Friday, June 25, 2021

A Christmas to kill for?

While health authorities throughout the world are urging their citizens to stay home this Christmas, in Botswana home is a four-letter word this festive season. With no indigenous Motswana calling Gaborone home, health officials are worried that the A1 Christmas crush will be transporting the Covid-19 virus home from Gaborone which is the virus epicenter. The 2020 Christmas holidays have coincided with a rise in pandemic fatigue – people’s sense of being exhausted with changing their behaviour to help curb viral spread. This has resulted in a staggering number from Botswana’s COVID-19 epicenter seeking to travel to their home villages.

Botswana’s Presidential COVID-19 taskforce Tuesday said it has seen a worrying trend that those who seeking interzonal travel permits are from high-risk zones, especially the greater Gaborone area. In one of the last few days, the online travel permit system showed that over 150,000 people had active permits and have travelled outside their zones, said Dr. Mosepele Mosepele, the deputy coordinator of the taskforce team.

“This was a clear indication that people are ignoring the advice from health authorities to minimize traveling during the Christmas holiday period,” he said.

Botswana which has one of the highest rural to urban migrations in the world has a very peculiar demographic structure. Most of Batswana who migrate to the city never severe their links with their “home villages”, they own cattle and retain land in the village. These rural assets are valued both in monetary and social terms and serve as a valuable safety net for households with uncertain livelihood prospects within the city. And the looming retrenchments from the Covid-19 fallout just made those uncertain livelihood prospects real.

This is a lethal cocktail for Botswana which is already at a high level of community spread, and is seeing a lot of people making a beeline out of the virus epicenter to their home villages. It will also be a stress test for the country’s Covid-19 Case fatality rate (CFR) which is the third lowest in the world. Although Botswana has suffered a spike in Covid-19 infections in recent weeks, on the positive side, the country experienced a sharp CFR decline. The CFR is an index used to measure the mortality risk of COVID-19 – the likelihood that someone who catches the disease will die from it.

The latest report by the Johns Hopkins resource Centre, updated on 30th November 2020 indicates that although more people are getting infected, the infection is not as lethal as previously reported. Botswana’s COVID-19 daily infection rate has doubled in two months; however, the CFR has dropped by 50% during the same period. Botswana’s daily recorded cases hovered just above a hundred as recently as October 2020, at the time the country’s CFR stood at 0.6%.While the latest statistics paint a worrying trend in the daily infection rate, indicating a 100 percent increase over just a couple of weeks, the sharp decline’s the country’s CFR to 0.3% is something of a saving grace.

This means Botswana currently has the third lowest Covid-19 CFR in the world after Singapore at 0.05% and Qatar at 0.2%.Botswana share the third position with the United Arab Emirates which also has a CFR of 0.3%The World Health Organisation (WHO) uses among other indicators, the CFR which is the proportion of individuals diagnosed with a disease who die from that disease and is therefore a measure of severity among detected cases. The CFR is the number of deaths from the disease divided by the number of confirmed cases and multiplied by 100. 

However, with the country’s younger population from Gaborone transporting the virus to the frail and aging population in their home villages, Botswana may see a spike in its CFR. According to official statistics, Gaborone has the second youngest population after Jwaneng with more than 98% of its residents under the age of 65. Regarded as a workplace and not home, Gaborone has only 1.9% resident who are above 65 years, which is five years post retirement age. Most elderly people are in the rural areas: Kgalagadi North 9.4%, Central Tutume 8.1%, Central Bobonong 7.7%, Ngamiland West 7.1% Central Mahalapye 6.5%, Serowe Palapye 6.3% etc. According to the World health Organisation, “in many countries, older people are facing the most threats and challenges at this time.

Although all age groups are at risk of contracting COVID-19, older people face significant risk of developing severe illness if they contract the disease due to physiological changes that come with ageing and potential underlying health conditions.” International research has revealed that holiday season travelling is a Covid19 super spreader. According to Nature, a health and epidemiology newsletter “five million people left the city of Wuhan in China in preparation for the 2020 Lunar New Year holiday, an event that coincided with the start of the pandemic1. The holiday is one of the world’s largest mass migrations, when hundreds of millions of people travel to visit relatives.

“Elsewhere, such as in the United Kingdom, the epidemic followed a one-week school holiday break from 17 to 21 February, when thousands of people came back infected with the virus from ski resorts in northern Italy and tourist locations in Spain, says Zhengming Chen, an epidemiologist at the University of Oxford, UK. More recently, Canada saw its highest numbers of COVID-19 infections in the two weeks following Thanksgiving on 12 October.”

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