Crazy management of Covid-19 in Rwanda

By The Rwandan Analyst

Covid-19 pandemic touched quite all world countries including Rwanda where are estimated 40798 cases and 453 deaths. Among 13millions of inhabitants, only 300 thousand received at least the first vaccine of Pfizer ; AstraZeneca; Biontech ;Vaccin Oxford ;JohnsonJohnson which were donated by various rich countries such as UK; US; France, India, etc… The present article discusses strategies put in place by the rwandan government to curb this ravaging pandemic inside the country.

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was identified in WuhanChina in December 2019. The disease has since spread worldwide, leading to an ongoing pandemic

Symptoms of COVID-19 are variable, but often include fever, cough, headache, fatigue, breathing difficulties, and loss of smell and taste. Symptoms may begin one to fourteen days after exposure to the virus. At least a third of people who are infected do not develop noticeable symptoms. Of those people who develop noticeable symptoms enough to be classed as patients, most (81%) develop mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspneahypoxia, or more than 50% lung involvement on imaging), and 5% suffer critical symptoms (respiratory failureshock, or multiorgan dysfunction). Older people are at a higher risk of developing severe symptoms. Some people continue to experience a range of effects (long COVID) for months after recovery, and damage to organs has been observed. Multi-year studies are underway to further investigate the long-term effects of the disease. 

Transmission of COVID-19 occurs when people are exposed to virus-containing respiratory droplets and airborne particles exhaled by an infected person. Those particles may be inhaled or may reach the mouth, nose, or eyes of a person through touching or direct deposition (i.e. being coughed on). The risk of infection is highest when people are in close proximity for a long time, but particles can be inhaled over longer distances, particularly indoors in poorly ventilated and crowded spaces. In those conditions small particles can remain suspended in the air for minutes to hours. Touching a contaminated surface or object may lead to infection although this does not contribute substantially to transmission. People who are infected can transmit the virus to another person up to two days before they themselves show symptoms, as can people who do not experience symptoms. People remain infectious for up to ten days after the onset of symptoms in moderate cases and up to twenty days in severe cases. 

Several testing methods have been developed to diagnose the disease. The standard diagnostic method is by detection of the virus’ nucleic acid by real-time reverse transcription polymerase chain reaction (rRT-PCR), transcription-mediated amplification (TMA), or by reverse transcription loop-mediated isothermal amplification (RT-LAMP) from a nasopharyngeal swab.

Preventive measures include physical or social distancingquarantining, ventilation of indoor spaces, covering coughs and sneezes, hand washing, and keeping unwashed hands away from the face. The use of face masks or coverings has been recommended in public settings to minimize the risk of transmissions.

While work is underway to develop drugs that inhibit the virus (and several vaccines for it have been approved and distributed in various countries, which have since initiated mass vaccination campaigns), the primary treatment is symptomatic. Management involves the treatment of symptomssupportive careisolation, and experimental measures.

Strategies

Preventive measures to reduce the chances of infection include getting vaccinated, staying at home, wearing a mask in public, avoiding crowded places, keeping distance from others, ventilating indoor spaces, managing potential exposure durations, washing hands with soap and water often and for at least twenty seconds, practising good respiratory hygiene, and avoiding touching the eyes, nose, or mouth with unwashed hands. 

Those diagnosed with COVID-19 or who believe they may be infected are advised by the CDC to stay home except to get medical care, call ahead before visiting a healthcare provider, wear a face mask before entering the healthcare provider’s office and when in any room or vehicle with another person, cover coughs and sneezes with a tissue, regularly wash hands with soap and water and avoid sharing personal household items. 

The first COVID-19 vaccine was granted regulatory approval on 2 December by the UK medicines regulator MHRA. It was evaluated for emergency use authorization (EUA) status by the US FDA, and in several other countries. Initially, the US National Institutes of Health guidelines do not recommend any medication for prevention of COVID-19, before or after exposure to the SARS-CoV-2 virus, outside the setting of a clinical trial. Without a vaccine, other prophylactic measures, or effective treatments, a key part of managing COVID-19 is trying to decrease and delay the epidemic peak, known as “flattening the curve”. This is done by slowing the infection rate to decrease the risk of health services being overwhelmed, allowing for better treatment of active cases, and delaying additional cases until effective treatments or a vaccine become available. 

Analysis of Rwandan covid-19 policies

The lines below assess the implementation of those world health organisation standards to curb the covid-19 pandemic in Rwanda. 

Contestable statistics

In a hospital located in northern province, a medical expertise was issued stating that a victim of road traffic accident was dead due to covid-19. Parents of the deceased claimed that insurance companies will not pay the damages as the cause of death is not a road accident; the hospital authorities were then compelled to change their minds and delivered a new expertise.Thanks to our exchange with some staff of Rwanda Biomedical Center  notably physicians working in the field of pandemic survey, we succeeded to know that statistics published are generally false just serving to intimidate the rwandan public and attract donors who feed budgets of countries suffering from effects the covid-19 pandemic on their economies. Indeed, undoutedly, any observer many wonder the reason which Uganda and Rwanda are working as isolated islands while they are landlocked shouting loudly about the covid spread whereas neighboring countries like Tanzania ; Kenya ; Burundi ; South Sudan ; Democratic Republic of Congo are not worried by this ephemeral influenza. A friend of mine part of staff who publish those statistics revealed that those numbers are just manufactured for political and financial purposes in the detriment of rights of citizens and huge losses involved. 

Lack of survey

All measures were taken infringing human rights of citizens such as prohibiting movements throughout districts ;consumption of alcoholic drinks ; limiting social distances ;wearing masks and washing hands. However, any study was not conducted to report their respective impacts on the spread or limitation of the pandemic throughout the country. Therefore, there is wondered parameters on which the state bases its resolutions to alleviate or worsen the limitation clauses vis-a-vis the rwandan citizens

Crazy solutions

A series of alternatives were taken by the rwandan government to curb the spread of this pandemic.What is their real efficiency to produce tangible results.

Prohibition of bars and alcoholic drinks

People taking alcoholic drinks are severely sanctionned with heavy fines while those drinking lemons are tolerated as if the alcoholic drink contains covid. Indeed, even in restaurants, people eating and taking lemons or juices are in good way but when surprised eating and drinking beer you are immediately arrested and detained and you are released after having paid 15OOO Rwf ;the owner of the restaurent is fined with 450 thousand, a deterring fine which results in the definitive closure of his/her business.

Prohibition of travels between districts

People remain in their districts and if they are contaminated they continue to infect each other and finally all districts are attained because the virus was not curbed inside the district. 

Prohibition of religious worship and meetings

In some specified districts religious ceremonies and service meetings are absolutely banned ; in others, they are limited to 30% of the ordinary number whereas markets are open whereby sellers and buyers touch each other exchanging merchandises and banknotes.

Washing hands and dressing masks

The only thing people succeeded is washing their hands but as many persons touching taps, this does not insure safety.As masks disturb free respiration few persons correctly put their masks and their permeability does not assure at 100%.

Social distancing 

Social distancing of one meter at least prevents the access of the virus because according to specialists contrarily to other microscopic viruses, this virus is heavy that it falls before attaining an objective located in one meter distance ;as solution there is advised to make a distance between people avoiding their direct contacts.

To make this feasible, buses have to load 50% of their ordinary passengers.There is then wondered whether there is possible a put is meter distance in a car while meantime motorcycles and bicycles whose size does not exceed 1 meter go on transporting clients; hair saloons where customers and hair dressers are tightly sitted are not worried. 

Avoiding crowded indoor spaces and ventilation

The CDC recommends that crowded indoor spaces should be avoided. When indoors, increasing the rate of air change, decreasing recirculation of air and increasing the use of outdoor air can reduce transmission. The WHO recommends ventilation and air filtration in public spaces to help clear out infectious aerosols. Exhaled respiratory particles can build-up within enclosed spaces with inadequate ventilation. The risk of COVID-19 infection increases especially in spaces where people engage in physical exertion or raise their voice (e.g., exercising, shouting, singing) as this increases exhalation of respiratory droplets. Prolonged exposure to these conditions, typically more than 15 minutes, leads to higher risk of infection.

This efficient solution is jeopardized with students of primary and secondary cycles who must take busses to go or leave schools who collide in the stations; markets which are open and where buyers and sellers cannot materially respect social distancing 

Curfew

Now people are obliged to be at their homes not later than 6h p.m and leave their residences after 4h a.m. The issue not yet addressed is relationships between covid-19 spread and the nighty hours where nevertheless people non longer gather as they tend to sleep.

This absurd alternative is a serious violation of fundamental rights of citizens while any rational explanation is not provided and prejudice all lucrative activities such as hotels ;tourism ; restaurants ; supermarkets ;all but a few ;cause road accidents from drivers hurried to not exceed the deadline beyond which sanctions are not affordable.

Conclusion

Considering the foregoing, covid-19 pandemic was an occasion to infringe human rights including impoverishing rwandan poor populations who are dying of hunger as all market ways are closed. Worse, the solutions decided by the masters of Kigali are mostly absurd and help the click to cover embezzlement of funds they regularly get from donors while meantime they raise up taxes against traders who already lost their economies ; schooling children underwent a blank year while their children were allowed to attend online courses scheduled by their costing schools (école belge; la riviera; green hills academy; école française Saint Exupéry, etc.) inside or studying abroad ; staff of  private institutions who were automatically suspended by their employers who were not able to maintain the contractual commitments. 

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