By Aidan Eyakuze, Dar es Salaam TANZANIA
Sweden is being vilified for pursuing herd immunity against Covid-19 at the relatively high cost of lives. The UK tried it for a while until the rising number of deaths – both real and projected – forced the government to introduce a lockdown.
Tanzania’s approach has been
different. Rather than putting people on lockdown, we have put data on
lockdown. People are more or less free, even encouraged to roam, while
observing largely voluntary protective behaviours: mask-wearing, hand washing
and social distancing.
Data, meanwhile, is under tighter
control than ever before.
No data has been released on the
numbers of Covid-19 cases or deaths since April 29, 2020. The number of tests
reported as having been carried out is just 652, compared to over 100,000 in
neighbouring Uganda, 95,000 in Kenya and 75,000 in Rwanda by June 5, 2020.
Tanzania’s President John Magufuli,
has spoken of the fear-inducing effects of data and the harm that this can do,
and has cast doubt on the reliability of testing done at the national
laboratory.
Night burials have stopped (or
been stopped) and quarantine locations and hospitals are empty (or have been
emptied).
On May 27, the Medical Association
of Tanzania noted a significant reduction in Covid-19 cases, but did not
provide any data to support their assertion.
When the data is on lockdown,
such statements can be neither verified nor contradicted.
We seem to be pursuing a strategy
of herd immunity. And we are doing it in data darkness.
Government has little control
over the virulence of Covid-19 in its jurisdiction. But it can control how that
virulence is communicated to the public and how citizens perceive the situation.
Government can shape perceptions of reality much more than they can influence
the facts.
In Tanzania’s case it has done so
by suppressing the data.
Citizens’ understanding of the
virus shapes their expectations and actions. If their perceived reality is
better than expected, people lose their fear of Covid-19, faith and trust in
the official story is strengthened and they change their behaviour accordingly:
let us go to the beach and have a party!
However if citizens’ experience
of the outbreak is worse than expected – growing infection numbers, more deaths
– people will lose faith in the official story. An erosion of trust is a
serious risk for a government looking for re-election in October this year, as
is the case for President Magufuli’s administration.
Data from neighbouring countries
help to shed some light on the extent of Covid-19 in Tanzania. Ugandan authorities show
that at least 45 Tanzanian truck drivers having tested positive in Uganda and
repatriated between April 23 and May 25. Similar stories from the borders with
Kenya and Zambia have been reported.
More scientifically, modelling
done by the MRC Centre for Global Infectious Disease Analysis at Imperial
College London was published on May 26, 2020. Using official death data – from
when Tanzania was still reporting such data – as a starting point, the model
estimated the true number of infections in Tanzania during the 4 weeks between
April 29 and May 26, 2020 to be 24,869.
If true, Tanzania would have
replaced South Africa (with 23,615 cases) as Africa’s coronavirus epicentre.
The model’s estimates of daily
deaths make for less alarming reading, suggesting that “if current levels of
interventions are maintained”, by June 8, coronavirus related deaths would fall
somewhere between four and 27 fatalities per day. That is a small fraction of
the average number of daily deaths experienced in pre-Covid19 Tanzania of
1,011.
Or to put it differently, a few
extra deaths – reported as “pneumonia”, for example – can easily be shrugged
off by government, and then also by citizens, as nothing unusual.
If, and it is a big if, the
outbreak in Tanzania really takes hold, however, similar models estimate as many as 200,000 fatalities
from an unmitigated outbreak. That would be much harder to hide.
The numbers may well turn out
lower – I really hope so – and the government may retain control of the
narrative. But if the models prove to be anything close to accurate, the cost
will be huge. People will die unnecessarily. And public trust will be seriously
damaged.
Hiding the truth may be a short-term
win for the government, but one that could have devastating consequences in
future. Transparency – even when the news is bad – would build trust that at
least the government has the common interest at heart and is doing its best to
protect lives.
The future is unknown. Everyone
hopes that the worst outcomes suggested by epidemiologists are avoided. But
locking down data while encouraging people to move around as normal won’t make
this easy.
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