By Dr Ian Clarke
From my research into different countries handling of Covid19 it is becoming evident that there are very different outcomes depending on how decisively the country acted. I have been looking at Greece, which is a Mediterranean country not unlike Italy, but while Italy has had a horrendous experience with Covid 19, Greece has had relatively few cases.
The difference is that Greece took action early in terms of identifying cases and tracing, testing and isolating contacts, while Italy responded when the virus was already out of control. It does not mean that Greece is unaffected, but whereas Italy has 110,574 cases, with 13,155 deaths, Greece has 1,212 cases with 46 deaths. Even taking into account that Italy has a population of 51 million while Greece has a population of only 10 million, there is a staggering disparity between the two countries.
Corona reached Italy and spread within the population to the tune of 10,000 cases before anything was done, and by that stage it was too late. “We realized our house was on fire only once most of the first floor had burned down,” said Professor Massimo Galli, an expert on infectious diseases at Milan University. The same scenario is unfolding in Spain and parts of the USA such as New York, though other States are currently less affected. One difference between countries with better outcomes and those with poor results is leadership. In countries where there has been proactive and credible leadership the results have been good, whereas if the leadership was not respected, or there was lack of trust and confidence in the leadership, the results have been poor.
Both Italy and Greece have had a bad decade with mounting national debt, high unemployment, and in the case of Greece, the fear of default from the Eurozone. Both have had divided governments with frequent elections, but the current Prime Minister of Greece, Kyriakos Mitsotakis, seems to be striking the right note in terms of getting people to pull together, whereas the Prime Minister of Italy, Giuseppe Conte, is struggling to bring his bickering politicians together.
The same could be said of New Zealand led by Jacinta Ardern. She has given clear messages and taken decisive steps. I am proud to say that Uganda has followed the path of Greece and New Zealand in aggressively tackling this Corona pandemic. I was at first unsure if these draconian measures were appropriate in the light of the economic consequences, especially since we have relatively few cases. But the public health dangers outweigh the economic consequences right now, and it is better to aggressively tackle this epidemic.
The Minister of Health went on television this week and gave a detailed update on what the MOH is doing, and why they are doing it. She was clear, concise and scientific in her approach and her strategy and plan is good. In fact it is now up to the government officials on the ground, such as the District Health Officers, the District Surveillance Officers, the RDCs and the MOH District Hubs to ensure that they implement the plan. The government is being strongly supported by the private sector, which has made goods in kind, and funds available to the MOH. Many of the mandatory quarantine centres have been supplied with mattresses and bedding from donations from the private sector, and the emergency lines and call centres have been set up by the private sector.
Since private transport is banned I was walking up the hill from my home when a young man remarked,
‘But you are a big man, you should not have to walk’
It is precisely this attitude that usually ruins good plans in Uganda. Corona virus is no respecter of persons and we all need to obey the rules and work together to ensure it is controlled. We should also recognize that the fight against Corona moves through several phases: The first is detecting and isolating index cases, the second was contact tracing, the third is lockdown preventing the spread from one part of Uganda to another, the fourth will be case management i.e. when patients are admitted to hospitals with significant symptoms.
Although the Minister announced the use of the Mulago Specialized Hospital and the new Woman’s Hospital there are still many issues in terms of having fully functional isolation ICU beds because of the small number of intensive care physicians in the country, and the high level nursing care, which will be necessary. For all these reasons it is best that we stop the spread of the virus now and minimize the number of people who get sick, then we can deal with the economic measures to be taken as the next step.
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