Frankly, we don’t know, but I doubt it. It might be interesting to follow up on this. In Zanzibar you can’t hide information, even when a poisonous turtle killed some people in Pemba, the WHO knew. Our teams would have known of a mysterious disease around New Year, we would have known of people in intensive care, of any deaths of unnatural events. No - for us the index case, the first corona cases found in Zanzibar, were clearly a tourist couple coming from Germany. They were tested on March 18. They were the first admitted to the Kidimni isolation facility, fortunately with minor symptoms, and have since been released.
Finally, when and how will Zanzibar know that it has pushed through, that the worst is over?
By WHO definition Zanzibar will be declared virus-free if there are no new cases for four weeks, because the incubation time is 14 days. The problem: there can be another wave. But we have to stay optimistic.
