Just over a year after the coronavirus was first reported in China countries are still reeling from its effects. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19 disease, has infected over 90 million people globally and resulted in more than 1.9 million deaths. In January 2021, South Africa has the highest number of cases on the African continent and has seen a surge in daily infections since December.
The race to find and provide effective vaccines and therapeutics continues. Non-pharmaceutical interventions are still needed to limit the transmission of COVID-19. They include isolating cases, quarantining contacts as well as relevant, accurate and timely risk communication. Hand and respiratory hygiene, infection control and prevention are also vital.
Evidence-based research and interventions are important in the fight against COVID-19. But it is equally important to pay attention to social measures and people’s everyday experiences. These contribute to adherence to government regulations relating to COVID-19. Adherence isn’t always easy or possible in certain circumstances. For example, living conditions may make it difficult to keep a safe distance, and access to water may be limited.
In view of these potential difficulties, a group of young scientists who are part of South Africa Young Academy of sciences came together to discuss how policy briefs that focus on non-pharmaceutical interventions could be made more accessible for the general public and policy makers alike. The group comprised experts in the behavioural, social, natural, health and human sciences.
In particular, we drew from policy briefs compiled by a public health initiative called Resolve to Save Lives. This initiative puts together data on COVID-19 trends in Africa from multiple sources. These briefs target decision makers involved in the COVID-19 response in Africa, including national task forces and emergency operation centres.
Issues and possible solutions
The briefs are intended to inform public health and social measures in Africa. They are based on social, economic, epidemiological, population movement, and security data from 20 African Union member states. The briefs highlight the various strategies African governments have taken in responding to COVID-19 and whether these are effective or not.
We discussed the briefs in a closed webinar. It aimed to assess whether the briefs take into account the real experiences of people in our communities. The people invited to the webinar included academics, students and representatives of non-governmental organisations.
The webinar highlighted some big issues. These are listed below.
Environmental factors are important in the southern African region’s responses to COVID-19. Most countries in the region did not have a disaster management plan in place, and this contributed to environmental challenges. An example is the disposal of used masks in the streets, with many ending up in rivers and other water bodies. There is, therefore, a need for a disaster management plan which would guide the safe disposal of these waste materials.
There is an overuse of hand sanitisers (for example in shopping malls when people move from one store to the next), which may lead to antimicrobial resistance. Some ways to limit the negative impact of overuse of hand sanitisers on the skin should entail thorough washing of hands with water and soap when available. There should also be extreme caution and avoidance of diluting and combining different sanitisers. A point also highlighted by Winston Morgan, a reader in toxicology and clinical biochemistry at the University of East London, in his assertion that we should “avoid combining pre-prepared products with other ones”.
While government task teams have some diversity and interdisciplinary experts, there is a bias towards the health and “core science” professionals. Psycho-social and political sciences should also be represented in policy decision making processes. The role of traditional leaders, faith groups and businesses must also be taken into consideration. It is important to have this multi-sectoral response as COVID-19 is more than just a health problem.
Governments should strengthen evidence-based risk communication and engage community leaders and trusted people to encourage adherence to public health measures and dispel misinformation. In addition, there needs to be an open and honest conversation between traditional leaders and governments on cultural practices and people’s need to perform rituals.
For example, in many communities, initiation schools are an integral part of community life. Such rituals are an integral part of many communities and people want to practise and observe traditional rites. But these events may be high risk as the initiates might find it difficult to observe COVID-19 safety protocols. Working closely with traditional leaders who have in-depth understanding of such rituals can assist in ensuring adherence.
It is important to acknowledge that COVID-19 has affected all aspects of people’s lives. The young scientists’ webinar was an opportunity to understand the similarities and differences in challenges associated with COVID-19 in communities across southern Africa.
It highlighted the need for policies that are appropriate for people’s real lives. These need to be “living documents”. This can only happen if communities are consulted in making decisions affecting their lives. Pharmaceutical and non-pharmaceutical interventions have to be adopted alongside one another.