Zimbabwe extended its lockdown by an additional 14 days today, following the trajectory of several other countries worldwide.
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2) is a very contagious virus that causes Covid-19, a deadly respiratory disease. It is very difficult to mitigate its spread.
Despite our best efforts, ultimately and unfortunately, at some point or another in the future, it will infect the majority of people who come into contact with it.
The nature with which is easily spreads and fast, means that it easily overwhelms most if not all health systems, regardless of where they exist, how rich the countries are, or the colour of the skin. Even the most sophisticated hospitals can be brought to their knees in a matter of days as thousands get infected, fall dangerously ill to the point of needing hospitalisation. Consequently, hospitals run out of beds, staff and supplies, leading those who could otherwise survive with minimal medical care become potentially fatal cases.
Lockdowns were introduced to prevent that precise apocalyptic scenario. To “flatten the curve”, slowing down the rate of new infections so that health systems are not overwhelmed.
This buys time for governments to strengthen healthcare systems, by getting critical supplies quick, increasing capacity, caring for those who fall ill and limiting fatalities.
During a lockdown, states are meant to create a buffer around vulnerable people who would die if the got infected, like the elderly or people with underlying health conditions. There is intense capacitation, often characterized by wide-spread testing, contact tracing and screening.
When China locked down, they built new hospitals in record time, boosted production at factories that produce the sundries, equipment, and protective clothing. Germany, which kept stockpiles for such emergencies activated them immediately. South Africa hired more staff, set up warehouses to accommodate those who cannot self isolate in their homes, constructed makeshift hospitals among other things.
Lockdowns cannot be permanent. They are meant to buy time, so that a country can prepare for the inevitable increase in Covid-19 cases.
A good and strong healthcare system ultimately results in a reduction in mortality. A lockdown is meant to buy time while such a system is built, or boosted.
It is a futile to enforce a lockdown without aggressive efforts in all the realms mentioned above, and this is the problem with Zimbabwe’s approach.
While Zimbabwe has made some efforts, in its fight against Covid-19, it has not adequately bolstered its health systems response for safe lifting of the lockdown, and the meagre resources available are being diverted to the fight against Covid-19 at the expense of other diseases.
There has been no hospitals built, the testing and contact tracing is simply not enough, the vulnerable have not been buffered from society, and there has not been a massive initiative to get critical supplies, PPEs, or the several ICU beds that will be required when the virus peaks.
The health system that should getting strengthened is in fact getting stretched, and long before the virus gains momentum. We are already witnessing an increase in Malaria cases, presumably due to lack of funding or the concentration of all efforts towards Covid-19. Some people are missing appointments to pick up their ART and BP medication and other drugs and there appears to be no plan in place for these very vulnerable people who the lockdown is meant to protect.
Secondly, for any public health policy to work, it has to be accepted by the same public, and there should be wide consultations with experts in public and private sector health.
European countries are complying with lockdown measures as they are getting food aid and relief cheques. In Zimbabwe the relief efforts are more of a pittance than actual relief.
Zimbabwe cannot continue with a lockdown for the sake of a lockdown. But the country cannot also just lift the lockdown without meeting the conditions that make it safe to do so. Its a catch 22 that could bring more than just the health system to its knees, but the whole country.
- Dr Benson Mudiwa is a Zimbabwean medical practitioner.