Monrovia – In announcing further relaxed measures at the weekend, President George Manneh Weah extended the guidelines intended to prevent the spread of the deadly Coronavirus to another two weeks.
Report by Rodney D. Sieh, [email protected]
The President’s rationale is that the country’s level of experience with the Coronavirus and its mode of transmission, the strides being made in its containment and in view of developments in other countries, the need for further extension of the constitutional measure is not required.
From all indications, it appears, Liberia, bearing any massive increase of infections, is well on its way to reopening its doors to the rest of the world. But is the timing right? Are authorities sure they have done all they can to curb infections, enhanced messaging and created the environment for a secure post-COVID-19 Liberia?
COVID-19 ‘Not Over’
“It’s not over until it’s over,” says Mr. Tolbert Nyenswah, former head of the National Public Health Institute, Senior Research Associate and expert with the International health department, Bloomberg School of Public Health at the Johns Hopkins University
Recalling his days in the fight against the deadly Ebola virus outbreak of 2014, Mr. Nyenswah noted: “We said “Ebola must go is everybody’s business”; now, “COVID-19 Must Go Is everybody’s Business.”
Since April 8 when the State of Emergency and lockdown were imposed and Liberia’s first case was reported on March 16, the number of positive test cases for the deadly Coronavirus, have surpassed 300 with more than 30 deaths.
Since then, Mr. Nyenswah asserts, Liberia has been on an increased trajectory. “Experts have warned and said repeatedly that Africa does not need “copycat” and one-size-fit all approaches that are adapted by the West.”
High Recovery for Liberia
As of Sunday, the NPHIL reported 334 cases(128 active), 30 deaths and 176 recoveries.
To date, Africa has recorded more than 36 000 confirmed cases of COVID-19 and more than 1500 deaths. According to the World Health Organization, West and Central Africa are the most hit. So far there are 11 000 cases in West and Central Africa, and 300 people have died. In the week of 13 April, cases increased by 113% in Central Africa and 42% in West Africa.
But even as experts express the fears that the worst is yet to come, Liberia and other countries are relaxing measures, counting on the fact that the continent has so far been spared an explosion in COVID-19 case numbers.
In Liberia, valid concerns over the efficiency of the testing protocol has led many to wonder whether the numbers being reported reflect the actually reality.
The first country to implement a lockdown in the WHO African Region was Rwanda on 21 March, since then 11 countries have followed. A further 10 have instituted partial lockdowns of cities or high risk communities.
Preliminary WHO data indicate that countries that implemented nationwide lockdowns found that the weekly increase in the number of new cases fell significantly from a 67% rise in the first week after the lockdown to a 27% rise in the second week. Furthermore, the initial analysis indicates that countries which implemented partial and targeted lockdowns along with effective public health measures may have been even more effective at slowing down the virus.
Three months after the first case of COVID-19 was detected in sub-Saharan Africa, the WHO says much progress has been made in tackling the virus.
“The risk of putting in place these controversial measures like lockdown, curfew, travel restrictions, that are not traditional public health measures and lifting them prematurely without explanation, has an implication that the outbreak is over. This is certainly not the case. No country globally as well as in Africa that is out of the woods yet. “It’s not over until it’s over” as we use to say during my days managing Ebola. Also we said “Ebola must go is everybody’s business”. “COVID-19 Must Go Is everybody’s Business.”
– Tolbert Nyenswah, former head of the National Public Health Institute, Senior Research Associate and expert with the International health department, Bloomberg School of Public Health at the Johns Hopkins University
Early Relaxing a Concern
Many countries implemented lockdowns and key public health measures early and these appear to have helped slow down the spread of the disease. However, there are concerns that if these measures are relaxed too quickly, COVID-19 cases could start increasing rapidly.
According to the WHO, thirteen countries in sub-Saharan Africa implemented lockdowns along with other public health and social measures nation-wide, while ten more instigated partial lockdowns in hotspots. Preliminary analysis by the World Health Organization (WHO) found that the doubling time – the number of days for case numbers to double in a given country – increased during the lockdown period in most of the countries of the region. (5 days to 41 in Cote d’Ivoire, 3 days to 14 in South Africa). Seychelles started implementing public health and social measures before the notification of its first confirmed cases and seven weeks have passed since its last reported case.
So far, a number of countries have begun easing their lockdowns, and according to WHO’s initial analysis, the impact on doubling time appears to be varying depending on the timing and duration of the confinement measures. For example, Burkina Faso started implementing a partial lockdown of 17 days after the notification of its first confirmed case and recorded an increase in number of cases during the lockdown period by 253%. The confinement measures were implemented for 38 days and resulted in a significant reduction of daily new cases.
WHO has issued interim guidance to Member States, which encourage a gradual adjustment of public health and social measures, while constantly assessing risks. Beginning with the re-opening of international airports, with a mandatory 14-day quarantine of all travelers, the guidelines progress through a series of steps for countries to take to regain some normalcy. As countries open up, good hand hygiene, coughing and sneezing etiquette, physical distancing and the use of masks will remain part of the new normal. The steps will need to be constantly adapted according to the trends in the data and maintained until the pandemic is contained or there is a vaccine or treatment for COVID-19 which is accessible to everyone.
Mr. Nyenswah agrees: “What is needed is sustained social mobilization, intensified community engagement, that promotes ramping up testing in COVID-19 hotspots. Psychosocial suppose and economic stimulus packages, infections prevention and control for frontline workers including routine health care providers also incentivizing them and on time. Strategic measures will also involve contact tracing, tracing 100% all contacts, isolate the sick and quarantine suspected and probable cases.”
In Liberia, President Weah announced further easing of restrictions, extending the curfew from 9pm to 6am. “The restriction requiring people to stay indoors at a certain time of the day will be lifted in counties that have not reported any case of the disease so far,” the President said.
Additionally, movement to and from counties not yet affected by COVID-19 will be restricted. With the exception of basic supplies, all other such movements between/amongst counties are prohibited.
Airport Reopening June 21
The President also announced that the Roberts International Airport will reopen open to commercial flights on the 21st of June.
This coming on the heels of several meetings between authorities at the Roberts International Airport and stakeholders, both local and international to explore the possibility of reopening the Roberts International Airport to commercial flights.
Bishop John Allan Klayee, Managing Director of the Liberia Airport Authority(LAA) told FrontPageAfricaThursday that ongoing discussions have been going on for some time with the goal of making sure that all the mechanisms are put in place before the airport is reopened for business.
Said Bishop Klayee: “In order to open the airport we have been having series of meetings with the stakeholders – Ministry of Health, the National Public Health Institute(NPHIL), the United Nations Refugee Agency(UNHCR) and the United States Aid for International Development(USAID). We have also been comparing notes with our next-door neighbors – Sierra Leone, Ghana, Guinea and the Ivory Coast as well as the International Air Transport Association(IATA), the International Civil Aviation Organization(ICAO) and the Airports Council International Europe(ACI).”
Bishop Klayee explained that all of the stakeholders have already sent their regulations for post-COVID-19 flight operations which are being studied. “We have also gathered regulations from neighbors and are in the process of putting in place our own regulations together and submitted to the Ministry of Health and the Ministry of Transport.”
The new regulations include a mandatory public health concept for travelers with technology aided screening, testing and quarantine procedure. The new concept is drafted in in keeping with an advisory from the Airport Council International and the National Public Health Institute.
Hotels, guest houses, gaming centers are also set for reopen under the new relaxed measures.
to reopen beginning the 21st of June, with the observance of the required health measures
The President has instructed the Ministers of Transport and Health; the heads of the Liberian Civil Aviation Authority, the Liberian Airport Authority and the National Public Health Institute to publish the health protocols that will be instituted once the airport resumes operations.
The government admonishes everyone to continue to adhere strictly to all the safety measures intended to halt further spread of the virus in Liberia, including social distancing and regular hand washing. The wearing of face masks in public places remains compulsory. The joint security will continue to enforce these rules. All other protocols that were previously announced not amended by this release remain in force.
As Liberia and other countries embark on easing restrictions, some experts says, the danger of putting in place these controversial measures like lockdown, curfew, travel restrictions, that are not traditional public health measures and lifting them prematurely without explanation, has an implication that the outbreak is over. “This is certainly not the case. No country globally as well as in Africa that is out of the woods yet, says Nyenswah. “People should not be complacent COVID-19 is a deadly disease that is capable of causing serious illnesses and deaths. It’s however a mild disease as compare to Ebola or Lassa fever that are virulent, so people should submit to regular testing when the feel the signs and symptoms of Coronavirus disease (COVID-19).”