Sierra Leoneans, PEACE, BE STILL!!!
It was a good thing that a cross-sectional nationally representative sero-survey was conducted in March 2021. As a matter of fact, any responsible and epidemiologically-minded COVID-19 Response should embrace such a fact-finding mission. So from NaCOVERC’s perspective, we are proud to have partnered with Ministry of Health and Sanitation, Statistics Sierra Leone, CDC and other agencies to have a sense of the scope of COVID-19 exposures that may have fallen out of the raider.
Our people seem to fret simply because the report indicates that the COVID-19 cases in Sierra Leone may have been 45 times under-reported. Our first instinct is to focus on the word ‘under-reported’ and ‘45 times’. That’s scary right? And some of our folks (even scientists) may have hastily concluded that “NaCOVERC bin dae lie pa we”. As a Response, we can discountenance it as a pardonable naivety.
Perhaps the word ‘under-reported/under-reporting’ has conveyed a meaning that is totally out of the context as framed and understood by the team of very distinguished researchers. This kind of survey is not new. Let’s look at Kenya, UK and US.
On May 30, 2020, Kenya had reported 2093 cases (90% of which were asymptomatic). However, when a SARS-CoV-2 sero-prevalence was done the same May, it indicated a prevalence of 4.3% representing 1.3 million infections.
On July 2, 2021, the British Medical Journal published a study suggesting that long covid cases in UK were being under-reported in GP records. The term ‘long covid’ in that study referred to persons who continued to show COVID-19 symptoms after four weeks. The lead researcher (Ben Goldacre) noted that “we were surprised to see almost a hundred-fold difference in prevalence between population survey estimates and formally recorded diagnoses for the same condition”.
By mid-November 2020, CDC had reported about 10.8M COVID-19 cases and over 244,000 deaths. But when the University of Minnesota ‘Center for Infectious Disease Research and Policy’ did a cross-sectional study which was sponsored by Pfizer and Merck, the research revealed a sero-prevalence of 14.3% (suggesting median 46.9M infections), compared to the 10.8M cases reported by CDC. The report also suggested that 35% of deaths were unreported.
What these discrepancies between ‘reported cases’ and ‘sero-prevalence figures’ tell us, is that, no country can have a perfect grip of cases. A good number of cases (particularly asymptomatic and mild) may not present at health facilities and testing centers. Countries may therefore wish to get a true picture of the percentages of their populations which may have been exposed to COVID-19 but not captured in the laboratory-confirmed data. That is the function of the serologic study.
No country can test its entire population.
Sierra Leoneans should withhold our tongues from lashing out, and have full faith in the integrity of the Response as well as celebrate our hard-working health professionals. Rest assured, we are not doing anything silly here, we are a highly respected component of the global public health ecosystem (albeit under a severely challenged local health care system).
If the serologic study suggests that 45 times more may have been exposed to COVID-19, thank God we don’t have people falling like leaves. We regret any loss of lives and continue to commend our fallen loved ones to the richness of God’s mercies and eternal bliss. We can’t spend time arguing on figures. Rather, we will use the findings to recalibrate our posture and bolster our response capabilities. We will test more and also vaccinate more. We have run out of AstraZeneca doses (this means our people have appetite for vaccines). We ramped up from average 3000 to 5000 tests per week before the 3rd wave……we want to ramp up further. We will deploy antigen tests so that infections at health facilities (public and private) and in communities can be tracked. We will continue to do PCR tests and intensify our track and trace efforts. We will ramp up functional beds and give the best care to cases in treatment and care centers. Our risk communication and community engagement will be sustained -and we continue to ask all citizens to own this fight and see it as WAR on our lives and livelihoods.
Our key commitment is to beat the third wave and prepare to respond to any future waves. And so, we thank our partners here and abroad for their support, and advocate for Africa to have immediate access to vaccines so that we inoculate beyond the abysmal 1.5% of our continent’s population.
Sierra Leoneans, HAVE NO FEAR. GOD IS WITH US.
Solomon Jamiru Esq.