Cementing Covid response

By July 29, Malawi had 107 from 3 858 confirmed coronavirus cases.  Locally transmitted cases are higher than imported. 

Some districts can be classified as hotspots due to high testing coverage.

We can suppress transmission if everyone with coronavirus infection is traced, tested, isolated and cared for.

At 11 percent, access to testing is limited, especially  in remote areas.  

Social and economic perspectives of the coronavirus disease (Covid-19) would help the government reassess whether the current approach is appropriate for mitigating catastrophic impacts of the pandemic.

The average age of confirmed cases is 36 years.

While the fatality rate is 2.8 percent slightly lower than the global rate of 3.9 percent, Covid-19 keeps  claiming lives of middle-aged persons who are critical for wealth creation and household livelihoods.

Several people aged over 40 have succumbed to Covid-19. 

If local transmission is not suppressed, the death rate will translate into high absolute numbers and a high risk for the economically active age group.

Given that the Ministry of Health is revising the national Covid-19 strategy, we need to draw lessons from the current response and integrate all risk factors to avoid a repeat of the tragedy  Malawians experienced at the start of HIV: The booming of coffin businesses as well as number of orphans.

Community engagement has proven effective in HIV prevention, treatment, care, support and reducing social stigma.

There is inadequate awareness of Covid-19 prevention, especially in the rural areas.

The key Covid-19 messages are mainly spread through newspapers, radios and television. This is good because many  Malawians have access to the radio.

However, community engagement and social mobilisation are critical for confronting myths and misconceptions.

Since church services and other gatherings continue, these could become effective platforms for  community engagement, exploring innovative ways such as repurposing old clothes for making masks as not everyone can afford  them.

Do we understand how communities perceive quarantine or scientific evidence that an asymptomatic person can transmit coronavirus?

Communities form their own theories of ill health and some people stop HIV treatment because they  do not feel sick anymore.

Understanding the community perspective of quarantine, especially for asymptomatic household members, can enhance adherence to the rules.

Stigma might be another setback  to quarantine. People might feel uncomfortable to be labelled as Covid-19 patients or suspects.

The nature of Covid-19 burials can also reinforce social stigma where communities have not been adequately prepared for this. 

While there were several factors, community engagement and social mobilisation contributed to significant behavioural change in the fight against Ebola in Liberia, Guinea and Sierra Leone.

Some communities have been photographed chasing health workers during burial of Covid-19 victims. Have the health authorities tried to understand why this happened?

Malawi is endowed with social scientists who can do quick assessments to generate critical knowledge for development effective community packages for every aspect of Covid-19 response.

 We can also learn  from the National Malaria Control Programme. Prior to the roll-out of rapid diagnosis test, we were mainly treated based on symptoms. Although not a gold standard, this saved lives.

There is clear evidence that test kits might be inadequate.

Right now, testing is concentrated in urban areas or district hospital level, excluding the rural majority which has a higher risk due to lack of resources.

This is a huge bottleneck for effective case management and surveillance.

The health sector should consider customising the protocol to Malawi context.

In the early days of Covid-19 in Europe, due to limited testing, symptomatic individuals were advised to quarantine.

We can also do better in decentralising support, redesigning flow of patient at facilities and building functional call centres to offer support and advice to the communities. 

Let us protect our health workers and also help the communities. Our health facilities are already overstretched.

 Together we can defeat Covid-19.