Dealing with public health emergencies of any kind requires unprecedented adjustments to normal life and procedures. When you have a situation like we do in Africa and Ghana where the health systems are not resilient enough to adjust to heavy inflows of patients who require clinical treatment in the event of an outbreak, the situation ostensibly assumes a grimmer picture. As at 19th March, 2020, Ghana had reported nine (9) confirmed cases of COVID-19. All these cases are reported to be “imported cases” of the virus involving people who had travelled outside the country and had tested positive upon return.
As a country, we are at critical point in dealing with a potential catastrophic public health situation. Public health emergency response requires a plethora of action packages required to effectively contain the virus in the event of transmission through community spread. Community spread unlike imported cases involves persons who have no history of travel to infected regions of the world contracting the virus from other people within the community.
Response to public health outbreaks includes Emergency operation center, multi-sectorial Response Linking and Public Health with Law Enforcement and finally Deployment of Medical Countermeasures and Personnel. The string the links all the response actions is communication, the term is Risk Communication.
Risk communication is fundamental to public health practice and critical to the success of any public health response and we can do better than what is currently been done. Risk communication activities are particularly important in supporting the management of any acute public health event, especially at an early stage when decisive action must be taken in the context of uncertainty.
Effective risk communications also make a fundamental contribution to the management of emerging diseases and other public health threats by informing decision-making, encouraging positive behaviour change and maintaining public trust.
The usual practice of pitching two political adversaries against each other on morning shows to debate for political capital shouldn’t apply in extraordinary events like such a public health emergency.
Worse of all is creating an environment for antagonism between politicians and the country’s foremost public health experts on live national television where they contradict each other. Case in point is when a ranking member of the parliamentary select committee on health cast doubts on the preparedness of the nation to deal with the global spread of Covid -19 on the same show where the deputy director of public health at the Ghana health service is educating the public on the country’s preparedness.
The public are left with no choice as to who to trust and when public trust in state apparatus is lost; public health response is irreparable hampered. Trust is required to stimulate and encourage positive behavioural change.
The penchant of the media to create content for publication on their various platforms (radio, television, Internet, print etc.) sometimes override the need to scrutinize the accuracy and appropriateness of information been disseminated. This situation we find ourselves as a country cannot be business as usual. Whiles numerous media houses are impressively disseminated preventive practices and encouraging behavioural change, similar platforms are countering those efforts with preposterous assertions and insinuations. In these times editorial discretion to weed out politically laced assertions that will likely derail efforts at containing the spread of the virus is of outmost importance.
Key components of Risk communication during emergencies involve health emergency communications, operation communications and behaviour change communications. Health emergency communications is rapid dissemination of information and health messages to a population during a health emergency. The objectives of health emergency communications are to build public trust, enable and empower populations to adopt protective measures, reduce confusion, and facilitate enhanced disease surveillance.
The convoluted dissemination of information from a varied number of government information machinery seems to be counterproductive to achieving the desired goal of informing the public. The politics of the nation is so polarized there is a trust deficit with the government communication. Leave the communication to the experts.
The population are least polarized towards public and civil servants involved in the multi-sectorial approach to the response of the spread of the virus (Public health experts, police, immigration etc.) as compared to politically appointed individuals. The covid-19 pandemic has claimed the lives of 9,278 people, a case fatality rate of about 10%. Yes, majority of the lives lost are older people with pre-existing conditions like respiratory diseases, diabetes and heart conditions, Conditions that exist among the Ghanaian population.
Mensah-Boaheng et al found the prevalence of diabetes from meta-data analysis among Ghanaian adults to be 6.46%. This means that, some 1.86 million people are potentially at risk of fatality by virtue of having one underlying condition (Diabetes), should all of us fail in our attempt to containing the spread of the virus.
More lives could be lost from the inaccessibility to health care for others with acute and chronic conditions as a result of over burdening of the current health infrastructure with covid-19 cases should we experience community spread. Be responsible for your lives and the lives of others who are most vulnerable in society.
Dr. Ken Osei Mensah (MLS)
Department of Global Health Security
Graduate School of Public Health
Seoul, South Korea.