Slowing Spread of COVID-19 in Ghana; Start with Thermometers, End with Communication

Blood sample with respiratory coronavirus positive

I left the shores of Accra, Ghana on Saturday February 15, 2020 at midday via Ethiopian Airlines en route to Canada. My five weeks anticipated stay was to be hosted by a professional organization while travelling from Toronto to Calgary, Waterloo and back to Toronto.

The first two weeks in Toronto were very much relaxed, with the news of COVID-19 pretty much present in China and very mild few cases in Italy. But bear in mind when I arrived at the Toronto Airport there was no screening, just a welcoming smile from immigration officers who asked very few questions and stamped my passport.

In mid-February, many countries, Canada inclusive as well as Ghana, were not very much as worried as countries that had reported cases. My third week in Calgary, Alberta was a very interesting moving from one business meeting to another, connecting with social entrepreneurs, business and policy leaders in the value chain and yet we met, shook hands and gave hugs, why? Because no case of the virus had been reported yet in Alberta and above all there wasn’t panic and much of the news was focused on China.

Well, all these began to change in my last few days as there was a gradual build-up of tension in Toronto, with over 101 COVID-19 cases. There was an increasing rise in panic and tension in Toronto when I got back on Sunday March 15. Most shopping malls had shelves running empty of items such as sanitary pads, toilet rolls, tissues as well as hand sanitizers.

Then on the same day, March 15, news broke that Ghana had placed a travel restriction on incoming flights from countries with more than 200 COVID-19 cases, with exception to Ghanaians and foreigners with resident permits.

Hearing this, I quickly had to cancel my plans and booked a flight back to Ghana. I needed to get back, despite hearing that there would be mandatory quarantine for those with symptoms of COVID-19 and mandatory self-quarantine for those without symptoms, but from countries with high impact of the condition.

I started my journey back on Tuesday March 17, flying from Toronto to Montreal as international flights could only fly from Montreal after a national emergency declared by the province of Ontario. Armed with two 500ml containers of hand sanitizers, tissue papers, soap, my own personal water bottle, I landed in Montreal and connected to Brussels in Belgium only to have my flight cancelled.  The reason? The flight, operated by Brussels Airlines, had to merge two flights together, in the almost empty Brussels airport, with over 70 per cent of those on board being Ghanaians.

We landed in Accra on Wednesday March 18, 2020 and rode a shuttle bus that took us from the plane to the arrival section of the airport which looked very less busy. The only major queue was that of passengers from my flight.

We were given a form to fill that asked for flight number, name, address and if we had any COVID-19 related symptoms, but from the structure of this form any passenger for fear of quarantine could lie if he/she wanted to.

We went through a screening. And by screening, let me explain, because this is what I didn’t see in most airports in Europe; I must give credit to Ghana Immigration. A live online monitor picked the temperature of every passenger in the queue, the temperature was recorded on the questionnaire form filled by the passenger, and that form was kept by the health officials. No further questions asked, you were allowed to move to immigration, received your passport stamp, and proceeded freely to the luggage pick up area and off you went.

The Gap in This System.

Bearing in mind that Ghana Immigration and health officials have done great work in checking for temperature and quarantining those with high temperature and symptoms of COVID-19, I strongly believe this is not enough.

The questions I keep asking myself are; what of the remaining passengers who currently show no symptoms at all and have normal temperatures? How are they able to verify if information shared on the questionnaires is valid? Why aren’t the rest informed that they needed to do a mandatory self-quarantine, as I realize that some few Ghanaians I had spoken to on the plane didn’t know that self-quarantine was compulsory and a few were living outside Accra with plans to travel home by public transport the next day.

I must say with much confidence that most of the Ghanaians I had interactions with on my flight didn’t know there was a need for mandatory self-quarantine. To make our airport, and our country, safer, I strongly recommend a third booth to be set up for incoming passengers. Yes, passengers go through screening and those with bad temperature and symptoms are separated; the others should pass through the third booth after passport stamp.

Here, immigration officers should review the filled form, verify the contact details and address given as this is very important. For example, if a passenger stays in Kumasi, how is he/she travelling? By public transport such as Intercity STC, VIP, flight or will be picked up by relatives?

Does the person live alone or with family? If by public transport, what is the best guidelines to follow and if such officers through the interview with passengers cannot fully assure that passengers will commit to healthy guidelines, then they should be quarantined until full verification is made.

Finally, before leaving the third and final booth, passengers should be given a printed self-quarantine guideline that explains in simple steps the best practices and what to do and not do when in self-quarantine.

The need not to have pets and any person around you, need to have food brought to your doorstep and not into your room, best cleaning and health practices, coupled with emergency numbers to call, should the person feel and experience any symptoms or need a doctor.

The reason for the emergency number printed and handed over would enable the person to call ahead of time before reporting to the hospital, this way doctors are aware that you may or may not be COVID-19 infected and put the needed logistics in place. This way, you are safe and also do not infect other people.

A big thumbs up to the Ghana Health Service for the set-up of emergency COVID-19 hotlines for all to call should there be any COVID-19 related cases.

I am now in the second day of my MANDATORY self-quarantine in Accra and have decided to share this experience from the comfort of home while getting myself busy. I do hope that the Ghana Immigration Service will go further to do more and I also do hope and pray that dozens of Ghanaians who came in from Brussels, a highly COVID-19 infected airport, would quarantine and keep data of everyone they have come into contact with.

I also pray that fellow Ghanaians will support the government in the fight against COVID-19.  My simple advice would be to mitigate (ban flights entirely for four weeks) and adaptation (work effectively on contact tracing of already passengers who came in for the last one month and put measures to track and remedy).            

In summary, it seems the government has done what it does best by putting the needed technical fixes and solutions to the problem, in terms of the set-up of a modern, standard monitoring and screening system at the airport coupled with the presence of health personnel.

Meanwhile, getting travelers who come into the country to understand the risk they pose to each other, fellow citizens and the need for shift in behavior is an adaptive problem that needs to be addressed. 

All the current 11 recorded cases of COVID-19 in Ghana are imported from Norway, Germany, Switzerland, Turkey, United States of America, United Arab Emirates and United Kingdom. From my interaction, with most travelers most did not or were not even aware there was a need for them to mandatorily quarantine themselves for 14 days, neither was I or other passengers that came through had any communication on this; bearing in mind some passengers were travelling out of Accra that same night.

Communication, not just online but also at the point of entry is a crucial aspect of the process needed for behavioural and adaptive change.

In simple words, temperature taking is a technical solution and getting mass population and travelers to understand the risk they pose to each other, should they have had contact with an infected person is adaptive and this calls for inclusive support from civil society organisations whose primary focus is on health education and to citizens to all citizens alike.

The author is a social entrepreneur who is currently in a mandatory self-quarantine in Ghana

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