Ramp up Vaccines, Not Indiscriminate Closing of Schools

By Dr Parkie Mbozi

A reader asked me to describe, in a few words, what is going on in our country regarding the Covid 19 campaign. I will answer by reciting some of the adages I used in my past writings: 1. The chickens have come home to roost; 2. We are reaping what we sowed.

Zambia is today the epicentre of Covid 19. We have the highest and most rapidly increasing cases among all our eight neighbours and second only to South Africa in the SADC region. Our official positivity rate, amid low testing, stands way higher than most countries world-wide, at over 30%. And yet, at less than 0.1% (precisely <0.1%) of the population, we have administered the lowest doses of vaccines (per 100,000) in the region.

The sad reality is that we have very badly managed our Covid 19 campaign. What we are seeing today is a cumulative effect of what have not done properly since 2^nd March when we kick-started our campaign, after the first two cases were recorded. On both fronts – prevention and immunization – we have got it wrong and even now, with the highest cases of both infection and death, we are still fixed in what I have been calling ‘half measures’.

We are dillydallying on what measures to take, as if we have a choice or are in in a position to negotiate with Covid 19. I can say with confidence that our Covid 19 campaign is no better now than it was 15 months ago. How can that be after so much knowledge and global experience? For instance, to-date we have not designed a Covid-19 Alert levels system (Levels 1-5 in South Africa, for instance), which would guide when to do what.

Alert Levels adopted by a number of countries, whereby each Level has a different set of rules, are predictable on what the public can and cannot do. With an Alert Levels System, the standard thresholds in Covid 19 infection rates would automatically predicate what Level the country would be placed on and the measures come with the particular Level. There would be no second guessing as to what to do and when, as the case is now.

Just as an example of how shambolic of campaign is, on 18^th March 2020, with just two cases of infections and zero death, bars were allowed to open up to 22 hours and churches for one hour. A week ago, with up to 61 deaths and 3000+ Covid 19 positive cases, again bars we restricted to 18 – 22 hours opening hours and one hour for church service. Clearly our campaign is as confusing today as it was 15 months ago, mainly due to lack of an Alert Levels system.

I first raised serious concerns about our half measures to combat Covid 19 and flatten the curve in an articles titled, “What is the Science Behind Some of Zambia’s COVID 19 Half Measures?” and another titled, “What is Zambia’s COVID 19 Strategy Kanshi?” The two articles were a follow to the very first one on the subject published on 27^th February 2020 titled, Is Zambia Ready to Cope with And Contain the Coronavirus Outbreak? This was about a month before the country was hit by the virus on 18^th March 2020.

In the first article I questioned the efficacy of some of the measures the country had put in place to fight the pandemic. A few days after my article, most neighbouring countries went into one form of lockdown or another. Zambia has avoided a total shutdown despite numerous calls for it from political parties, religious organisations, etc. Our major concern seemed to have been business rather than the now known patterns of the spread of the pandemic. I warned then that, “Only time will tell whether our trajectory and/or model is a better one.”

When I first questioned the safety measures and guidelines (in March 2020), the Covid 19 infection cases were in single to two digit and zero to single digit mortalities. Yet today, with four digit (thousands) new infections and upper two digit (50 and above) mortalities, the same questions about our guidelines and measures can be asked. Let’s look at some of them one by one.

Church hours: In March 2020 then Health Minister Chitalu Chilfya announced that churches should meet for not more than one hour. On this I wrote, “The logical of the directive is that one hour is not long enough for exchange of the virus. This is against the science, which postulates that the virus can be passed on or acquired within seconds. There is also ambiguity as to size of the crowd that is permissible. In some countries the permissible crowd sizes had been reducing from 100 to 10 and later two people (e.g. UK, USA, Italy, etc).”

These ambiguities applied then and still apply to church and other social gatherings such as weddings, funerals, matebeto, etc. Even with the current calamities, these activities are still permitted to go on, as if we can die without them.

Bar hours: regarding bars, in March 2020 I wrote, “this is perhaps the most confusing of the measures. On 18^th March Dr Chilufya announced that bars would be open only for two hours. Later Charles Banda, the local government minister, issued a contradictory instruction and instead said bars would be closing two hours earlier than normal. This implies that it doesn’t matter for how they would be open provided they closed two hours earlier than normal (e.g. 02:00 instead of 04:00; 20:00 instead of 22:00 and so forth). So, this infers that whereas government is concerned about church meeting lasting more than one hour, it is not concerned about bars and bottle stores that would be open from 11:00 (normal time) until about 20:00 instead of 22:00, whatever the case. Not to mention lack of strict guidelines on ‘social distance’ in these ‘watering holes’. “

Today the same questions can be asked. Last week it was announced that the bars would be allowed to open on week-ends and from 18 hrs to 22 hrs. Like one reader asked, ‘does it mean the virus will go to sleep on those three days?” Isn’t week-end the time when many of us like to venture out?

Testing: In March 2020, I questioned the policy on testing, especially at points of entry. I am not privy to what currently obtains at our borders and airport. However, having recently traveled to South African through Botswana, one thing for sure is that Botswana re-tests any traveler into that country regardless of having a valid Covid 19 test certificate. What should be of concern is the low testing amid reportedly shortage of testing kits at our facilities. At this point we should be doing above 50,000 tests per day and not the current 8 – 10,000.

Lockdown: we have avoided any discussion around lockdown, of any form, even in Covid 19 hotbeds. So life goes on normally in markets, public transport and other public places. No clear guidelines for, say, how our buses and other forms of public transport should be loading. In South Africa, for instance, buses would be at half capacity. Our focus here seems to be only on rotational work schedules for the few of us in formal employment, while life goes on normally in markets and other public places. Contrast to Zimbabwe, whose borders have been closed to travelers for months now or Botswana, where to enter any shop or bottle store or market you would have to be masked up, temperature tested and contact details recorded in a book.

The point is that whatever we have been doing has not worked well. I wrote then that “time will tell”. And indeed time has told us. The World Health Organisation (WHO) writes that “Cases are on an upward trend in at least 12 countries with Uganda, the Democratic Republic of Congo, Namibia, Zambia, Rwanda and Tunisia among the countries worst affected.”

They say numbers don’t lie. Here are the latest WHO numbers (cumulative infections) for Zambia and its neighbours: Angola (38,819); Botswana (70,071); DRC (40,438); Malawi (35,075); Mozambique (75,138); Namibia (84,705); Zambia (148,568); and, Zimbabwe (47,284). Consider that the population of DRC, for instance, is 86.8 million, five times Zambia’s.

Given that our prevention campaigns have not worked, the question is, ‘what now?”. My answer is that we need to ramp up immunization or vaccination. The Americans and Europeans have showed that it pays to be vaccinated. Unfortunately, during the first scramble for vaccines we were ndwiiiii to the point that other countries, including Zimbabwe, a country in dire straits, managed to outpace us. Whereas we only managed to vaccinate 147,115, Zimbabwe hit the one million mark (1,108,203) and Angola almost 10 times more (see table below).

At less than 0.1%, Zambia is wallowing in the same league of least vaccinated countries, which include: Lesotho, Liberia, Central African Republic, Benin, South Sudan, Congo and Chad. With all due respect to these countries, we deserve better. Contrast to the elite league of Israel (57%); Malta (54%), Bahrain, UK and USA (all above 45%).

In conclusion, I argue that rather than indiscriminate closing of schools, our authorities should direct their energies to procuring vaccines for us all, starting with all front line staff (teachers included as our South African counterparts are doing). What sense does it make to close schools out there, in controlled environments, and in peripheries of our country where not a single person has contracted the virus? After all, the science is unequivocally clear about the resilience of our children to Covid 19.

Our school authorities have had enough time to study the elaborate WHO guidelines for re-opening of schools. There are also numerous and tested school guidelines from such countries as the United Kingdom, which could have been adopted by now. The challenge is the usual lack of planning by our Ministry of General Education, despite having planning directorates.

Second, our authorities should adopt the GIS concept of area mapping and characterization. That means mapping and dealing with affected schools on individual basis, rather than indiscriminate closure. If it’s ok and being applied to places of work, why not to schools?

So, fellow citizens, let’s demand a clear vaccine roll out plan now before the announced four million doses arrive in September, if at all. Without a strategy, those doses will expire before they are administered. Ask Malawi. LET US DEMAND!

The author is a researcher and scholar with the Institute of Economic and Social Research, University of Zambia. He is reachable on [email protected].