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Opinions of Monday, 30 March 2020

Columnist: D. C. Kwame Kwakye

Coronavirus and Ghana's emergency preparedness: Assessing some of our behaviour pattern

Coronavirus emerged in China on December 31, 2019 (www.time.com) and from there till now it has now become a global problem spreading to some other countries and taking the lives of many.

The coronavirus which began in China has now killed 723 as at the time of writing this article, and the number of confirmed cases has risen to 34,598, according to official data released early Saturday by the Chinese officials. Most of the newly recorded deaths according to a report occurred in Hubei Province, the heart of the outbreak. Two areas outside Hubei now have recorded more than 1,000 cases each. There have been 288 confirmed cases and one death in two dozen other countries apart from China (www.nytimes.com).

According to a story titled "Coronavirus: Which countries have confirmed cases?" and published on www.aljazeera.com, the following countries have confirmed cases of coronavirus. While some European countries including Belgium said on February 4 that one of nine Belgian citizens repatriated from Wuhan had tested positive for the coronavirus, Finland has an infected person. In the Finland situation, a Chinese tourist who was admitted to hospital for tests was confirmed on January 29 as having been infected with the coronavirus. The patient came from Wuhan in China.

French health officials have confirmed five new cases of the coronavirus on February 8, bringing the country's total to 11. The new cases were all British citizens who had shared a chalet at a French ski resort with someone who had recently travelled to Singapore.

France was known as the first European country to record cases of the virus. Germany has registered 14 confirmed cases of the coronavirus as of February 8, with a majority of those infected in southern state of Bavaria. In the Germany situation, it is reported that the patients in Germany are employees of the auto parts supplier Webasto, who were infected by a colleague from China who was attending a course in Germany. Italy has 3 infected individual. One of 56 Italians evacuated from Wuhan has tested positive for the new coronavirus, the health ministry said on February 7. The other two are Chinese tourists who tested positive for the virus on January 30, 2020.

The remaining countries are: Russia - 2, Spain - 1, Sweden - 1 and United Kingdom - 3.

Australia has confirmed 15 cases of the virus as of February 8, including three people who have already been treated and discharged from hospital. Most of the patients arrived in the country from Wuhan or Hubei province. United Arab Emirates in the Gulf region has 7 reported cases of the virus, United States - 12 while Canada has 7.

The remaining who have reported cases of the virus are countries of Asian origin: Cambodia - 1, India - 3, Japan - 64, Malaysia - 16, Nepal - 1, The Philippines - 3, Singapore - 40, South Korea - 24, Sri Lanka - 1, Taiwan - 17, Thailand - 32, and Vietnam - 13.

The above clearly shows that, coronavirus has assumed international dimension and all of us are at a risk. Countries have started screening visitors who enter into their country especially from China. But as it stands, the virus is now found in Europe, the Gulf area, the America's and far away in Australia. The only continent yet to report a recorded case of the Corona virus is Africa.

WHAT IS CORONAVIRUS?

"Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV)" (www.who.int). A novel coronavirus (nCoV) is a new kind that has not been previously identified in humans.

Coronaviruses typically attack the respiratory system of humans. The name comes from the Latin word corona, meaning crown, because of the spiky fringe that encircles these viruses. It mostly infect animals, such as birds, cats and bats. Only seven, including the current 2019-nCoV, SARS, and MERS, are known to infect humans (www.vox.com).

Coronaviruses are zoonotic, which means they are transmitted between animals and humans. Detailed investigations that were done found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans.

A zoonosis (plural zoonoses, or zoonotic diseases) is an infectious disease caused by bacteria, viruses, fungi and parasites that spread between animals (usually vertebrates) and humans. Major modern diseases such as Ebola virus disease and salmonellosis are zoonoses.

Some popular zonootic diseases are: animal flu, anthrax, bird flu, bovine tuberculosis, dengue fever, Ebola, hepatitis E, malaria, rabies, ringworm and swine flu. There are others that are not too common and I would not bother you with it.

Common signs of coronavirus infection include fever, cough, respiratory symptoms, shortness of breath, and breathing difficulties. In very severe cases, infection can cause severe acute respiratory syndrome, pneumonia, kidney failure and even death (www.who.int).

Advice for the public

Because of the outbreak of coronavirus (2019-nCoV) in China, the World Health Organization (WHO) has outlined some measures that citizens of the world can apply in order to increase their chances from not being infected with the virus. These include:

Frequent Washing of Hands.

According to WHO, Wash your hands frequently with soap and water or use an alcohol-based hand rub or hand sanitizers if your hands are not visibly dirty. This is because washing of hands with soap and water or using alcohol-based hand rub or sanitizers helps to eliminate the virus from your hands.

Practice Respiratory Hygiene.

WHO says, when coughing and sneezing, our mouth and nose should be covered with flexed elbow or tissue paper. The tissue should be discard immediately into a closed bin and hands should be cleaned immediately with alcohol-based hand rub or soap and water. The reason is, covering your mouth and nose when sneezing and coughing can prevent the spread of viruses and germs. If you sneeze or cough into your hands, you may contaminate objects or people that you touch. We should try and avoid this.

Maintain Social Distancing.

Maintain at least 1 metre (3 feet) distance between other people and yourself, particularly those who are coughing, sneezing and have a fever. This is where most of us are guilty. We normally stand very close to fiends and have tête-à-tête conversation. This should be minimised or avoided. When someone who is infected with a respiratory disease like 2019-nCoV sneezes or coughs, they project small droplets containing the virus in the air. You are likely to breathe in the virus if you are too close to the infected person.

Avoid touching Eyes, Nose and Mouth.

This is because our hands touch many surfaces which can be contaminated with the virus. We even shake hands with almost everyone that we meet which is a normal behaviour of Ghanaians. Touching your nose, eyes or mouth would transfer the viruses into your system from the contaminated surfaces you might have come into contact with.

If you have difficulty breathing, fever, and cough seek medical care as early as possible. Inform your health providers or professionals if you have traveled in an area in China where 2019-nCoV has inflected people, or if you have come into close contact with someone with who has traveled from China and has respiratory symptoms. Whenever you have the above symptoms, seek medical care promptly because fever, cough and difficulty in breathing are symptoms of respiratory infection or other serious condition including 2019-nCoV. With the above, coupled with a personal travel history to places where coronavirus have infected people put one at a higher risk.

As a general precaution, practice general hygiene measures when visiting live animal markets, wet markets or animal product markets. Ensure regular hand washing with soap and potable water after touching animal products and animals; avoid contact with sick animals or spoiled animal products, avoid touching nose, eyes, or mouth with hands. "Strictly avoid any contact with other animals in the market (e.g stray cats and dogs, rodents, birds, bats). Avoid contact with potentially contaminated animal waste or fluids on the soil or structures of shops and market facilities" (www.who.int). In concluding on the advice, the WHO cautions us to avoid consumption of raw or undercooked animal products. Also, to handle raw milk, meat or animal organs with care, to avoid cross-contamination with uncooked foods, as per good food safety practices.

Enter Ghana

From the above, it is established that, hand washing with soap and running water is one of the highly recommended hygiene practices which can help to protect one from getting infected with a lot or viruses including 2019nCoV and germs.

In Ghana, there has been a lot of hand washing with soap campaigns on our airwaves, in schools etc in recent past. All these were done to inculcate the habit of hand washing with soap to be part of the Ghanaian culture.

This particular habit is yet to be ingrained into us as Ghanaians. Even if it has been part of us, other factors inhibit us from practicing it. Should the coronavirus emerge in Ghana, how prepared are we to combat it? As I put this piece together, water isn't flowing regularly in my area at Ayikoo Ayikoo in Cape Coast for about four days now. So, implementing this common exercise of hand washing with soap would be problematic. Indeed, at the office of my workplace, our places of convenience has been locked over this week, all because water isn't flowing.

On the 6th of February 2020, it was reported that, residents of Sekondi-Takoradi metropolis and municipality in the Western Region will have to brace themselves for the further extension of the ongoing water rationing; since the Ghana Water Company (GWCL) is still unable to provide enough water to meet demand.

Although the inadequate water supplied to the treatment plants at Inchaaban, for redistribution has been largely blamed on the dry season, activities of illegal miners popularly called 'galamsey' on some water bodies in the region have worsened the plight of inhabitants in this area during this dry season.

Responding to this situation of water rationing, the Communications Manager of the Ghana Water Company Limited (GWCL), Stanley Martley said The levels (of water bodies) are low, so it is also causing rotation around the intake, so it becomes difficult for us to abstract enough water. But if they (galamsey operators) stop, we can now dredge the intake area and we can have some water as well (www.myjoyonline.com).

If in today's age and time, getting adequate water to improve hygiene is difficult, because the GWCL cannot get enough fresh water to purify for the population to consume let alone washing of hands, then what would happen should we be afflicted with coronavirus?

This depicts us as a people who are not serious with issues of health and hygiene. If the provision of portable water, with all the investments governments have made over the years, we still ration water, then we have a long way to go as a nation. We have allowed illegal miners to compound our problem and we have sat down doing little to stop this canker.

DESIGNATED HOSPITALS FOR CORONAVIRUS

As part of efforts to control and deal with any emergencies associated with the deadly coronavirus, the Ministry of Health has designated the Ridge Hospital in Accra and the Tema General Hospital as centres to manage possible cases of coronavirus in the country. It is said this forms part of the countries plans to prevent and control any case that may be detected in the country and ultimately protect the Ghanaian population from other ramifications.

In a statement issued on Monday, January 27, 2020, the Ministry said it has activated the countrys emergency preparedness and response plan amidst the rising number of infections from the novel Coronavirus (2019-nCoV) in other countries of the world. It has also directed all Regional Directors of health to designate treatment centres in their respective regions to deal with cases if they arise (www.citinewsroom.com).

This is a good move but something happened that I find it difficult to comprehend. While the Health Ministry has designated these hospitals for treatment of coronavirus, the Korle Bu Teaching Hospital doctors fled at the sight of two suspected coronavirus patients at the facility. The story is reported on the 6th of February 2020 on myjoyonline.com captioned "Malicious panic hits Korle Bu as doctors flee over suspected coronavirus case". According to the story, the head of the Public Health Department, Dr. Philip Amoo at Korle Bu Teaching Hospital has revealed that a lack of a well-resourced holding bay at the hospital caused pandemonium among doctors. Dr Amoo went ahead to describe the situation at Ghanas biggest referral hospital as malicious panic, and said some doctors on duty even began to flee the health facility for fear of getting infected.

The difficulty I have is that, government of Ghana has designated two hospitals to respond to Coronavirus so how come the suspects were sent to Korle Bu? Why didn't management of Korle Bu refer them to the hospitals equipped to deal with that emergency? Why would the doctors flee by the mere sight of suspected coronavirus patients? Should it had happened that, the suspects had coronavirus, the doctors fled, what would have happened at Korle Bu and Ghana by now? Is this, the acceptable standard practice of health professionals especially doctors in such situations?

Consequently, the Chief Executive Officer of the Korle Bu Teaching Hospital, Dr Daniel Asare has justified the actions of the medical officers who allegedly fled the scene when they heard that two patients suspected to have contracted the deadly coronavirus disease had been brought to the hospital on Fedruary 5, 2020 as applying common sense. He went on to explain that, the decision by some staff to rather not attend to the patients was just a matter of the application of commonsense and being wise as it is safer to flee when one has no safety precautions than to contract the deadly disease (mobile.ghanaweb.com).

Even if youre a press person and they say there are suspected cases, dont go, go back and have a protective device. It is wise, commonsense. We have trained our people to use precautions and not to hide under insurance because there is no insurance cover for death (Dr. Asare, 2020).

This defence by Dr. Asare to me is weak. I am sure he knew at all material time that, the Health Ministry had designated hospitals for this purpose and same information had been relayed to his staff. If all Korle Bu health providers flee because of this virus, then, what happens to the other patients on admission? If Doctors at our biggest and well-resourced hospital can flee for lack of protective devises due to coronavirus scare, then your guess would be as good as mine should similar situation arise in the less endowed regional or district hospital across the country.

CONCLUSION Corona virus apart from China has now affected other countries in Asia, the gulf, the Americas and Europe. We can only pray it doesn't get to Africa and our dear motherland. I pray for the Chinese people and hope they are able to unravel the secret to finding a solution to this strain of coronavirus to halt the deaths and also to assist other countries where the virus has infected others. I pray the scientist across the globe would rally behind China in trying to develop an antidote to this pandemic before it gets to cataclysmic proportions.

I pray that we are not saddled with coronavirus in our dear motherland. Because, Ghana recorded its worst outbreak of cholera in 2014 with eight out of its ten regions being affected. The cholera outbreak started in June 2014 and continued to 2015. By the end of January 2015 when the outbreak was finally contained, over 28, 000 cases with 243 deaths had been recorded in all 10 regions of Ghana then. If cholera with known cure can cause such a havoc in our land, then what would happen with a virus that the world is yet to find a cure?

Provision of portable water is still a problem in 21st century in Ghana with some regional capitals having to ration water while others have to grapple with irregular supply.

Let us all rise up and fight the 'galamsey' menace and work hard to safeguard our fresh water bodies to guarantee all year round supply of quality water. With this, we would be able to wash our hands under running water, so should the corona virus infect any of us, with improved hygiene in our land we shall be a little safe. The time to act is now. We have a nation to build.

D. C. Kwame Kwakye

Broadcast Journalist

GBC, Radio Central

0244 976 550