By Lisa R. White
Thank God the President of the Republic of Liberia, Dr. George Manneh Weah, has constituted a Special Presidential Advisory Committee for the Prevention of the coronavirus (COVID-19) in Liberia.
Clearly, he understands that the coronavirus outbreak requires all national and international hands on deck to handle eradicating the virus. With donor support, I hope the President takes his initiative a step further and establish a standing Incident Management System (IMS) and an Emergency Operations Center (EOC) to help manage all the details of this crisis and any future crisis.
The World Health Organization reports that worldwide the virus has infected more than 184, 000 people and has killed at least 7,500. This global pandemic has arrived in East, West, Central and Northern and Southern Africa. Senegal, Ghana, Nigeria, Kenya, Togo, Cameroon, the DRC, Burkina Faso, Egypt, Algeria, Tunisia, Senegal, South Africa, Morocco. These countries have reported confirmed cases.
Even Liberia’s neighbors, Guinea and Cote D’Ivoire have confirmed cases. Al Jazeera is reporting that most of Africa’s cases came from those who travelled abroad and returned. Only five people have succumbed to coronavirus so far — all in North Africa, reported Al Jazeera, with the Sub-Saharan region recording no deaths and very low numbers of confirmed cases.
Unlike many of these countries, Liberia has the hard won experience of successfully combatting Ebola. Through the active implementation of lessons learned, data collection and communication along with International and national engagement, and community activism, key measures were put in place – aggressive communication campaigns, contact tracing programs and reliable reporting mechanisms to eradicate the virus.
There were also vigilant hand washing schemes, meaningful calls to action like calling community or traditional leaders when sick or when seeing someone who is sick, seeking early treatment and no touching. These measures helped to combat the deadly but survivable disease. There is a collective memory of what to do. Business and homes a like have installed hand washing stations. The Ministry of Health and the National Public Health Institute of Liberia are working to ensure the relevant parties are quarantined and effective contract tracing is activated.
However, the coronavirus is not Ebola. New measures, campaigns and messages are needed because COVID-19 is infectious in a pernicious way Ebola wasn’t. The US Centers for Disease Control and Prevention (CDC) has said the coronavirus is not just spread between people who are in close contact with one another (within about 6 feet) but it is also spread through respiratory droplets produced when an infected person coughs or sneezes. These droplets, said the CDC, can land in the mouths or noses of people who are nearby or possibly inhaled into the lungs.
Imagine, though, the prospect of an infected person displaying symptoms and sneezing in a taxi. Those people are potentially affected. When they get out of the taxi, they in turn infect the people they come into contact with.
The Ministry of Transport is encouraging drivers to wear masks and has reduced the number of authorized passengers in a taxi to one in the front. What about passenger safety? Should passengers wear masks and gloves, too?
Good crisis management critically examines the worst-case scenario. For example, what will parents do if one child or another family member in the household has the virus and the rest of the family doesn’t? How will the family manage that? How will sanitation be handled? Are hospitals and clinics equipped with enough gloves and masks to manage the crisis? Will the borders be closed?
How will infection prevention be handled at congested markets across the country or with the people who travel to Guinea or Sierra Leone to buy and sell or visit family? What measures are put in place for this scenario? How will they be informed about accurate and reliable ways to prevent infection?
Ebola was more than a health emergency. The epidemic severely impacted the provision of health care services and caused setbacks in the treatment and control of other diseases including: HIV, TB and Malaria, according to the CDC, but Ebola also affected the population on the social, cultural, economic and political level.
Ebola changed the way greetings were conducted and it caused the need for safe burials which was a departure from traditional burial ceremonies. Other social norms were either transformed or were temporarily dropped from the cultural fabric of society.
We are seeing a similar impact of COVID-19 in Italy. Worshippers stand outside of churches, six feet part from each other and listen to a prelate’s sermon. During Ebola, pastors distributed holy communion through individual packets that were thrown away after use as opposed to using one Chalice for all parishioners.
The overall economic impact of the Ebola epidemic on Liberia, Guinea, and Sierra Leone was an estimated $2.8 billion with incomes declining and poverty increasing, reported the World Bank.
Ghana has reported two confirmed cases of COVID-19. As of 17 March, there are 143 suspected cases. Consequently, Ghanaians have taken to social media and created the hashtag, “#closebordersnow,” indicating their drive to stop any more cases from entering the country and preferring prevention to cure. Their trending message is a clarion call to the Ghanaian government to do more than enhance border disease surveillance and temporarily ban government officials from traveling; a prescient example for Liberia’s Presidential Advisory Committee.
Even the World Health Organization is urging governments to do more.
The good news is that the Liberian government is taking concrete steps to contain the virus; we must still critically examine how the coronavirus will impact our daily lives.
Transportation played a major role in spreading Ebola throughout the country. What will be the plan, for instance, for citizens who commute from one county to another or from one regional country to Liberia using taxis, pem-pems or keh-kehs and are infected? What is the plan for transportation in Monrovia and its environs? Will there be, for example, hand-washing stations at regional transportation hubs? Will taxi drivers be required to make hand sanitizer available to passengers?
And, what is the best way to communicate with Liberians about efforts to contain/prevent the virus? What if a good portion of the population doesn’t have a radio, access to the internet or phone? How will they get critical information on COVID-19 prevention or obtain accurate and reliable information about preventive measures from people they trust?
What happens if there is a civil servant go-slow? What happens if school does not resume next week? Are distance-learning programs planned?
Do ministries and agencies reduce or suspend services? Do businesses stop their activities entirely? What role will the police play? Will the courts and the legislature suspend activities? What about Liberia’s industries? How will the grocery stores provide food if this epidemic stays a while? What is the plan for the continuity of LEC?
The engagement of representatives from all sectors of society must contribute to the coronavirus eradication effort to ensure stakeholders, regardless of location, level of education and industry can access good, reliable information, make informed decisions based on accurate information and are able to trust the message and the messenger, hence the need for the standing EOC and IMS.
This is crisis management: Ideally asking these tough questions and planning for all aspects of a crisis before it happens through the analytical and judicious examination of “worst case” scenarios.
Now that we are in the crisis, we still need to consider those questions, and if deemed relevant, take the appropriate actions. A nationwide community outreach “Coronavirus Must Go” campaign with action oriented messaging is essential to take ownership of the eradication efforts.
With leadership and collaboration comes the power to effectively overcome the challenges this crisis has brought to Liberia’s shores through the quick implementation of necessary measures and the timely communication with stakeholders using their preferred communications channels.
We applaud the President’s Advisory Committee, all ministries and agencies, business, educational institutions for doing all they can to help the country eradicate the coronavirus.
One day soon this COVID-19 business, like Ebola, will be a thing of the past. We will all look back, understand the lessons learned, put them in our crisis management play book and say, “eh, Liberia, in union strong, success is sure.”
About the author:
Lisa R. White is a crisis communication specialist who consults with businesses and organizations on their crisis management plans and community outreach initiatives. She is the former UN Ebola Emergency Response Mission Public Information Officer for Liberia and former Senior Radio Producer with the UN Mission in Liberia (UNMIL). She can be reached at [email protected] for questions or comment.