Learn from history in employing non-pharma COVID-19 interventions

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By Ebenezer Chike Adjei NJOKU
Mohammed Z. Imoro, a Development Practitioner and Senior Project Officer at the Participatory Development Associates (PDA), has called on stakeholders, particularly the government, to draw relevant lessons from historical incidents of pandemics in the formulation and implementation of Non-Pharmaceutical Interventions (NPIs) in the fight against the ongoing pandemic.
With the rise in the number of cases and its ensuing domino effect on all spheres of human interaction as well as the availability of a vaccine being months, if not years away, he stated that the successful implementation of NPIs – community mitigation strategies used to contain pandemics/epidemics before medical treatments are developed– would be the singular, most important factor in containing the pandemic and consequently restoring the economy

“Despite their short-term [negative] economic effects, NPIs, by containing a health crisis will ultimately have a net positive effect on post-pandemic recovery. This will in turn offset any short-term losses resulting from the containment measures. The dilemma for policy makers is to assess the trade-offs between economic stability and containing a health crisis,” he disclosed.
Chronicling the events from a century ago in a report titled ‘Pandemics and the Use of Non-Pharmaceutical Interventions: Lessons from the 1918 Pandemic and Covid-19’, he noted how measures put in place to curb the spread of the Influenza outbreak were largely ineffective due to the slow pace of adoption as well as weak enforcement of the said measures.
These, he noted, were compounded by inability of the ill-equipped health facilities, whose resources had been depleted by the war, to handle an outbreak of that magnitude.

Drawing from accounts of the period, he stated, “In places like St. Louis that adopted early measures right after the arrival of the flu witnessed lower levels of mortality and experienced better post-pandemic economic recovery. In contrast, cities like Philadelphia where interventions were adopted late with loose enforcement experienced higher levels of peak mortality and greater economic disruptions.
“The response to the 1918 influenza outbreak in the Gold Coast was similar to that in Philadelphia, albeit to different extents. Interventions began late, and in the absence of a coordinated response strategy from the colonial government, enforcement faltered.”
Whilst he lauded stakeholders, particularly the government, for the swift public health, economic and social interventions which were put in place prior and subsequent to the first confirmed case, as well as acknowledging the effects of some forms of NPIs on the nation’s largely informal economy, he expressed grave concern that growing non-compliance with NPIs can potentially reverse the current gains and push the country into a severe health crisis.

A disturbing trend
Since the easing of restriction of movements in areas identified as hotspots for the disease – Accra, Tema and Kumasi – on April 20, the nation has witnessed an increase in the case count from 1,042 to 24,518, representing a more than 2,200% increase over the course of 12 weeks.
There have been calls from some quarters to introduce and sternly enforce measures such as naming-and-shaming, as well as non-custodial sentences such the issuance of spot fines, as well as punitive community service measures such as garbage collection and similar sanitary engagements to curb the flagrant disregard for Covid-19 public health safety protocols.

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