The NDC technical team on Covid-19 has asked government to make public all COVID-19 isolation centres in the country.
According to the team, transparency in the management of patients helps to reduce misconceptions about the virus.
“Transparency in patient management is also key in reducing misconceptions about COVID19 and the stigmatization of its sufferers and survivors.
We recommend to government the full disclosure of the locations of all isolation and treatment centers around the country, as well as their respective capacities.
Greater public knowledge of these locations may boost care-seeking behaviour as prospective patients will be reassured of treatment near their homes and loved ones or, at least, in their region or district of residence,” the team wrote in their latest proposal to government on the pandemic.
They also reiterated their call for government to put in place measures for testing across the entire 16 regions of the country.
Below are details of the team’s proposal to government
1. Testing & Contact Tracing We take note of efforts made by government to scale up testing and contact tracing efforts as part of measures to identify and isolate persons who have contracted COVID-19. Concerns about the comprehensiveness of the strategy remain, and we list below related recommendations and those for the broader aims of COVID
2. Community Impact Mitigation The oscenes reported at food distribution points in Accra and Kumasi over the course of the lockdown have been alarming, and threaten to defeat the underlying point of the social distancing protocols that have occasioned their necessity.
The congested cues for cooked food, and its distribution in limited and overcrowded spaces, makes them a potential hub for COVID-19 transmission. Residents of the communities in question are low income, live in very close quarters, and have low rates of healthcare utilization; a combination of factors that would make local
transmission within them as efficient as it would be hard to detect with a clinical testing model. We recommend urgent action to prevent this risk from manifesting itself as reality.
3. Health System Strengthening Concerns remain about the preparedness of Ghana’s health care system to adequately deal with a surge in clinical cases of COVID-19 while effectively protecting the frontline health workers and other supporting and auxiliary clinical staff.
Despite repeated assurances to frontline health workers about the supply of PPEs, complaints persist in several regional and district hospitals about the unavailability of protective gear.
Recent revelations surrounding a high profile COVID19 death also suggest that the processes for procurement of certain palliative pharmaceuticals are progressing at a worryingly slow pace. We recommend the following for immediate action.
3.1. Distribution of PPE’s from central storage at regional and district hospitals to frontline departments and their staff must commence immediately to buttress the safety, confidence and motivation of clinical staff as the risk to them steadily increases.
3.2. Reconsideration of the specific definition of healthcare workers is emerging as a necessity.
The present focus on staff with direct patient contact ignores the role of several categories of support staff in the case management process, the risks faced by auxiliary staff like janitors, and the modalities of COVID-19 transmission in that context.
The risk of contracting COVID-19 extends beyond those professionals who have direct contact with patients, and planning for protective equipment should reflect that and make provisions for the various staff categories in accordance with their respective risk exposure.
3.3. An accelerated procurement protocol must be established for the supply of COVID-19 related pharmaceuticals to maximize the efficiency of care and avoid costly delays in access for patients.
This would also support the flexibility of the clinical response component of Ghana’s fight against COVID-19 by creating a mechanism that allows for the rapid inclusion of emerging therapies with proven efficacy into Ghana’s treatment protocols.
The rapid evolution of knowledge and perspectives about the virus and its physiological effects demands this kind of dynamic range in Ghana’s clinical response.
3.4. Transparency in patient management is also key in reducing misconceptions about COVID19 and the stigmatization of its sufferers and survivors.
We recommend to government the full disclosure of the locations of all isolation and treatment centers around the country, as well as their respective capacities.
Greater public knowledge of these locations may boost care-seeking behaviour as prospective patients will be reassured of treatment near their homes and loved ones or, at least, in their region or district of residence.
3.5. We reiterate our pressing recommendation from our previous document for the immediate settlement of NHIA debt to providers, the suspension of capitated outpatient payments, and the inclusion of COVID-19 testing and treatment to the NHIS’ list of essential health benefits.
These will provide demand-side incentives for proactive care-seeking behavior, and eliminate the risk of perverse incentives created by supply-side cost-sharing.
Altogether, this will afford health facilities greater flexibility and autonomy in preparing and equipping themselves to respond to the COVID19 threat.
4. Health Education It remains clear that information and education about the reality and risks of COVID-19 have failed to penetrate the public consciousness to a meaningful degree.
There remains widespread doubt and denial of the virus itself, and skepticism about the necessity and usefulness of the public health interventions that have been enforced.
This, if not addressed immediately and aggressively, will fundamentally undermine the national effort to flatten the pandemic curve.
5. Data Release & Information Management Consistency and factual accuracy are critical to preserving public trust in the management of the crisis.
The data released from the Ghana Health Service and Ministry of Information must have epidemiological relevance to the COVID-19 outbreak, it must be presented in a consistent manner to allow for trend analysis by third-parties, it must be logically consistent, and it must have practical utility. We note concerns on all those fronts.
An emerging concern in the management of information is the public understanding of the rules around funerals and burials.
This has been highlighted by recent complaints by staff at various mortuaries about overcrowding of their morgues as families are either unsure of whether burials are covered by the restrictions on movement or choosing to delay funerals until the lockdown is lifted.
This is a sensitive topic grounded in our sociocultural perspectives as a people, but it is important to consider the implications of overcrowded morgues given the harsh realities of the weeks ahead.
We recommend urgent clarification of the matter, and subtle encouragement to families to consider early burials in advance of funeral rites and memorial services to be conducted after the lockdown.
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