Mozambique must enforce distancing measures as covid-19 spreads, experts say

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As new chains of community transmission of covid-19 are discovered daily across Mozambique, public health experts say the government should more strictly enforce lockdown measures.

“Unfortunately, difficult moments are approaching and are inevitable” Eduardo Samo Gudo, deputy director of the National Health Institute told Zitamar News. While infections in Mozambique are still expected to peak in January and February 2021, “from here to there the curve will be increasing,” he said.

The window of opportunity to avoid a catastrophic situation in the country is getting smaller,  the Mozambican Minister of Health, Armando Tiago, told journalists on Friday.

On Monday, Mozambique recorded its first death from covid-19: a 13-year-old girl from Nampula with underlying health complications. However, as the number of cases of covid-19 rises beyond 200, and community transmission increases, the health ministry anticipates more patients will need to be hospitalised and there will be more deaths from the disease, Samo Gudo said. The national health system will come under great pressure and may not be able to respond adequately, he warned.

The State of Emergency, which has already been extended once, ends on 30 May. The government has the power to extend it one more time until 30 June.  President Nyusi is expected to make a decision this week on what new measures should be introduced to prevent the virus spreading still further. 

Now that the virus has reached the community transmission phase — when the disease spreads between people who have not had contact with other outbreaks outside of their community — stronger measures are needed to limit the movement of people, public health specialist, Jorge Matine said.

Despite the measures adopted to encourage physical distancing of people, at the moment many continue to operate as normal, he said. “One of the clear indicators that circulation continues almost in the same way is the level of pressure on public transport as well as the usual traffic jams” he told Zitamar.

Another problem, according to Matine, is how health authorities treated Mozambicans returning from South Africa, who were tested in transitional reception centres and allowed to go home before the results of their samples were revealed.

“This has caused many to transmit unknowingly to other members of their communities,” he said, predicting “more complicated days” for the general population as well as the national health system — as containing transmission in suburban and rural areas will be “more difficult” than in cities.

“In the cities it’s relatively easy to direct people to stay isolated and take care, but the conditions in poor areas do not allow for this — or only a little,” Matine said. “The authorities will have to prepare themselves for home quarantine control because there is no room for institutional quarantine”.

However, Matine says there is no need to implement phase 4 of the state of emergency, also known as lockdown, yet, arguing instead that the government should better implement the prevention measures currently in place.

“What we are seeing is that as in the first State of Emergency, people are still relaxed and nobody is enforcing the implementation of measures in their entirety” he said, stressing that there is now a greater need to confine people, as more people are infected. 

However, the key issue is how to stop the pandemic spreading in conditions of extreme poverty where people live hand to mouth, said economist João Mosca from the Mozambican think tank Observatorio do Meio Rural, which advocates, among other measures, for the distribution of food  to poor neighborhoods, as well as the distribution of money to families without resources or business.

These measures should be accompanied by compliance with personal hygiene rules, the strengthening of health services, ensuring the functioning of key economic sectors in the context of the crisis, and severely penalising non-compliance and behaviour of economic exploitation, he added.

The most recent measure adopted to mitigate the impact of the new coronavirus, is the 10% reduction in energy prices for all consumers made by Mozambique’s state power company EDM. However, this measure will have little or no impact for the very poor, and the government should ensure water and energy bills are not issued at all, Matine said.

Only one of Mozambique’s 11 provinces, Niassa, is yet to be impacted by covid-19. In Cabo Delgado has been hardest hit, with 116 confirmed cases, two of whom are health professionals.

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