In a press release announcing a report to that effect the ECA noted the devastating effects of the imposition of lockdowns in these countries as they responded to the coronavirus disease and the fact that these lockdowns have led to some dire economic consequences.
According to estimates by the ECA, a one-month full lockdown across Africa would cost the continent about 2.5 per cent of its annual GDP, equivalent to about $65.7 billion per month. This is separate from and in addition to the wider external impact of COVID-19 on Africa of lower commodity prices and investment flows, it said.
The report noted the impact of lockdowns in slums where about 56 per cent of Africa’s urban population lives and where it is not possible to follow WHO recommendations on regular hand washing, social distancing and avoiding crowded places.
Residents of slums the report acknowledges often live hand to mouth through informal jobs that require contact with others, and staying at home is not an option.
“Lockdowns in such contexts are not feasible,” the report said.
Citing emerging data based on a study of close to 2,000 residents living under lockdown in five slums in Kenya, it indicates that: Over 75 per cent of residents left their homes an average of three times in 24 hours; Though 95 per cent of public areas have hand-washing stations, 32 per cent of households cannot afford extra soap for hand washing and 84 per cent cannot afford sanitizer; Face masks were used often, at levels reportedly as high as 73 per cent, however, 19 per cent were unable to afford them; The biggest currently unmet need, reported by 76 per cent, was food, with 98 per cent reporting that the situation was a result of the impact of COVID-19; Missing meals or eating less were reported by 70 per cent. Slum dwellers may also be more vulnerable to the extreme consequences of the disease: chronic diseases that predispose individuals to the more severe complications of COVID-19, such as hypertension, obesity or diabetes, are more prevalent in populations living in poverty.
The report took cognizance of the fact that access to health facilities and personnel is also acutely limited in slums.
“In addition to the risk that COVID-19 represents to the lives of slum dwellers, COVID-19 infection may be harboured in slums and could cause the disease to spread throughout the rest of the affected countries,” it added, among others.
The report then suggests that governments can work with community organizations within informal settlements to ensure the communication of health-related information on COVID-19 and to improve access to hand-washing stations and affordable face masks.
The report recommends seven lockdown exit strategies that have been identified from proposals and trials around the world.
The ECA states that they are assessed with respect to the extent to which each strategy minimizes uncertainty over fatalities. In most cases, countries are applying a combination of several strategies such as testing, contact tracing and gradual segmented reopening.
They are improving testing; lockdown until preventive or curative medicines are developed; contact tracing and mass testing; immunity permits; gradual segmented reopening; adaptive triggering; and mitigation, the report stated.
One other strategy recommendation is that under adaptive triggering, nations can ease lockdown once infections decline and re-impose if they begin to rise above intensive-care capacity. These would require regular shutdowns lasting two-thirds of the year, making little difference to permanent lockdown from an economic perspective. African health-care capacity is limited meaning capacity would quickly be exceeded, potentially resulting in fatalities.
Lockdowns, the report notes, forestall severe vulnerabilities, and that testing, contact tracing and easing restrictions may be possible for countries with sufficient public health systems and that have contained COVID-19 transmission, put in place preventive measures, engaged and educated communities, and minimized risks to vulnerable groups.
“Gradual segmented reopening may be needed in countries where containment has failed with further measures to suppress the spread of the disease being required where the virus is still spreading, notes the report. The spread of the virus is still accelerating in many African countries on average at 30 percent every week,” it said.
The report suggests that active learning and data collection can help policymakers ascertain risks across the breadth of policy unknowns as they consider recommendations to ease lockdowns and move towards a “new normal”.
It further urges African nations to take advantage of being behind the curve.
“This may be an opportunity to learn from the experiences of other regions and their experiments in reopening; and to use the ‘extra time’ afforded by the lockdowns to rapidly put in place testing, treatment systems, preventive measures, and carefully design lockdown exit strategies in collaboration with communities and vulnerable groups.
By Emmanuel K. Dogbevi