Letters

Danger lurking in Covid movement curbs

lockdown

Police officers at a road block during a Covid lockdown. PHOTO | EVANS HABIL | NMG

Summary

  • If public health campaigns are long and measures employed adversely impact on lifestyles and livelihoods compliance may diminish as time goes by as a result of suffering, frustration, disillusionment and fatigue.
  • Efforts aimed at curtailing spread of the virus have adversely affected lifestyles, resulted in loss of livelihoods and possibly also caused increased incidence of psychosocial disease and other ailments.
  • What is not clear is the benefit or benefits derived from movement restriction as a public health measure for control of Covid-19 among the LIMCs.

Public health measures employed to curtail development and spread of disease should ideally pose no harm to targeted communities.

The measures can, however, result in undesired effects or turn out to be ineffective if health campaigns and interventions are not well thought out. The effectiveness and uptake of public health measures may also be influenced by beliefs, behaviours and cultural practices of target populations.

If public health campaigns are long and measures employed adversely impact on lifestyles and livelihoods compliance may diminish as time goes by as a result of suffering, frustration, disillusionment and fatigue.

Important factors for achieving success with public health ventures are: Evidence-based interventions with major impact, regular monitoring and evaluation of strategies employed, public-private sector collaboration, political commitment and frequent updates for health care providers, decision makers and the public.

Focus on these key areas have resulted in success of public health campaigns targeting control of smoking, tuberculosis and polio.

In the case of Covid-19 and especially in poor countries, success of public health measures employed continues to be elusive more than one year after commencement. Efforts aimed at curtailing spread of the virus have adversely affected lifestyles, resulted in loss of livelihoods and possibly also caused increased incidence of psychosocial disease and other ailments.

The key containment strategies for Covid-19 have been respiratory hygiene (face masks, and cough etiquette), hand hygiene (washing hands frequently and avoidance of handshakes), social distancing, containment or movement restriction (curfew and lockdowns) and vaccination.

Some of these were largely already recognised by the public as good health practice but others were new and were accepted as temporary measures to be observed for control of the pandemic.

When Covid-19 cases were reported to be rising in spite of the measures the public got wary and desperate especially those dependent on daily wages. It soon became apparent to the public that suffering and death could occur as a result of either Covid-19 or serious socioeconomic difficulties resulting from containment measures.

Industries that rely on free movement or a 24-hour economy have been adversely affected by Covid-19 movement restriction orders. This is clearly a scenario where the treatment is deleterious or perhaps even worse than the disease itself.

What has been lacking is evaluation of the impact of the public health measures on lives and livelihoods of individuals, families and the country. Evaluation and monitoring should especially focus on potentially harmful measures such as movement restriction.

The goal of lockdowns is to slow down disease transmission to prevent health facilities from being overwhelmed, says Oghenowede Eyawo. This strategy can be effective if well thought out, efficiently executed and if it is frequently monitored and evaluated. Unfortunately, it impacts negatively on the socio-economic situations of people and especially those residing in Low- and Middle-Income Countries (LMICs).

Research shows that movement restriction has a negative impact on the socioeconomic status and general well-being of people living in LMICs.

CROWDED AREAS

What is not clear is the benefit or benefits derived from movement restriction as a public health measure for control of Covid-19 among the LIMCs.

Furthermore, if you coop up communities already living in overcrowded set-ups, won’t you make them more vulnerable to respiratory tract disease like Covid-19 and other ailments?

Isn’t it better to let them get out and get on with their businesses while at the same time encouraging them to practice the other evidence-based public health measures: Wearing of masks, good hand hygiene and social distancing?

There is insufficient evidence in support of using curfew and lockdowns as public health measures for control of Covid-19 in poor countries and furthermore these strategies are potentially harmful to the general welfare of poor communities.

Joseph Kimani Wanjeri, public health PhD student