All primary contacts of six known cases have been isolated – says president Bio

Sierra Leone Telegraph: 8 April 2020:

President Julius Maada Bio has today given an account of the successes, challenges and lessons learnt from the three days national lockdown which ended last night, as he encouraged all Sierra Leoneans to help with the increased surveillance at community levels, and for more citizens’ participation in the fight against the Coronavirus.

Speaking this afternoon in State House, this is what the president said:  

Let me take this opportunity to express my gratitude to Sierra Leoneans for their sacrifice in complying with advice from our healthcare experts. You have demonstrated that we all care deeply about our collective health and the future of this nation.

I thank citizens, communities, our healthcare professionals, service men and women, the Sierra Leone Association of Journalists, Civil Society Organisations, corporate groups and more, for their outstanding cooperation.

The threat of the highly infectious and deadly Corona virus (COVID-19) is real and it is with us. As at this morning, we have identified seven positive cases so far. These are difficult times for those persons and their loved ones. Let us pray with them and stand with them as a nation. Let us practice empathy and let us desist from all actions that may lead to stigma for the patients.

Let me also add that our monitoring and surveillance systems may not have been picture perfect but they have worked to capture each of the known cases. We will continue to make them even more robust.

We continue to strongly urge citizens to wash their hands often with soap and water, leave home only if you have to and stay away from crowded places, use facial masks, and observe cough etiquette.

THE LOCK DOWN

The lock down was a necessary public health intervention

1. To scale up surveillance, contact tracing, and testing for all known cases;
2. for possible new cases, to detect, isolate, and quarantine those persons;
3. to map out the possible spread of COVID-19 in Sierra Leone;
4. to re-assess and strengthen our COVID-19 pillars and institutions;
5. to re-align agenda and goal-setting across government and with development partners; and,
6. to deploy additional expertise and resources to fight COVID-19.

The Interim National Coordinator and his team have now provided government with a comprehensive report for consideration. We will predicate all future actions on what we have learned so far.

I will briefly discuss some of them and request the Minister of Health and Sanitation and the Interim National Coordinator and Minister of Defence to provide more detail.

PRIMARY TARGETS

For the primary targets of the lockdown, we achieved the following:

1. 100% of primary contacts for the six known cases were identified, isolated, and are now being monitored;
2. Nearly 78% of secondary contacts of the six cases were identified and are being monitored;
3. 205 persons under quarantine were visited by security, psychosocial, and surveillance personnel;
4. The Ministry of Information engaged all national television and radio stations and 61 community radio stations throughout the lockdown. Daily press briefings at the EOC will continue.

BEYOND THE PRIMARY TARGETS – We

1. Increased the surge capacity of our response staff – case investigators, contact tracers, and quarantine officers.
2. Expanded testing laboratories to five testing laboratories and the activation of a regional laboratory in Kenema
3. Will increase the number of treatment beds from 30 to 70 with the preparation of Jui. We have also assessed other potential treatment centres in the Western Area;
4. Conducted case management and Infection Prevention and Control training for 174 healthcare professionals with a plan to cascade that training to the regions;
5. Supplied food to all quarantine homes;
6. NACSA also provided Le4 billion worth of food and other essential support to our most vulnerable populations including persons living with disabilities;
7. Our security forces worked hard to enforce the lockdown. In addition to other duties they were deployed to quarantine sites, and also apprehended 5 transport boats and 36 crew.
8. The Ministry of Water Resources worked with Guma Valley and SALWACO to supply water across Freetown and the Western area;
9. Ministry of Information is also supporting seven CSOs to undertake social mobilisation nationwide.

TECHNOLOGY

We are pleased to announce that:

1. All data have been synchronised and harmonized on the national District Health Information systems platform including contacts, traveller records and laboratory tests conducted;
2. The EOC now has high speed cable wireless infrastructure and other systems for improved communication and connectivity including a virtual EOC;
3. We have mobilised Sierra Leoneans with technical expertise from government and the private sector to develop apps and solutions to support the COVID-19 response.

CHALLENGES

We have also identified a number of challenges, most of which we are working to resolve:

1. Issues with wrong contact details and wrong addresses for contacts, particularly for secondary contacts – we are urgently considering emergency regulations so that the provision of any wrong information relating to COVID-19 alerts and contacts would be a criminal offense.
2. Stigmatisation of contacts is leading to non- cooperation – moving forward, we intend to use unique identification tags for contacts and we will increase public communication to enhance cooperation and lessen stigmatisation;
3. Quality control of contact tracing and surveillance data – DSTI is supporting the design of digital contact tracing with geo-coding;
4. Efficient use of testing supplies: tests should be run in a batch to make best use of supplies, but specimen collection is varied. We are developing a repository system for pooling samples and a central dispatch system.
5. Coordination between actors working on Quarantine (Surveillance, Labs, Security, and Psychosocial), including difficulty locating homes and some homes not receiving daily food provisions – We have developed new standard operating procedures and DSTI is supporting data collection tools to improve tracking;
6. Unofficial disclosure of lab results – There is strong communication with lab personnel and we are developing a bar code system for future use.;
7. Positive COVID cases from the health sector causing significant risk to ongoing health services (specifically ODCH and NEMS) – We are working on reviewing workforce safety strategies;
8. Non-COVID deaths in community during lockdown – RED CROSS stepped in to support corpse collection to mortuaries
9. Admission to health facilities has gone down drastically, as public fears COVID (from 100% occupancy at ODCH to below 25% today) – We want to encourage the public to use hospitals.
10. Transportation for healthcare workers during lockdown – we will add more buses and enhance coordination
11. Health workers anxious about their own protection –EOC & MOHS staff conducted case management training and visited case management facilities with a view to boosting confidence and morale;
12. Some contacts are self-quarantining, raising concerns – MOHS has assessed all self-isolation for safety
13. Maritime security: Trawling fishing vessels interact with foreign vessels for transhipment & fishing vessels continue to come from Guinea. The Ministry of Fisheries and Marine Resources will consider stopping transhipment and boats carrying passengers will be impounded;

PRANK CALLS

Necessary Regulations will be promulgated shortly

• Noting that 117 is Sierra Leone’s Emergency Alert Call Number used for reporting deaths, suspected diseases and other emergencies.
• Also noting that 117 is the primary number for the public to engage with the Ministry of Health and Sanitation during the COVID-19 outbreak.
• Observing that for the month of March, the call centre was burdened by large volumes of prank calls at a ratio of 98.7% to 1.3% valid emergency calls.
• Prank calls are non-emergency calls.
• As such, my government will take the following actions against any person who makes a prank call to an emergency alert telephone number 117 or emergency alert telephone call centre with immediate effect.
• All offenders will be identified on a daily basis and will face the following consequences:
• Offenders SIM cards will be blocked immediately.
• A fine of Le 5 MILLION will be imposed on all offenders
• A further fine of Le10 Million Leones will be imposed against repeat offenders
• Offenders may also face a term of imprisonment.
• All fines imposed on offenders for prank calls will be directed to support the Governments emergency preparedness response.

These necessary Regulations will be promulgated shortly.

I have continued to chair virtual meetings of the Presidential Task Force on COVID-19 and provide the needed strategic leadership to protect the people of this country from the ravages of this disease. New and additional measures will be announced shortly. (END).