Dear President Lungu
I must first apologise for contacting you in this way, but I know no other way. The times are desperate.
I do not in anyway doubt that you are committed to leading the fight against Covid 19. So far, you have done whatever one can could do under the circumstances and I would like to commend you for that. From around 18 March to the end of June, the number of people who contracted Covid 19 was very small compared to most parts of the world and nearby South Africa. What is clear is that this disease does not respect persons. Two of our own ministers who were at the forefront telling the public to adhere to the guidelines the government had set out got infected. This should have sent a signal to all that the disease is subtle and one careless move by anyone can mean infection.
We now know that in up to 85% of people who are infected with the SARS-Cov-2 virus, only experience few or no symptoms at all. The remaining 15% are the ones who are most likely to seek medical attention. In the best healthcare systems and most well resourced countries in the world, up to 5% of those infected will be seriously ill needing intensive care support and at least 1% die. Under normal circumstances this would not be a big deal. What is a big deal concerning Covid is that it is highly infectious and less dangerous. What this means is that if left alone, it would infect the whole country in a matter of days. This is the danger. If 5% of the 17 million Zambians were to be seriously ill within a period of one month, they would need more than 800,000 hospital beds! Even as mild as the disease is, there would still be about 1 million people seeking medical attention over a very short period of time. There is no capacity in the Zambian healthcare system to cope with such numbers. There are not enough resources, including human resources to deal with such a tragedy. One should bear in mind that even healthcare personnel would also be ill, and even more than the general population as has been seen in many parts of the world.
I have painted a grim picture because the tide can change if we act now.
First and foremost, Your Excellency, you need to marshal your troops. This war needs people who are 100% committed and not distracted. I as a medical doctor, knows that there is so much we do not know about this disease, but there is also a lot that is being known every hour. The publications are mounting and no one can single handed keep track. In my opinion, I submit to you sir that the minister of Health must be moved to another less demanding ministry at this time when he is facing criminal charges in court. The minister cannot afford to be distracted at this crucial hour. It is actually for his own sake too that he be moved since you have refused to suspend or fire him. The Ministry of Health needs a leader who is fully committed. Furthermore, we need external financial help more than ever before in the ministry of health. Donors must have confidence that the money they give will reach the desired targets and not end up in someone’s pocket. When it comes to corruption perception is the name of the game. The ministry of health has not fared well when it comes to corruption over the last few years and having its minister in court on graft charges just strengthens suspicion and donors my count the cents they give.
Lastly, we must get help for more test kits. Testing must be made more widely available to every person who wants to be tested. We have now passed the phase where we test contacts only. We must roll out testing in every place where measures have been eased. What was done in Kafue should now be repeated country wide. I understand the need to keep the economy moving as much as possible. In order to do this, we may have to carry out local lockdowns like we did for Nakonde. People must be banned from leaving or entering hotspots for 14 days.
It is time to enforce the ban of mass gatherings. In this, I would suggest that you sir, lead by example. When it comes to political gatherings, it looks as though nothing has changed except for the face coverings by some. Let us bear in mind that the virus can also enter through the eyes from the hands so that in crowded places we may not wash our hands before touching our eyes even if we have a face covering. The WHO advises to avoid crowded places, especially in doors.
I believe that we still have a chance to beat Covid. No one has the monopoly of knowledge concerning how to deal with this pandemic, but we must all put our heads together and cast emotions aside but face the cold facts before us.
May God bless the Republic of Zambia.
Dr Charles Ngoma
(Former Vice President, Zambia Medical Association)