Dear Mr. President,
This is an open letter from a former colleague who contested with you in the last March 7, 2018 Presidential election, but more importantly from an ordinary citizen who cares profoundly about Sierra Leone’s readiness to the COVID-19 (Corona Virus) that is increasingly causing immense panic and merciless deaths around the world.
As the World Health Organization (WHO) Chief, Tedros Adhanom said: “Our greatest concern is the potential for the virus to spread to countries with weaker health system.”
Mr. President, as you may be aware; Senegal reported its first case of COVID-19 on March 2, 2020 almost a day after Algeria reported two new cases on 1st March, 2020. So far, Algeria, Egypt and Nigeria have reported cases, according to the World Health Organization. The Ethiopian born WHO Chief emphasized that the main reason for the declaration of the corona virus as a health emergence is not because of what is happening in China, but what is happening in other countries.
While I recently scrambled to officially take a glimpse at Sierra Leone’s COVID-19 strategic response and readiness, I was disappointed that the Ministry of Health and Sanitation’s website is obsolete and antiquated. It has not been updated since August of 2017. I was increasingly anxious that we may not be up to speed in containment, isolation and testing potential infected people of this virus. I am even concerned that a strategic response team, advance laboratory testing system, stringent and robust public health policies may not be adequately designed or properly implemented in the event of an outbreak.
Your Excellency, it is encouraging, however, to know that your recent visit to Lungi, Port Loko District will help in health education and increase the visibility of this emerging threat. Indeed, more needs to be done to prepare the nation for such pandemic which is now dangerously crawling in our sub region. Based on our past Ebola crisis, we still lack the medical infrastructure and health resources to mitigate and control a catastrophic viral disease that is keeping the global community in constant fear and agony.
As someone who has a firsthand assessment of our medical system, I would like to proffer some valuable contingency measures and recommendations to prepare our people and country against this dreadful disease. I encourage you to see this health emergency as a serious threat with every effort on your part to plan for the eventuality, should it occurs. We can defeat any form of human threat, if we prepare ourselves with the tools, expertise and resources necessary.
Firstly: The setting up of a 9 member COVID-19 Task force is essential to centralize and coordinate active government health and public policies. This task force should comprise of policy makers, epidemiologists, medical practitioners and even Nurses. The Minister of Health and Sanitation should coordinate real time training of health care workers together with the 9-member task force. This strategic unit including doctors and health care workers will be the frontline people to the fight against any intrusion of the Corona virus. They should be the team that will advise, design and develop the readiness and response to any potential COVID-19.
Secondly: The urgent need for a laboratory testing facility in the capital city of Freetown, Lungi and Port Loko, Bo, Kenema and Kambia Districts must be established within the next forty-five days. The World Health Organization (WHO) has prepared a “disease commodity package” that includes an essential list of biomedical equipment, medicine and supplies necessary to care for patients with COVID-19.
The Hasting and Jui facilities must be refurbished with the health care setting that meets the World Health Organization’s guidelines from laboratory diagnosis to clinical management, from infection prevention to risk communication and especially, the vital early detection of the virus. We must not wait until an emergency has occurred to act. Rather, we must have everything in place ready to test, treat and quarantine infected people on real time basis.
Additionally, Mr. President, we must be able to identify and manage the disease and work expeditiously to limit any on-ward transmission, if in the eventuality it attacks our shores. “As countries in Africa confirm cases, the virus is no longer a threat to the continent, but a reality,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa. The situational report on WHO database (04, March, 2020) indicated that four new countries (Argentina, Chile, Poland and Ukraine) have reported cases of COVID-19 in the past 24 hours. We cannot be complacent and think we are immune from the new pathogen that has killed more than three thousand people worldwide.
Indeed, Mr. President, it was clear that we were able to reduce the infection of the Ebola Virus in 2014 by 65% due to early intervention. These experiences should be a learning guide in the way we prepare ourselves for such future potential threat. The best preventive strategy is early detection and the immediate quarantine of the virus carriers. Therefore, we must equip these two medical locations (Hastings and Jui) as the treatment centers with separate holding facilities.
Thirdly: We need to establish a data collection center for the COVID-19 that will provide guidance on early investigation. The COVID-19 data collection center will pair with the Laboratory diagnostic team and the 9-member national response team to develop protocols for surveillances and case definitions. The data collection center must be staffed with epidemiologists and statisticians who can help understand the spread, its severity and the impact of the disease on the population. As in the past, a model of operation was developed to manage the contact tracing and isolation process during the Ebola pandemic in 2014.
Fourthly: As I mentioned earlier, the Ministry of Health and Sanitation should coordinate the real time training for effective preparedness and response. According to the World Health Organization (WHO), an online course has been developed on the general introduction to emerging respiratory viruses like Corona Virus in relations to critical care, infections and control including safety briefing for respiratory disease. Every health care worker, medical practitioner and the medical community must be trained and certified on these COVID-19 courses.
Fifthly: Health education and community involvement should be our biggest medium of communication to the people. In a country where access to Television is low and the illiteracy rate is high, we must build grassroots sensitization from the district councils to the Chiefdom levels to be supported by local Paramount Chiefs in their respective chiefdoms across the country. On the whole, Media and health practitioners have a great role to play in that direction. Your Excellency, the March 02, 2020 Lungi, Port Loko awareness tours must be a continuous “to-do list” for you. Sierra Leone is a place where skepticism and doubts defeat truths and pragmatism. By using your good offices to remind our people about the potential of this new viral threat, greater awareness can be achieved, and we must continue towards that direction.
Nonetheless, we must have the laboratory testing equipment; develop a culture of an early detection practices, proper surveillances, good clinical care, quarantine measures and better treatments facilities. Let me share a similar advice I gave to President Ernest Koroma at the height of the Ebola Virus on my open Letter to him on 08/30/2014. That our problems need to be solved first by us and additionally looking for whatever supports others can provide. We must be the drivers of our own destiny not someone else.
That we continue to let others dictate our future and we have not addressed the issue of proactive leadership because we rely on “outside” intervention as the solutions to our political, economic and social problems. Also, it is critical, Mr. President, that you have one Strategic Unit COVID-19 Task force as the main “command and control” center of operation to evaluate, monitor and to make tactical or strategic decisions where necessary. Avoid creating duplicate task forces/units that may be redundant and unnecessary.
Finally, Mr. President, the only way forward is to create better response plans, used learning experiences from the past, appropriate the necessary resources and follow the basic rules of medical practices. While Senegal reported its first case of COVID-19 on March 2, 2020 almost a day after Algeria reported two new cases on 1 March 2020, Algeria, Egypt and Nigeria have also reported cases, according to the World Health Organization. Like Ebola and other viral pandemic, the COVID-19 will be history and the state of normalcy will emerge again.
We continue to pray that this inhumane disease never reached our beautiful shores. Even the way and manner you plan the effective preparedness and response to the Corona virus will surely define your Presidency. You have a choice today to seize the moment and keep our country safe. That is the essence of leadership and we hope you will live to our expectation.
May God guide you in this challenging time; give you the strength and wisdom to lead. May God save our people from this pending viral threat. May God give you the steady hands to continue to move Sierra Leone into a COVID-19 free nation, where our people live together in peace and harmony.