Ghana is in a comfortable 4th position with confirmed cases standing at 161 with 5 deaths. Of this number, 44.7 percent of all cases are community spreads (or what the Ghana Health Service refers to as ‘Routine Surveillance’), while 55.3% were detected after the President shut down the country’s borders and ordered the mandatory quarantine of all entrants. It is possible that a full half of community infections could have been avoided if the President had ordered the border shutdowns a week before, and only a tenth of cases would have been recorded if he had shut down the borders after his arrival from Switzerland. Total homecare (recovery) cases are 49. There’s no doubt that the total number of infections would be 1,000 without the mandatory quarantine instituted, but we cannot hope that the numbers stay that way.
For mandatory quarantine, and barring any truth to bribery and extortion rumours that celebrities and politicians are paying their ways out of mandatory quarantine, we can be certain that the rate of confirmed infections will not exceed 30 percent of the quarantined population. All our fears are rightly for community infections, the progression arithmetic that Italy, Spain, the United States, Iran and South Africa (Africa’s COVID 19 League Table Leader at 1,326 confirmed cases) are currently experiencing. When Ghana’s routine surveillance or community infections exceed 50%, we will be in deepshit country because that is exactly when our rates will be aiming to make a dash for peak levels.
This is why this Jungle Boy and a duo of frontliners have teamed up to bring you this special worst-case scenario for examination. Our worse-case pandemic scenario starts with 250 community infections. The GHS and the MOH need to have switched from a centralized to a decentralized management model at that point. This requires the conversion of the various constituencies as Clusters (CCs or Constituency Clusters). Each CC is a first responder center where suspicious cases can be reported. These CCs can run from a container shop or from a mobile kiosk. The cluster must consist of two nurses at the least, a medical doctor, and an ambulance purposely fitted to transport cases. The CC must be heavily protected for bio-hazard reasons, and must have more PPEs than the Korle has plastic, and a mobile telephone with a tracker. The CCs’ role in this fight is to serve as the first contact for probable cases in the constituencies and must be equipped with tools to assess a patient for signs of COVID-19. If we are lucky to have procured ABT.N COVID-19 test kits, then the testing could be done and the results found out in 5 minutes before the cluster transports the patient to Regional Clusters (RCs); a tented pavilion equipped with the necessary quarantine and treatment equipment that can be set up at regional sports stadia to receive patients from the CCs.
We don’t have the manpower and financial muscle to build new hospitals like the Chinese did; and we dare not overwhelm our current hospitals – they barely have the capacity to handle anything beyond what they are already doing in our misbegotten excuse for healthcare delivery in Ghana (don’t get us started on NHIA arrears). We may have to convert the Dome at the AICC into Accra’s RC though (we wanted to suggest Parliament House but we are feeling benevolent).
Ultimately, this proposed approach will eliminate prank calls (CCs require walk-ins), and allow better and meaningful coordination of the coronavirus fight in Ghana. It will lead to rapid responses to peaking cases, reduce the risks of overburdening regional and national hospitals and allow an efficient trace of cases. Food distribution, as well as exit permits from homes, can be managed through the CCs. Mass testing can also be done through these CCs like Germany has been doing. And if Chinese PPEs won’t come, let’s provide Ghanaian tailors with the materials they need to make facial masks for their communities. And this will work after government proceeds from oil and gas, cocoa, VAT, customs duties, remittances, and taxes from foreign consulates have all completely disappeared together with the $100m IMF cash. It might be difficult to pay public sector workers as well if this coronavirus issue persists for more than two months, which is why the President needs to be decisive at these times.
Trust us when we say that allowing peak infections will mess us up beyond our wildest imaginations; why do you think Sierra Leone is on lockdown over just one case? They know they are no Wuhan nor Madrid. Let’s get cranking, Mr. Government; before we all die. And we need to stop government appointees from peddling false hopes. We may have 400 ventilators as the President’s advisor on health posited, but we are of the candid opinion that these ambulance ventilators are incompetent for ICU use. Let’s therefore get the clusters to begin their work and we may prolong our peak deaths until antidotes are found. We need to prepare to have an Italy on our hands, folks while praying as hard as we can.
Happy Lockdown all the same!
Contributors: Emmanuel Agyeman Joseph Kofi Asante JayJay D. Segbefia