It is, perhaps, unintended but we have somehow managed to communicate to the masses that Covid-19 no longer exists in Ghana or that it is not as problematic for the Ghanaian as it is for others in richer, better-resourced nations that have evidently got it worse.
This is likely a by-product of the fact that we have only a tiny fraction of global confirmed cases of Covid-19 (around 0.11%) and that our case fatality ratio (CFR) is significantly less than 1 percent of our confirmed 47991 cases. So, we take our resultant sense of security and go to crowded pubs, sit in packed buses, and visit busy market places, all the while ignoring all the safety protocols, because the statistics don’t lie. Right?
Wrong. It almost always depends on what statistics you’re looking at. A new study by scientists at the West African Centre for Cell Biology of Infectious Pathogens (WACCBIP) reveals exactly how deceptive our reliance on confirmed cases may be. The study, which estimated the levels of exposure to SARS-CoV-2 (the virus that causes Covid-19) within Accra and in Kasoa, measured positivity to the virus in blood serum taken from 1305 individuals.
Using an antibody rapid diagnostic test (RDT), the scientists detected the presence of Covid-19 antibodies—protective proteins produced by the immune system in response to the presence the virus—in almost 20 per cent of the tested individuals.
That numbers up to about 250 people out of 1305 tested. This, from a test kit that the scientists admit, may miss about three out of 10 positive cases, even though it is accurate in detecting exposure around seven times out of 10. Basically, the 250 figure is very likely an underestimation of the actual exposure rate.
Let’s place the number in context. Projecting the study sample to the population of Accra, which is an estimated 6 million people, it would mean that, even with a 70 percent accuracy in measurement, there would be about 1.2 million people who would have been exposed to the virus. More than one million people in Accra (and Kasoa) alone.
For context, the entire United States, the world’s most severely hit country, has recorded almost nine million confirmed cases, a figure resulting from considerably more testing. The U.S. is currently conducting 1 million tests per day, Ghana is running less than 1000 tests per day. Our 47991 confirmed cases look shaky in the light now, don’t they?
The study also revealed that around 80 per cent of 1305 tested did not experience any known symptoms and more than 90 per cent had not been previously tested for the virus at all. Given that a majority of our confirmed cases were detected from individuals who were tested because they presented with symptoms or had been in contact with someone who was known to have been positive, this must be a source of concern.
Granted, it is not all negative news. The numbers would point to an even lower CFR than we are currently estimating. It suggests that the Ghanaian population may be generally showing some increased resistance to the virus than others in the most affected parts of the world. Scientists are still working to understand this, but what is clear is that we have been relatively lucky so far.
But, for how long are we going to ride our luck? We are clearly not out of the woods yet and, now, we have the data to prove it. Authorities must complement their stat-peddling conferences and updates with clear, unequivocal communication about the real, still-active dangers related to disease spread and the possibility of the virus evolving.
That’s another very real, very dangerous possibility that the communication on prevention and safety against Covid-19 rarely covers. In April, WACCBIP scientists and some of their colleagues at the Noguchi Memorial Institute for Medical Research sequenced genomes of SARS-CoV-2, explaining that the strains they found in Ghana pointed to community spread and the presence of locally unique strains. The scientists were offered platforms on all major news outlets to explain their findings, which, according to them, suggested that the virus had evolved slightly since it was first reported in Ghana.
In another new study, they have found more evidence to suggest that the virus is adapting to the Ghanaian environment within which it has now found community spread. Several unique mutations (changes in the original genetic structure) and substitutions (variants of the virus that have become permanently established in the population) have been detected in Ghana. Some of these have not been identified anywhere else in the world. This means that there is a very real danger that the virus could adapt quickly and become more virulent, causing in Ghana the kind of devastation we have seen in other countries.
However, we don’t tell our people this. It is not enough to simply tell people what the symptoms are and how to prevent getting infected. It is not even enough to tell people they could die of this new disease that we still don’t know enough about. It is not enough because, when they do not see a preponderance of sick people or corpses, especially without adherence to touted safety protocols, it suggests to them that the risks are exaggerated or even non-existent.
Much of the communication—what we have decided to communicate—has largely been effective. According to the WACCBIP scientists, every 9 out of 10 people they included in their study had a good grasp over the preventive measures against Covid-19 and the symptoms of the disease.
However, based on the rate of exposure, it is clear the knowledge is not translating into preventive action. So, our people know how badly they could feel if they got sick and how to avoid getting sick; they just do not know why they need to avoid getting sick.
This is where we now need to direct our communication efforts, particularly to the portion of our population that is not highly educated or situated within what we would consider a high economic status. This is the section of the population that is at the highest risk of exposure. The WACCBIP study revealed that there is a significantly lower rate of exposure among individuals with a tertiary education compared to those with lower levels of education or none at all.
A similar divide exists between the high-income demographic and the low-income demographic. An affluent person with higher education is less likely to be exposed to Covid-19 than a non-wealthy person with low or no education. Municipal markets and lorry stations—places where the affluent are least likely to visit—were the places the scientists found the highest rates of exposure.
The least fortunate in our society are the most at risk. We need to ensure they understand why there’s a need for a collective maintenance of all safety protocols. They got the message when we hounded them with soundbites repeating the symptoms and safety measures; they will get the message when we tell them that the virus is still here and it could become more deadly at any time.