The COVID-19 situation in Ghana
Worldwide, the coronavirus (COVID-19) pandemic has disrupted public health, economic and social systems in ways unprecedented since the Spanish flu of 1918. The general perception at the time was that the pandemic that started as a flu outbreak in Wuhan province, would only hit China and probably some Asian countries, and disappear just like SARS did in 2003. However, it has already passed the one-year mark and spread to almost every country in the world. It is having a serious impact on people’s health, livelihoods, economies, and behaviours.
In Ghana, the first official cases of COVID-19 were reported on 12 March 2020. The Health Minister announced the nation's first two confirmed cases in Accra. The two cases were identified as people who had returned to the country from Norway and Turkey. These imported cases initiated the first contact tracing process in Ghana, helping detect several dozens of cases in a short period of time.
Following the discovery that the pandemic had already started to spread in Ghana, the government instituted measures to stop local spread of the infection and any further import of the virus into the country.
Measures included shutting all land borders to the country together with the closure of the main international airport in Accra. Intermediary initiatives saw persons entering the country between the time of the announcement and the shutting of the borders being quarantined in 4 and 5 star hotels at the expense of the Ghanaian government.
Testing began early
Two institutions, namely the Kumasi Centre for Collaborative Research into Tropical Medicine (KCCR) in Kumasi and the Noguchi Memorial Institute for Medical Research (NMIMR) in Accra, served as initial testing centres for all suspected cases. Samples from the northern part of the country were taken to the KCCR whilst those from the southern part were taken to NMIMR.
These centres undertook PCR testing of about 1,000 samples per day, due to pooling of samples, many of which were negative. To complement efforts, Zipline, a company with a mission to “provide every human on Earth with instant access to vital medical supplies” collected samples from over 1,000 health facilities located in difficult to reach rural areas of Ghana and sent them to the testing centres using drones. This was very significant as it helped to facilitate quick case detection and initiation of treatment for all positive cases.
Beginning in May 2020, the government of Ghana empowered other health facilities to establish testing centres. Some private health facilities also started to undertake tests for the coronavirus. Even though testing was initially centralised in the two aforementioned institutions, hospitalisation took place at health facilities within the district where the positive cases had been found. Isolation centres were created in almost every district to handle COVID-19 cases.
Stigma, for those who were infected was rife in Ghana during the initial periods. Recovered persons faced stigma in their communities. It took a long while for people to understand the disease and for the stigmatisation to dwindle.
A partial lockdown was placed on the two biggest cities, Accra and Kumasi, which were the epicentres for the pandemic, from the end of March 2020 for three weeks. There were restrictions on the movement of people, with the police and military mounting road blocks to carry out checks. Only workers of essential services (in sectors like healthcare, media, food vendors/restaurants, security agencies) were allowed to move around in these cities. People in the rest of the country could move around since no cases had been reported at the time.
The Government of Ghana banned all public gatherings including conferences, workshops, funerals, festivals, political rallies, church and mosque activities and other related events to reduce the spread of the virus. Beaches, pubs and night clubs were also closed. In addition, some measures such as fumigation exercises were carried out in most market centres nationwide.
All educational institutions ranging from kindergarten, primary, junior and senior high schools to tertiary institutions including universities, both public and private, were closed. With time, only candidates who were about to write their final exams at the junior and senior high schools as well as other tertiary institutions were called in May 2020 to complete their syllabus and to write their final exams under strict COVID-19 protocols. All other students were to continue their learning from home on online platforms.
For children in some kindergarten and primary schools, teachers will teach in a classroom, take videos and send them to the children through WhatsApp while their parents and guardians will pick up their assignments from the schools each week for them to do.
The lockdowns and other restrictions put in place affected many businesses since they were not able to operate. A good number of people lost their jobs and livelihoods as many organisations asked their skilled workforce to work from home while others were made redundant. For some business categories, the Government of Ghana rolled out various financial packages to help them survive the negative effects of the pandemic.
As part of measures to slow the spread of the COVID-19 infections in communities, the Ghana health service embarked on health education in every community. A contact tracing app, and a digital tool that helped infected people to get access to health services and also self-report symptoms, was launched. The Government of Ghana also made provision for the poor, especially people within slums, and in rural communities to have free access to water and electricity. During lockdown periods in the big cities, the government provided food to vulnerable people affected.
From July 2020, some of the restrictions were eased slowly, including opening of the airports and land borders from 1 September 2020. People were able to move much more freely between cities. All international travellers flying into Ghana were required to be tested in their country of origin before boarding.
On arrival, a test is also conducted at the airport in Ghana before anyone is allowed into the country. Those testing positive are made to quarantine at a designated hotel for 12 days before being allowed to go to their destinations.
Changing health-seeking behaviours
During the months that followed the lockdown (May to September 2020), people’s health-seeking behaviours changed. The number of people reporting to the health facilities with other ailments reduced drastically. People were afraid to visit health facilities, with the fear that they could catch the infection in such places.
We suspect that childhood immunisations may have been affected. Delayed health-seeking behaviours, may have led to deaths of children, and others due to the aggravation of their ailments. However, there is no data to verify this.
In Africa, the case numbers and deaths have not been as huge as on the other five continents. As of 31 December 2020, the case count for COVID-19 in Ghana was 54,771 and 335 deaths had occurred, putting the country in 89th position on the COVID-19 Worldometer that is compiled by the Johns Hopkins University.
Infections started going down in Ghana by September 2020 but within weeks they were up again. Health authorities attributed this to political rallies that were being organised as the country prepared to go to the polls on 7 December 2020.
On the African continent, there were 2,728,817 reported cases and 64,771 deaths as of 31 December 2020. The case count in Ghana and indeed in Africa, may not represent the true situation of the pandemic on the ground as some countries were not testing enough because of the high cost involved.
According to the Ghana Health Service, over 80% of the cases of COVID-19 have so far been asymptomatic. Only persons with severe cases are being admitted to health facilities. This contributed majorly to the low testing regime.
A moment to contemplate
As of 3 January 2021, the Government of Ghana announced the re-opening of academic institutions to allow all school children and students to go back to school. Restrictions on night clubs and beaches are still in place.
The pandemic is having a serious impact on people’s health, livelihoods, economies, and behaviours. Everyone has been affected in one way or another.
The dead have included the high and mighty, as well as the common people in the streets.
This pandemic has shaken us to our very core, and has created a moment to contemplate about the future, including our relationships with nature.