In response to the coronavirus pandemic, countries around the world imposed varying restrictions to combat the spread of the virus. But are these measures applicable everywhere, especially in poorer countries?
Sierra Leone has been praised as one of the countries that reacted well to the crisis.
As countries around the world grapple with the coronavirus, the West African state may offer valuable lessons on how to curb its spread with a fragile health care system and low budget.
After the outbreak of the novel coronavirus disease, Covid-19, started at the end of 2019 in Wuhan, China,it has been spreading rapidly around the world and countries face many challenges in preventing and managing the spread of a new virus within and across borders.
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The World Health Organization has expressed particular concerns about the vulnerability of countries with weak health systems. The head of the WHO had issued a stark warning: "Africa should wake up."
Learning from Ebola
Resource-poor countries like Sierra Leone have faced major outbreaks of infectious diseases in the past – most notably the 2013-2016 Ebola outbreak in West Africa.
Sierra Leonean health officials and scientists dealing with the Ebola outbreak gained valuable experience. They gained an appreciation for the role of health education, dissemination of correct information, raising awareness, and sensitization in controlling the spread of the outbreak.
These lessons highlighted the gaps in the country’s response and are key to preparing for emerging disease outbreaks.
As the country which had borne the brunt of the Ebola outbreak with 14,124 infections and 3,956 confirmed deaths, the poorest nation had taken no chances since the new coronavirus pandemic started spreading through Western Africa.
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Before the coronavirus outbreak, Sierra Leone was one of the two countries in Africa with facilities to test for the virus: a P3-Lab built by the Chinese during the Ebola outbreak.
Later, the country has set up three testing sites with the capacity to do 40 tests a day, in addition to a well-equipped, 30-bed isolation unit at the 34 Military Hospital.
Precautionary measures
The Sierra Leonean government has issued a raft of precautionary measures including the suspension of all overseas travel by government officials, and a ban on public gatherings of more than 100 people and on all sporting events.
The military has also been deployed at airports and land borders to enforce quarantine for all passengers coming from countries with over 200 cases.
On March 19, Sierra Leone denied entry to a Japanese family of four after one of them was found coughing on board a Kenya Airways flight.
The transport ministry then issued a 72-hour notice to all airlines to stop flights to the country, effective March 21, except for emergency medical flights.
Preventing false information
Before the Ebola outbreak, public health officials and the general population in Sierra Leone had limited information about the disease and how it spread. This made it easy for false information to spread.
With such limited knowledge, a large portion of the general public didn’t know how to prevent, manage, or control the disease.
Having that experience with Ebola taught health authorities in Sierra Leone to be proactive. There is little knowledge about Covid-19.
Health officials are educating the general public about how it’s transmitted and ways to prevent and control it. They have now embarked on serial community engagements, workshops, and radio and TV health programs designed to make people aware of the Covid-19 outbreak.
Using faith-based networks
Faith leaders are often among the most trusted members of a community and enlisting them in providing accurate information and encouraging cooperation among members of their congregations is extremely effective.
In chronically under-resourced African nations, faith-based institutions provide services, including health care, where governments sometimes can't reach.
Sierra Leone’s Covid-19 sensitization activities have been targeting community leaders, local chiefs, and health authorities in the border towns and villages along various crossing routes to neighbouring countries.
This is because local community leaders and health workers were at the frontline to bring the Ebola outbreak in Sierra Leone to an end in 2016.
Less touching policy
During the Ebola outbreak, Sierra Leone implemented a “less touching” policy, which limited the frequency of physical contact between people.
There is no scientific report to assess the impact the “less touching policy” had in halting the Ebola outbreak in Sierra Leone. But many believe that it played a major role in reducing the transmission of the disease.
Health officials are applying this policy for preventing this new outbreak.
Early quarantining
Perhaps one of the most relevant experiences Sierra Leone obtained from the Ebola outbreak, which is now being used to prevent the outbreak of Covid-19 in the country, is the targeted quarantining of all categories of Covid-19 patients.
Targeted quarantining is the process of selecting and subsequently quarantining individuals who are at high risk for an infection without testing the person for that infection.
Because of the challenges of a fragile healthcare system and poorly equipped laboratory, the health authorities in Sierra Leone have been quarantining everyone arriving from China and other Asian countries since December 2019.
They are also quarantining for 14 days anyone who arrives at Lungi International Airport with a very high temperature.
People arriving at the Lungi International Airport during the Ebola outbreak were quarantined only if their body temperature was above 99°F.
Sierra Leone’s major strength in halting the spread of Ebola during the outbreak was massive health education and community involvement in the design of Ebola control and prevention strategies.
