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COVID-19 testing: Zimbabwe's litmus test

25 Apr 2020 at 07:51hrs | Views
SINCE the country's first coronavirus (COVID-19) case was recorded on March 20, Zimbabwe has tested over 5 000 people and 28 were positive.

Four people, including journalist Zororo Makamba and, most recently, the mother to former minister Sylvester Nguni, Gogo Nguni, have since died from the respiratory disease.

Two have reportedly recovered. Health and Child Care minister Obadiah Mayo recently said the government was targeting 40 000 tests by end of April and that all prerequisites needed for this process were in place. But with five days to end of month, it is highly unlikely that the government will meet this target.

It would take at least 7 000 tests per day to meet that deadline. Stakeholders have made several calls for mass testing. They even suggested that during the lockdown, the government could take advantage and test as many people as it could, but around 400 people are being tested per day.

The Zimbabwe Association of Doctors for Human Rights (ZADHR) has repeatedly challenged the health authorities to increase the number of daily tests and conduct more intensive community screening and testing.

"ZADHR notes with great concern the small number of COVID-19 diagnostic tests that have been conducted in Zimbabwe. We urge the Zimbabwean government to urgently roll out a mass screening and testing programme ... ," the rights doctors said in a statement.

Testing is critical in assessing the magnitude of the problem as well as arresting further spread of the disease by quarantining the infected.

Community transmission of COV-ID-19 is now a reality in Zimbabwe, and a history of foreign travel to a country with COVID-19 should no longer be an important consideration when deciding who could have been infected and who should be tested.

Although stakeholders have indicated that capacitating the Bulawayo reference laboratory was a good move in terms of decentralising and widening testing capacity, only a few tests have been carried out despite earlier indications that the southern region could actually be the new epicentre of the dis-ease. There have been calls for the government to take advantage of the new measures for testing, which include those with flu-like symptoms as well as health personnel.

More testing should be done urgently in order for the country to have a true picture of the effects of the disease. Government has been accused of falsifying statistics and data and this has spawned widespread grapevine news, fuelling fake news as a result.

So now the country's hopes are pinned on Gene Xpert machines expected to beef up testing kits.

In normal circumstances, Gene Xpert machines are used to test for tuberculosis, but research has shown that they can test for COVID-19 if special cartridges are availed.

Recently, Information minister Monica Mutsvangwa told the media that 10 000 Gene )(pert cartridges were expected in the country, while, 20 000 more would be provided by Unicef. The move to use the Gene Xpert is earmarked to assist in the testing for COVID-19 in the country.

Moyo has roped in the army and police to help in collecting the samples as he said this would ensure a speedy pro-cess. The minister also told the nation that they had made efforts to procure testing equipment, but that reaching the 40 000 target would depend on samples available.

The low figures in testing have fuelled sale of dubious testing kits as desperate people try to establish their status.

This poses a major challenge for health officials as it will create a false sense of security to those who test negative using the rapid tests which give results in 15 minutes.

Meanwhile, Zimbabweans continue to suffer under the lockdown, with many people facing severe hunger and financial challenges as their sources of income, mainly in the informal sector, have been locked down. While the measure is key in slowing down the disease, it has exposed the poor who are forced to go out and look for food, a risky move that can poten-tially expose them to infection.

"The decision to extend or not extend the lockdown must be informed by people with relevant expertise and experience said Itai Rusike, the direc-tor for Community Working Group on Health (CWGH).

"The President's decision should be informed by obtaining evidence from the facts on the ground, by what is ethical and by making dear the trade-offs including between immediate and long-term challenges and outcomes!'

Rusike noted that Zimbabwe was al-ready overwhelmed by demands and, therefore, needed core measures to sup-port decision-making. He said there was also need for regular strategic review and communication of the pandemic's progression, its management and the impact of the lock-down intervention. "The majority poor are now getting hungrier and very agitated while sitting at home due to the lockdown restrictions,' Rusike said.

These community impacts may, if poorly managed, translate to their own negative health impacts in under-nutrition, diseases, poverty, mental disorders, violence and suicide.

"Taking a public health measure like a lockdown thus needs to be carefully balanced against and address the consequences for economically vulnerable communities,' Rusike said. The current lockdown will expire on May 3 and it remains to be seen if it will be extended and under what conditions.

South Africa has, in the meantime, taken a phased approach, whereby it will gradually lower restrictions depending on evidence of disease progression.

This has been made possible by massive testing which has allowed the Health ministry to strategise with correct data. Zimbabwe needs a similar approach, but in the absence of robust testing it would be folly to relax restrictions.

The World Health Organisation announced that coronavirus infection was officially a pandemic on March 11 as it had become a global scourge, swiftly spreading in various countries faster than it could be contained.

Earlier this month, health professionals in the country expressed con-cern over the country's limited capacity to test people for COVID-19 as that would mean a lot of cases would go un-detected.

The government has declared a state of national disaster and banned all pub-lic gatherings of more than 50 people for 60 days, church services, weddings and all international sporting fixtures as part of a raft of measures to minimise the potential spread of the viral infection.

President Emmerson Mnangagwa also ordered the closure of schools until further notice and has been preaching the gospel of social distancing. According to medical doctor Johannes Marisa, it is important for citizens to observe social distancing and other preventive measures as the country's health sector is largely incapacitated to deal with the pandemic.

"Zimbabwe has adopted a number of preventive measures against the spread of COVID-19. Social distancing, lock-down and quarantine have all been preached about,' he said

"These measures are very noble, cheap and easy if we all put our hearts together. It is surely better to protect ourselves from this global scourge than to wait for hospital admission!'

The public health specialist said it was essential for stakeholders to work together and ensure that the spread of COVID-19 was contained.

Source - newsday
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