Thursday, June 4, 2020

How to save lives as we sustain livelihoods

Covid 19  temperatures A health worker demonstrates how to take temperatures from a patient during a drill on how to handle a patient who has signs of Covid 19 at Mt Kenya Hospital in Nyeri on March 17, 2020. FILE PHOTO | NMG 
DENNIS KABAARA

Summary

    • Kenyans appear eager for a “return to normalcy“ - our “hustles”, schools, pubs and churches - without masks, or social distancing.
Friday is 84 days (12 weeks) since the first coronavirus case was confirmed in Kenya. Last night was our 70th of the nationwide dusk to dawn curfew; today is also the 60th day of the first movement restrictions we called “soft” or “partial” lockdown. At the time of writing this column, Kenyans appear eager for a “return to normalcy“ - our “hustles”, schools, pubs and churches - without masks, or social distancing.
Which brings me to the subject of “reopening”. From casual observation, the world is still learning about this virus, and the Covid-19 disease, and testing to find out if the virus exists, not the antibodies to fight it. We don’t know if, and for how long, recovery confers immunity. A vaccine is some way off, especially in eventually scaling it for global availability. Simply, this virus will be around for a while.
It is also true that Kenya is suffering an economic shock. Central Bank Governor Patrick Njoroge expressed fears last week that 75 percent of SMEs could fold this month. Think about sectors like trade, transport, hospitality and entertainment. Recent KNBS Labour Force data says we’re shedding jobs. It isn’t rosy for agriculture and manufacturing either, even as we’ve “mothballed” education.
Yet, the health emergency and economic shutdown represent two parts of a "trilemma" that includes a social/societal dimension we tend to ignore. From risk taking behaviour at one extreme to stigmatisation at the other. From disruptions to community, family and household life to a “new normal” of “contactless” social connections and interactions. Mental health falls in this space too.
Sadly, this highlights the untrue contrasts we make between health, economy and society; or Lives, Livelihoods and Living. How do we “remake Kenya” along these lines; not just “reopen the economy”?
We could quickly glance at what others are doing. After their lockdown, Uganda has begun a phased and socially-distanced “reopening” - private and public transport is back (except in border districts), as are stalls and malls, but schools, gyms, salons, bars and places of worship remain closed for now.
South Africa’s “reopening” from its own lockdown is based on a clever data-driven, five-level alert system that maps easing or tightening of allowable business activity and movement restrictions against the status of the pandemic in terms of the rate of virus spread, and the readiness of the health system.
In both cases, “reopening” is a phased process, not a single, headline-making, eye-catching event. For both countries, “reopening” is not “one size fits all” (the whole country) in “big bang” fashion, it is carefully calibrated to different internal local or regional circumstances. Mostly, these are “homegrown” processes, not imported ideas. All pointers that Kenya and Kenyans could learn from.
What, then, might the outlines of a careful and phased agenda for Kenya look like? On lives (the health dimension); controlling virus spread is important, as is the strengthening of health capacity and enhanced testing (where we lag South Africa, Ghana, Ethiopia and Uganda in absolute terms, and South Africa, Ghana, Uganda, Rwanda and Senegal relative to population size). So too contact tracing, surveillance and other virus monitoring, plus non-pharmaceutical interventions (NPIs).
There’s a critical point to repeat here: without a cure or a vaccine, the priority is to reduce and control new infections. This includes a focus on protecting vulnerable groups away from broader lockdowns.
On livelihoods (the economic dimension); the strong view remains that the quantum and quality of support to the private sector and the public has been woefully inadequate and still needs to be ramped up. Private sector must also lead in implementing the right workplace guidelines, tools and practices.
Add to this mapping of private sector and workers (especially youth) to assess different sub-sectoral impacts between risks to the economy and jobs, and risks of new virus spread and reproduction. Three “keywords” are central to this dimension; “resilience, sustainability and self-reliance”.
On living (the social dimension), it’s time to take a different approach.
“Bash and clobber” is no way to “flatten the curve” or fight the virus as we must now do better collectively and more aggressively.
This is the time to get Kenyans to fully buy into the overall “remake” strategy; to get us to embrace NPIs (hygiene, hand washing, masks, social distancing). Two “keywords” here; “trust and participation”.
Assuming we can get to a careful, phased and preferably multi-level “Lives, Livelihoods, Living” process agenda that is data-driven and targeted, and not “spray and pray”, one final thought comes to mind. How do we bring digital into this “remake” for a “contactless” Covid-19 world? Food for thought.

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