Permanent Secretary in the Ministry of Health and Wellness, Solomon Sekwakwa’s blunder was responsible Botswana’s first three recorded cases of coronavirus, and probably more.
Sunday Standard investigations have revealed that had Sekwakwa to reversed a directive by the Director of Health Services to enforce mandatory quarantine earlier last month, Botswana would have contained the first two cases of COVID-19.
A week before Botswana’s first two imported cases of Coronavirus slipped past border controls, Director of Health Services Dr Malaki Tshipayagae evoked provisions of the Public Health Act to enforce mandatory quarantine on all arriving travellers from affected countries for a period of 14 days.
A Savingram from Dr Tshipayagae addressed to HATAB dated 6th March 2020 states: following the latest World Health Organisation (WHO) on international travel and as per the Public Health Act (2013) in control of communicable diseases, the Ministry of Health and Wellness has taken a decision to enforce mandatory self-quarantine of all arriving travellers from affected countries for a period of 14 consecutive days, at their place of residence.
“Please note that those will be monitored by the Ministry of Health officers in their respective health districts. Furthermore, those who are here as tourists will be quarantined at their place of residence (hotel, guest houses, lodges, inns).”
The Director is empowered by the Act to enforce mandatory quarantine to control the spread of communicable diseases.
It is however, not clear if Permanent Secretary in the Ministry of Health and Wellness is empowered by the Act to reverse the Director’s decision.
Curiously, even before the ink on the director’s directive had dried, on March 7th, Permanent Secretary in the Ministry of Health and Wellness, Solomon Sekwakwa issued another Savingram, reversing the Director’s directive.
A Savingram signed by Sekwakwa and addressed to HATAB states, “ Reference is made to our Savingram REF:MH20/33 dated 6th March, 2020 in which the Ministry of Health and Wellness informed your office that the Ministry management has taken a decision to enforce mandatory self-quarantine of all arriving travellers from affected countries for a period of 14 consecutive days.
“The Ministry wishes to withdraw the correspondence with immediate effect. If there are any further developments you will be notified accordingly.”
The result was that Batswana returning from COVID-19 high risk countries were allowed to join their families and friends without putting them through quarantine, risking pre-symptomatic local transmission.
As it turned out, four days after Sekwakwa reversed the director’s directive and two days two days after the UK COVID-19 risk level was raised from moderate to high, a 27-year-old pre-symptomatic Motswana young man arrived from the UK. At the time, the UK had registered a total number of 1,140 cases with at least 21 deaths and was listed as a high-risk country.
He was however allowed to go home after being ‘advised’ to monitor his health. On March 28th he tested positive for the virus and the following day his partner tested positive too, recording Botswana’s first local transmission.
Minister of Health Dr. Lemogang Kwape could barely hide the disappointment on his face as he took the nation through the sequence of events leading to the first local transmission of the virus. The young woman (by the Minister’s own admission) had no travel history.
The ‘couple’, according to the Minister, tested positive for COVID-19 a day apart on March 28 and 29 following admission at Scottish Livingston Hospital (Molepolole). It was only two weeks following the gentleman’s arrival from the UK.
Molepolole is currently one of the COVID-19 flashpoints in Botswana and has been earmarked for contact tracing and testing.
In another case, on March 15th, eight days after Sekwakwa reversed the director’s directive, a pre-symptomatic Ramotswa old woman returning from South Africa with family members slipped past Botswana border controls. A few days later she was admitted to Ramotswa Lutheran Hospital, where she was tested for the virus. Her results were released post-humously, revealing that she was COVID-19 positive.
According to experts, cases of pre-symptomatic COVID-19 that fly under the radar without being detected may have fuelled the rapid spread of the virus. Experts say, ppeople with the virus but without symptoms or diagnosis because they did not feel very sick in the earlier stages, were the source of at least two-thirds of documented COVID-19 cases in China during the early days of the outbreak.
President Mokgweetsi Masisi this week dismissed Sekwakwa and his deputy Morrison Sinvula with immediate effect without citing reasons for their removal.