Bissau — After a dramatic increase in the number of confirmed cases of COVID-19 in Bissau city, the pandemic prevention and response activities in the country must be intensified. Better coordination and a scale-up from all actors responding to the pandemic are essential in protecting the population and health workers.
There has been an alarming increase in the number of COVID-19 cases in Guinea Bissau, most of which have been registered in Bissau city. The number of people infected with the virus has increased by fifteen in the last 14 days, from 54 on 30 April to more than 836 at the time of writing, leaving the country one of the most heavily affected in Africa in terms of cases per capita.
"In a small country like Guinea Bissau with a population of an estimated 1.9 million, and 250,000 people in Bissau city – the epicentre of COVID-19 in the country – this dramatic increase shows that the virus continues to spread in communities and faster than we thought," explains Monica Negrete, MSF Head of Mission in the country. "It also confirms that we are indeed on an upward trend of contamination, despite the preventive and response measures adopted by the authorities."
So far, three deaths have been officially reported. But with soaring numbers, it is possible that some deaths have not yet been registered.
Another worrying fact is that a large number of medical staff at the Simao Mendes National Hospital (HNSMS) have contracted COVID-19 and are currently in quarantine unable to work.
Furthermore, the high level of stigma and people's significant lack of knowledge about the disease in the country, makes the situation even worse and complicates any possibility of stopping the spread the epidemic.
Since the beginning of February, MSF has been participating in the national emergency committee for COVID-19 in Guinea Bissau. Decisions and actions in response to the health emergency are discussed and coordinated between government authorities and the various international organisations present in the country.
"Although measures have been put in place, such as isolation zones in designated health facilities and basic case management, the response is currently insufficient and often poorly coordinated at all levels in Bissau city and other regions," said Negrete. "International agencies, the UN system and other local actors involved in the response to COVID-19, must urgently redouble their efforts as there are still many needs that are not covered. The seriousness of the figures today requires strong leadership and commitment at the highest levels".
A better coordination based on transparency and solidarity is urgent to ensure that COVID-19 response plans are well disseminated and understood by the population.
MSF is calling on all actors responding to the pandemic in Guinea Bissau to make every effort to scale up activities at all levels. The following must be prioritised:
- Health workers in the country who are on the frontline responding to COVID-19 must be protected, in particular through the provision of the necessary personal protective equipment and other infection, prevention and control measures. In all health facilities, contingency plans including isolation zones and basic case management capacity such as oxygen, should be urgently put in place.
- Reinforcing epidemiology at national and regional levels and assuring data register and organisation at laboratories, contact tracing and monitoring of suspected and confirmed cases, are vital to understand the situation and take appropriate measures.
- Community engagement is also key: the population needs to understand the risks associated with COVID-19 and the appropriate measures to take to mitigate the spread of the disease. It is crucial to continue work in proximity with communities to provide home-based care and protect people. Regular awareness-raising activities should be provided with the involvement of communities and civil society.
- The COVID-19 response measures should not stop the most vulnerable people reaching essential healthcare services. Humanitarian assistance must be insured, particularly in guaranteeing the national and international movement of humanitarian health workers.
Finally, the response to COVID-19 should not completely absorb the country's available resources. The health system in Guinea Bissau is already extremely weak, and there is a risk that the reallocation of resources might come at the expense of other health priorities. More mobilisation of international actors and means are essential for protecting the health of population.