Interrogating impressions of triumph and inconvenient truths about mass testing and containment action across Africa

Solving the puzzle of correctly noticing a “flattening country Covid-19 curve” and deciding when to fully reopen the economy is a tough case-by-case adventure. There is no neighbour to trust and copy since no country has weathered the experience of reopening long enough to provide a robust benchmark.

A stealthy but ultimately explosive frenemy?

On a day when Tanzania surpassed Kenya in the confirmed cumulative number of Covid-19 cases, 480 against 384, probing questions emerge on just how stealthy but eventually explosive this highly infectious pandemic can be to any economy.

For a long time, the confirmed and reported cases in Tanzania have been much lower than in Kenya, if the numbers are anything to go by. When to reopen economies, with a careful measure of well-informed evidence and progressive policy advice, remains the focal point of discussions for all country leaders. The timeliness and swiftness of action in terms of containment measures, testing, and contact tracing are critical in this convoluted war. Covid-19 is here rightly so-called a frenemy. This is because, despite its extensive and adverse effects on social and economic activities, it has challenged countries to look inward and exploit their innovative and creative strengths.

Location-based intelligence and swift action — the powerful dual strategy against the pandemic

Tomas Pueyo recently posted a widely read study entitled “Coronavirus: How to Do Testing and Contact Tracing”. It sheds light on the question as to when to reopen economies following the ravaging COVID-19 pandemic. He also confirms the power of technology-led intelligence, working through effective contact tracing and tests that target geographic clusters and hotspots. Isolation and quarantine are the main action points used to avert the spread of the pandemic. Speed is of the essence.

Isolating 50% of the infected and 30% of their contacts is given in Tomas Pueyo’s study as an example of a winning strategy. The study shows that a delay of only two days in implementing isolation and quarantine can increase by 20% the percentage of the population to be isolated and the contacts to be traced.

Moving on to avert the complacency of ignorance

A recent open tweet by a Kenyan in Kenya asked what mass testing would serve if in the first place Kenya didn’t have enough capacity to handle the positive cases — no universal healthcare coverage in the first place. This question places us squarely between the proverbial rock and a hard place. The rock is the fatal blow COVID-19 deals to a weak and financially deprived healthcare system and an economy without a sound social safety net. The hard place is the hard choice between ignoring any potential cases to afford some short-term complacency, or facing the chilling fact that more tests would reveal more worrying numbers of the COVID-19 cases spreading within the community.

As shown in the graph below, the testing rate in Kenya has stagnated at 7 tests per million people per day. With the growing data from sampled cases, this trend has led to a linear and predictable fashion in Kenya, which since 13th April has assumed y = mx + c, where m (slope) = 11.47.Upon applying this equation and by maintaining the testing rate, the new projections from 30th April — 4th May 2020 are as shown in graph.

This trend has led to a linear and predictable fashion in Kenya, which since 13th April has assumed y = mx + c, where m (slope) = 11.47.

Given a highly optimistic scenario that uses Kenya’s published Covid-19 data and assumes that:

(i) the spread of Covid-19 has been contained within the communities;

(ii) Kenya’s testing rate by 29th April of 7 tests/million/day, on the same date lower than Ghana’s index of 68, Uganda’s 16, and Rwanda’s 14, is sufficient to establish the actual prevalence without enhanced mass testing; and

(iii) there could be a slow downward curving trend in Kenya’s cumulative Covid-19 cases starting from 16th April 2020.

Data-driven models similar to the ones shared here earlier (Article 1, Article 2, Article 3) and based on the assumptions above still project that with the business-as-usual testing rate in Kenya, the cumulative cases would peak around 17–26th June 2020, with some 635–700 cases. By any measure, going by observed trends, this is a highly optimistic scenario indeed.

The key policy message for Africa

Solving the puzzle of correctly noticing a “flattening country Covid-19 curve” and deciding when to fully reopen the economy is a tough case-by-case adventure. There is no neighbour to trust and copy since no country has weathered the experience of reopening long enough to provide a robust benchmark.

The situation should not be used to fuel disaster capitalism, whereby the privileged minority exploit the crisis to widen the gap among young learners, who are the future of Africa.

Education sector and inequality in digital access

The education sector, a key pillar of sustainable competitiveness, continues to suffer under Covid-19 uncertainty as the majority of learners inhabit locations disadvantaged by the wide digital divide in Africa. Innovative government interventions must henceforth look into ways of ensuring fair and equitable access to education by learners in the midst of this crisis. Equitable provision of technology infrastructure for education has, therefore, gained in importance during Covid-19 as part of critical public infrastructure. The Covid-19 situation should not be used to fuel disaster capitalism, whereby the privileged minority exploit the crisis to further marginalise and widen the access gap among young learners, who are the future of Africa. College students, for example, are at a critical transition moment when any loss of time has profound consequences for their job prospects.

Mass testing and containment measures

The unfolding experience is that community transition is now the principal mode of Covid-19 transmission in Africa, where the novel coronavirus was a latecomer anyway. Areas with high population densities, which also happen to be synonymous with poor infrastructure and poverty, are important transmission clusters. This gives the challenge of testing and containment a strong spatial and sociodemographic dimension.

From these perspectives, the ongoing call for adequate containment measures and mass testing in Kenya — targeted using location-based intelligence as economic sense would justify, is not vain activism but a veritable appeal.