How Science Advice was Inhibited and Facilitated in Ghana during COVID-19
Professors from the Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana reflect on how the country adopted and used science advice during the pandemic.
Marian Asantewah Nkansah, Yeetey Enuameh, Daniel Gyaase and Llona Kavege
Countries the world over initiated measures to curb the spread of the novel coronavirus to secure the health of their citizens after it was declared a Public Health Emergency of international Concern (PHEIC). In Ghana, the government introduced several measures including legislative instruments and policies based on the advice of local and international scientific advisory bodies such as the World Health Organization (WHO).
Though Ghana’s response was lauded as exemplary in the early days of the COVID-19 outbreak, the country seemed not to have developed a clearly documented strategic plan of its own. The country at that time relied predominantly on policy directives and executive orders from the Presidency, the Ministry of Health and the Ghana Health Service (GHS) that were guided by technical committees, public health expert bodies and other science advisory bodies. These directives and executive orders were made in line with the constitution of the country. In November 2020, the Ministry of Health released the “Ghana COVID-19 Emergency and Preparedness and Response Project & Additional Financing” document – projecting the country’s plan to adopt a One Health model based on the World Bank’s new Environmental and Social Framework in managing the outbreak.
Ghana’s response to COVID-19 pandemic
The “whole of government approach” taken in response to the pandemic had five main objectives:
- Limit the import of new cases
- Prevent community spread
- Isolate and treat the sick
- Cushion the impact of COVID-19 on the economy and peoples’ social lives
- Increase domestic production and promote self-reliance
To curb the importation of new cases, the President of the country imposed quarantine and isolation measures for all travellers and further ordered border closures in March 2020. To prevent community spread, the Imposition of Restrictions Act 1012 was passed. Human movements and non-essential businesses were limited in several administrative regions of the country, public gatherings were banned and contact tracing efforts scaled up. Sites of large human activity such as schools and markets were fumigated. Isolation and treatment centers for suspected and confirmed cases of COVID-19. The testing, tracing and treatment (3T) program was also launched.
To cushion the pandemic’s impact, preparedness plans were instituted to support persons and families in quarantine. Insurance packages and allowances were distributed to support frontline and healthcare workers, and subsidies for electricity and water pills were passed to avoid excessive financial burden on the public. These efforts notwithstanding, limitations to efficient science advisory and policy responses in Ghana included a lack of intragovernmental technical and advisory coordination, infrastructure, a lack of transparency in the form of information vacuum, and poor and inconsistent communication between experts and main stakeholders.
Facilitators to science advice
Early preparedness and response
The Disease Surveillance Department of the Public Health Division of GHS and Ghana Field Epidemiology and Laboratory Training Program conducted a readiness assessment and developed a response strategy including training on contact tracing before the recording of the first case in the country. The various entry points into the country were oriented on effective screening and handling of suspected cases.
Communication with the public
The President of Ghana became “the face” of the COVID-19 fight regularly addressing the Nation on measures taken to protect the population against the pandemic, and sharinginformation on total and new infections, categories of severity and recovery, as well as outlining new directives.
In-country and international collaborations
In-country collaborations were public-public and public-private sector collaborations. The WHO was the main international collaborator.
Science, technology, and Innovation
Testing and certification processes of relevant new products and devices were fast-tracked by the designated state institutions. Costs were waived in instances to encourage the participation of citizens and businesses.
Inhibitors to science advice
Management of limitations on human movements
Lockdown measures were introduced on March 16, 2020 after reports of the first confirmed cases covered only the two largest cities of Ghana i.e., Accra and Kumasi, which were hotspots at the onset of COVID-19. There was a massive emigration out of these cities during the interval between the announcement of the lockdown and its implementation, resulting instead in the spread of the disease to hitherto uninfected communities.
Tracking infection dynamics in real-time
Delays in the release of test outcomes resulted in difficulties in tracking daily infection trends earlier during the pandemic. Bulk results released periodically did not provide a clear picture of infection trends. A pooled sample testing method employed by Ghana was observed to have contributed to such delays.
Some updates of the status quo by government were perceived to be veiled political or campaign messages. Some appointments of individuals and committees of experts were met with shadow appointments by opposition parties. Such happenings could potentially have marred the coherence of decision-making and messaging during the pandemic.
Conspiracy theories and miscommunication about COVID-19
Conspiracy theories were centred much more around religious beliefs than hoaxes. The disease was believed by some to indicate the end of times. Others perceived the lockdown as a means to increase the use of the internet. While other messages portrayed the 5G network as causing the disease. There were those who perceived the vaccination programme to be a means of labelling the population with the mark of the Anti-Christ. Unfortunately, some of the religious leaders were the proponents of such theories.
Violations of the safety protocols
After limitations on movements and gatherings were lifted, most people did not adhere to earlier safety protocols instituted. Several social events went on with minimal or no regard for safety protocols.
Science Advice featured prominently in the management of the COVID-19 outbreak in Ghana. Some events served as facilitators or barriers to science advice on managing the outbreak. Notwithstanding the several inhibiting factors, science advise in diverse forms from equally diverse sources ultimately contributed to decisions that protected most of Ghana’s population from the extreme adverse outcomes of the outbreak.