Observations from a hot zone: COVID-19 and the threat of complacency
By Emily Bancroft, VillageReach President
Given our reputation for working in low-resource communities in sub-Saharan Africa, VillageReach donors are asking about the impact of COVID-19 and the measures we are taking.
It is without a doubt that we are experiencing disruption, but today the community that is seeing the most disruption is not in one of the health systems usually described as under-resourced. It is right here in Seattle.
Our health system is bolstered by a top-rated School of Public Health and one of the best teaching and research medical schools in the U.S. Seattle is home to a world-renowned cancer research center and arguably the most influential foundation on the planet. All this draws some of the brightest minds in medicine, epidemiology and health care systems to our Emerald City.
Despite this, funding for public health has been constrained for years in Washington state. Shock from increasing COVID-19 cases and deaths is sweeping through the city, and rapid response protocols have left public health officials asking the same hard questions that the Ministry of Health (MoH) in the Democratic Republic of Congo (DRC) had to ask when the Ebola outbreak was found in Equateur province. Where do we find resources and funding for unexpected epidemics?
The Seattle region has more reported cases of COVID-19 than any other region where VillageReach has offices. The measures we are taking to address the problem are very simple — beginning Thursday we asked Seattle-based staff to work from home until further notice. For roles that require working in the office, we are finding alternative ways for them so we can ensure everyone stays healthy. We cancelled trips in and out of Seattle to minimize the risk of spreading the virus to places where we work around the world. This is our responsibility as a public health organization.
The countries where we work in Africa are on high alert, and have been for the past two months. When I arrived in DRC on February 1, the Ministry of Health was already distributing information about novel coronavirus. At the airports, health workers were checking the temperature of visitors coming into the country. There was a coronavirus response task force already in action.
The general sense in the Seattle area is that we missed cases because we were focused on where we thought the virus would be circulating. The obvious was to look for people who recently returned from China or vacationers on cruise ships returning to port. Even now we are not able to test all potential cases, although this is starting to change. That is also a risk in sub-Saharan Africa — the ability to test and confirm is still extremely limited which means we do not really know whether the virus is already circulating.
The Ministry of Health and Population (MoHP) in Malawi is investigating how best to use their Health Center by Phone service as a resource for disseminating information. Hotline workers need to have the most up-to-date and accurate information for callers. We are working with Airtel, the mobile provider for the service, to investigate whether the network can rapidly share information via mobile phone on behalf of the MoHP. Although there are no confirmed cases in Malawi while I am writing this, the goal is to be ready when they come.
But what we are learning in Seattle is that a key tool in our response is linked to our ability to continue working while reducing opportunities for transmission — transitioning events to online, working remotely, and increasing cleaning and sanitation services. Companies around us that had the means to quickly moved to remote work, setting an example that made it easier for us to follow. There is already an economic impact of these choices; and we know that not everyone can afford to make those choices.
It’s clear that there is no dichotomy between global north and global south when it comes to COVID-19. This is a larger, one world problem. Globalization has countries connected economically and in proximity like never before and as with any pandemic, the poor and others who do not have access to quality health care will bear the impact. We have suspected a major pandemic that crosses borders and continents would come — is this it?
What we do know is that we can’t afford to get caught unprepared. Complacency is the enemy of progress, and with all the steps we have made towards resilient health systems around the world, it is complacency that puts us at the greatest risk of losing it all.
