11th January 2021
Adeyemi O. Aremu
Members of the South African Young Academy of Science
On 31st December, 2020, it was exactly one year since the incidence of SARS-CoV-2 infections were first reported to the WHO. Globally, the COVID-19 pandemic is still surging and as per the official data, over 85 million people have tested positive for the virus with over 1.8 million deaths. Although various treatment protocols have been tested, and more still are under trial as well as the vaccine(s) being approved by regulatory agencies for emergency use, the major highlight of the human response to this pandemic has been the non-pharmaceutical interventions, including implementation of various public health and social measures (PHSMs).
These include - but are not limited to - rapid identification, testing, and isolation of cases, voluntary quarantine of contacts, relevant, accurate, and timely risk communication tailored to communities, hand and respiratory hygiene, infection control and prevention and protecting health workers, shielding vulnerable populations most at risk, cancellation or adaptation of mass gatherings, school and work closures, international travel restrictions and entry screening, and internal travel restrictions or cordon sanitaire.
It is now well-established that the implementation of PHSMs need to be as per disease dynamics and changes in epidemiological conditions; and if effectively adhered to may lead to significant reduction in infection transmission. Phasing and adapting to transmission changes can also assist in lessening the burdens of PHSMs on essential health services, economic burden, and food security to name a few. It must however be noted and emphasised that support and adherence towards PHSMs requires behaviour change and may be dependent on the public’s trust in the government response.
In many African settings, essential health services have been hugely disrupted during the current pandemic, making the indirect effects larger than the direct ones. There are disruptions in supply chains, vaccination programs, nutritional interventions, functioning of outpatient departments, chronic medication supplies, and hospital admissions in general due to risk of transmission. Furthermore, the larger impact has been on the economic sector as a result of closure of workplaces and restricted movement. These restrictions led to inaccessibility to markets and have disrupted lives and livelihoods.
In a recently-issued special report series by the Partnership for Evidence-Based Response to COVID-19 (PERC), a consortium of global public health organisations and private sector firms, the following key findings and recommendations, with respect to health care disruptions in 18 AU member states (Cameroon, Cote d`Ivoire, DRC, Egypt, Ethiopia, Ghana, Guinea, Kenya, Liberia, Mozambique, Nigeria, Senegal, South Africa, Sudan, Tunisia, Uganda, Zambia, Zimbabwe) during the current pandemic (as surveyed between 4th and 17th August 2020) were highlighted:
- The indirect effects of COVID-19 on essential health services in Africa have been severe.
- The level of health care disruptions may relate more to existing health system issues and household-level situations than to the size of a country’s epidemic.
- Health care disruptions were highest among those with health problems and living in urban areas.
- Fear of contracting COVID-19 and cost were the most commonly reported reasons for missed or delayed health services.
- COVID-19 could slow the steady progress made in improving health outcomes across Africa for an array of diseases and conditions, but particularly so for communicable diseases and maternal and child mortality.
- Make the safety of health care workers a priority.
- Monitor, analyse and adapt policies based on subnational data.
- Target government service delivery programs and demand generation strategies to service most at risk.
- Empower people with information to lessen their anxiety and fear such as by adhering to the “3 W’s”: wear a mask, wash your hands and watch your distance.
- Foster demand for health services through community engagement.
The PERC consortium released several briefs on PHSMs implementation in Africa between May and August 2020 wherein several key trends were observed within the five regions of Africa (eastern, western, northern, southern, and central) and key recommendations were made with regard to disease dynamics, PHSM implementation and adherence as well as burdens.
To disseminate and discuss the above policy briefs, the South African Young Academy of Science (SAYAS), the Zimbabwe Young Academy of Science (ZIMYAS), the Mauritius Young Academy (Initiating), and the Democratic Republic of Congo Young Academy (Initiating), hosted a Southern African Development Community (SADC) National Young Academies Webinar under the aegis of US NAS/ASSAf on the Dissemination of Policy Briefs on Non-Pharmaceutical Interventions on COVID-19 on 29 September 2020. This collaborative webinar was aimed at:
- discussing the successes and challenges of the effective implementation of public health and social measures (PHSMs) by governments in the SADC region during the COVID-19 pandemic
- highlighting best practice(s) across SADC countries for emergency fore-sighting for public health for the current and future pandemics
- availing relevant knowledge to policy-makers to increase awareness of science and evidence-based knowledge in PHSMs interventions and promote its integration into practice.
The webinar provided space for the interrogation of the policy briefs and reflections on lived experiences of people on the ground. The interdisciplinary nature of the webinar allowed for diverse views and perspectives on the challenges confronting people affected by COVID-19.
In line with the key recommendations mentioned above, the webinar discussions highlighted issues to be considered, for example, the need to ensure that policy briefs are living documents that get disseminated and interrogated by those implicated in them, to create space for multiple voices when it comes to decision-making on regulations set-out by governments, to take seriously the unintended environmental impact of COVID-19, and to consider and put in place (environmental) disaster management systems.
It is therefore crucial to acknowledge the importance of engaging COVID-19 challenges from a multidisciplinary/multidimensional perspective.
You can watch this webinar at: https://youtu.be/NrB6za1jr1w
Pradeep Kumar: University of the Witwatersrand (Wits), South Africa (firstname.lastname@example.org)
Puleng Segalo: University of South Africa (UNISA), South Africa (email@example.com)
Adeyemi O. Aremu: North-West University, South Africa (firstname.lastname@example.org)