How to Manage the Coronavirus Conundrum

The Coronavirus pandemic is accelerating. While it took over 66 days for cases to reach 100,000, in 24 days that number increased 8 times. Given that the pandemic is still in early stages in many nations, those nations which have hitherto been spared of the worst by this storm should be prepared to ride it out somehow.

This disease presents a difficult conundrum to developing countries - esp. those in Africa - regarding what type of strategy they should adopt to manage it. However, the fact that these nations are joining the coronavirus ‘party’ this late gives them opportunities to learn how others have handled or mishandled the pandemic. 

The Trace, Test, and Treat Strategy

Two distinct strategies have emerged, both credited to have contained the mass outbreak of the disease. The first strategy is called ‘trace, test, and treat’. It involves conducting extensive screening of potential cases and tracking those who have been in contact with confirmed cases. Nations which have deployed this strategy include Taiwan, Singapore, and South Korea.

In South Korea the virus did not follow the normal script – a religious meeting of a Shincheonji sect with 250,000 members led to a massive outbreak of infections. However, the authorities decided to aggressively trace all contacts and test as many as possible, at one point up to 15,000 every day.

This strategy worked well given their pervasive use of technology necessary for surveillance and a culture where trust in government is high. A high degree of pragmatism is also needed. For example, Singapore, a city-state with 76% of its population being Chinese, quickly applied travel restrictions to China and other social distancing guidelines. Those who flaunted the rules were punished, including stripping foreigners’ visas out.

The Lockdown Strategy

The second strategy is lockdowns. This was firstly implemented in China where 57m people were locked down. The strategy worked well and new cases were reduced to zero, an astonishing feat. That said, it is interesting to observe that when Hubei was locked down there were only 830 confirmed cases in China, while New York has 67,000 cases yet the US is still dilly-dallying about taking similar measures. Locking people down is a decision which leaders of free societies will struggle with.

Models for African Nations?

Now, both strategies are not be ideal for our countries. The South Korea’s strategy requires the availability of many testing machines and centres. This doesn’t come cheap. Moreover, given that one needs a ubiquitous adoption of credit cards, CCTV, and digital apps solutions to effectively track people’s movements and determine who they have been in contact with, this is nigh impossible without it. Finally, without trust, people will flaunt their liberties and those who can will get away with it will endanger others.

Total lockdowns also have their own dilemmas, given that many people live hand-to-mouth. In Zimbabwe, a country which is already facing food insecurity, people are more concerned of starvation than Coronavirus. The same is true in India. So, it is possible that lockdowns can produce worse outcomes than the virus itself.

That said, there is a wrong way of implementing lockdowns. Images of police brutality in Kenya is one of them. Equally bad is the tendency to implement lockdowns without advance notice – e.g. India and China. When people are going to lose their livelihoods by governments’ actions, they deserve to know in advance.

So, what can our countries do?

One, try to avoid the overwhelming of the health system as much as possible. This is possibly the reason why Tanzania took the curious decision to close schools and colleges having reported only two cases. However, if this is what they intend to achieve, encouraging religious gatherings may be counterproductive. Religious events that became local Covid-19 epicentres in Qom, Kuala Lumpur, and Daegu are enough to make Tanzania revisit this position.

Two, governments need to broaden the criteria for screening. In Tanzania, again, only those with epidemiological risk factors are tested. However, for the current strategy to work, it needs to go hand in hand with an increase in ‘trace, test, and treat’ capacities. This will help nations to understand the true extent of the disease as they upgrade their hospital care systems.

Three, ramping up hospital capacities. Coronavirus will brutally expose the shortcomings of our systems. For example, when you only have 10,000 active cases you will need at least 600 ventilators. How many can be available and how many are free at any given point? People, God forbid that the number of active cases goes into tens of thousands while the status quo persists! Governments should engage private providers, business and religious leaders to improve this situation immediately.

Four, when the numbers get out of hand, lockdowns may be inevitable. If this is well thought out in advance, it may be the necessary evil. 

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This article first appeared on the Citizen of 2nd April 2020. While I have left it as it was, some facts ought to be changed to reflect the current situation. Thanks.