Why we can hope that Ethiopia will be spared the worst of the pandemic

Why we can hope that Ethiopia will be spared the worst of the pandemic

The current official projections suggest a worst case scenario up to 39 million people being affected by COVID-19 in Ethiopia. The Multi Sectoral Preparedness and Response Plan projects that 102,000 people could be infected in the next three months. According to the Ethiopian Public Health Institute by the end of April 235,000 people could be affected with the numbers reaching 1.94 million by the end of May. Even with social distancing measures over 15 million could be infected before the pandemic runs its course.

The numbers are very alarming. Insofar as this galvanizes action at individual, societal and governmental levels, it can be a good thing, so long as it does not lead to panic. However, I am hopeful that the trajectory of the pandemic may end up being different in Ethiopia (and possibly in other parts of Africa too) for reasons to do with the environment, poverty, globalization, culture, the timing of the pandemic and learning from the rest of the world, as well as the state system and leadership.

1. Climate, weather and flu waves.
Flus tend to spread more easily in temperate climates during cold weather and the COVID-19 pandemic occurred in winter in Asia, Europe and America, and may be subsiding with the coming of spring (see Bruce Lipton https://www.facebook.com/BruceHLiptonPhD/videos/577988852925866/). However, there are sometimes second waves as was the case during the 1918 epidemic in Ethiopia. A first wave starting in April spread during the rainy season and the second from October come to an end in November. COVID-19 spread to Ethiopia while the weather was warm. There is now what appears to be the start of the Belg small rains which may have an adverse impact, although it might also encourage people not to congregate, go out unnecessarily and abide by government recommendations and directives. We should, however, be wary of the possibility of a second wave as well.

2. Poverty as a blessing in disguise.
The spread of the pandemic in the rest of the world was exacerbated by hospital contexts where patients and doctors were exposed to high loads of the virus, before it was understood how easily and fast is can be transmitted. Ethiopia has few hospitals (0.3 for 1000 people according to World Bank Figures) and those who have been identified with COVID have been sent to special centres. However, should the worst case scenarios come true, the health services would rapidly be overwhelmed as many experts point out, hence the importance of heeding these warning and doing everything possible to avoid this happening.

3. Less locked into the global economy.
Ethiopia (and the rest of Africa) are less enmeshed in the global economy. International passengers come through Bole airport, and screening was put in place early on. Ethiopian airlines reduced flights to many countries including China in mid February and suspended flights to 30 countries relatively late on March 21. There is limited train travel – the railway to Djibouti runs every four days (It is worth remembering that the 1918 epidemic came through the Djibouti railway and worryingly there are currently 241 cases in Djibouti for a population of under a million, compared to 197 in Kenya, 34 in Eritrea, and 25 in Somalia). There is limited cross border road traffic and no evidence of spread by land, with the borders closed since March 23, when there were 11 confirmed cases.

4. Addressing the exogenous threat.
A strong focus on airport screening and follow up of foreigners and Ethiopians coming from abroad may be paying off and might mean that the pandemic will be have been sufficiently addressed to prevent the take-off of community transmission and its inexorable logic of exponential progression. In Ethiopia the categories that have been most at risk were initially those in contact with foreigners, including investors and government officials and then those with travel history. These are often among the better off and/or better aware sections of the populations, most of whom have been taking precautions, reducing contacts and even self-isolating, and it soon became clear that the risks were mainly associated with returned travelers and contact with them. The risks from those returning from Dubai (representing more than half the cases – See COVID Ethiopia Dashboard) and the forced evictions from Saudi Arabia are clear ongoing threats that the government is well aware of and seeking to address.

5. Fortuitous timing after peak season travel.
The timing of the arrival of the pandemic in Africa in general and in Ethiopia in particular was much later than in Asia, Europe and America. In Ethiopia the main tourist high season (December – January) had fortuitously passed before the pandemic was first identified on 13th March. Moreover, tourism was much lower this year than usual due to security fears. The holiday season when diaspora Ethiopians return had also passed, and less came and travelled within the country due to security concerns.

6. Learning from the rest of the world.
By the time the pandemic hit the African continent and started to spread, awareness of the means of transmission was much greater, and there had been time for debates about what measures can reduce risks and what behaviour make it worse, leading to government and societal action, including airport screening, isolating suspected cases, mandatory quarantine for travelers from abroad, following up their contacts, limiting meetings, closing schools and universities, banning large gatherings, etc.

7. Government action: the culture of campaigns.
The Ethiopian state is well known for its organizational capacity that has increased over the regimes, and its ability to organize zemecha campaigns, mobilizing people and resources rapidly and efficiently. While there may be criticisms and debates about whether measures should have been taken earlier (such as reducing Ethiopian airlines flights), there have been vigorous government actions, and media campaigns, including the messages before every telephone call, culminating in the State of Emergency. Finally, there has been impressive leadership notably from Dr Lia Tadesse, the Minister of Health (see her briefing and response to questions on facebook yesterday 12 April).

I should end by saying that these speculations are not based on any expertise or hard evidence and I may be proved wrong and foolhardy. But I also suspect that those that worst cases scenarios are also not based on accurate data on the progression of the pandemic as we only know the numbers tested, how many were positive, and how many died, but cannot have data on how many have been infected.

Ethiopia deserves a break and some good fortune as a country that has been ravaged repeatedly by famine, war, internal conflict (now hosting the largest global number of IDPs), and having faced many epidemics, and epizootics most recently the ongoing locust invasion.

We can only hope that the prayers of millions of Ethiopians will be heard and that this plague will pass by without inflicting the devastations seen in so much of our planet.

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11 thoughts on “Why we can hope that Ethiopia will be spared the worst of the pandemic

  1. Great title!

    I believe Ethiopia CAN be spared.

    The country may be spared, because the 14 day quarantine is preventing the virus from entering and the government is doing a great job learning from other countries and educating the public.
    The government, organizations, and citizens are doing a great job!

    -The land borders are CLOSED.
    -Everyone flying into Ethiopia must remain in specific hotels in a 14 day mandatory quarantine. This will keep it from entering!
    -A lot of public service announcements and coverage on TV, radio, and telephone
    -Changes to public transportation
    -Hand washing required before entering stores and banks
    -The government tracks people who have been in contact with those infected
    -Social distancing/space between people in public
    -One bank provided toothpicks to use for the ATM
    -At stores and banks there’s a rope to keep customers at a distance
    -On the street, there were people dressed up in Elmo and Mickey Mouse costumes demonstrating hand washing
    -Increased testing capabilities
    -A professional song and video to raise public awareness

    Keep Ethiopia safe!!!!

  2. The article is too complicated.
    Who can understand such technical language and read such a long article?

    I do not believe the weather thing for one second.

  3. I am reading this article only 2 days after it is published. The confirmed casea at this time is less than 90. However the article, based on a study published, claims this number could reach over 200k. Sometimes statistical data dont match reality. Either there are some incorrect assumption/parameters on the data interpretation/ projection or the country is doing eceprionally well to defy these predictions. We just need to be careful on how we communicate some of these information.

  4. Tegene Hawando,MD,Surgeon. · Edit

    I liked the way the current situation in Ethiopia is described.We all, who are worried about what would be coming in the next 2-3 monthes if the pandemic follows more or less similar speed and pattern as in the USA and European countries. How much some of the points mentioned in the article like weather/climate,poverty,season of toutist flow,etc,strongly modify the viral infection rate seems doubtful.But the lessons to be learned from others experience and the proactive preventive measures being taken by the governement so far are good
    and these are well described.
    Over all the author has a GOOD WISHE as we all do,but though cautiously.

  5. The federal government is doing well in creating awareness about the virus as well as mobilising aid for the less fortunate. More is expected from regional governments to enforce strict self distancing rules and for the media to create scenario based educational videos about self hygne and self distancing. Personally, self distancing is more vital for our country than anything else.

  6. This is just a laundry list of wishful thinking masquerading as a thought out observation. This is reckless and dangerous as it misleads many people. Your are considered a serious academic and you will be damaging for those who relax from an extreme crisis mode.

    Especially I can’t believe you actually penned the second point. You are arguing that since healthcare workers have been affected in the US/EU at a high rate; the lack of health infrastructure in Ethiopia is a blessing. Just wow!!! If a very sick person doesn’t go to a hospital then his entire family/community is the healthcare provider. The family has little to no chance of improving his/her condition just. On top of that, they will get infected! If ~20% of trained professionals are infected in the process of doing their job then all of the family members/community will get infected.

  7. Mesfin Beyero, Public Health Consultant · Edit

    What the writer has said towards the end of his script explains it all: the PRAYERS of millions of Ethiopians will be heard! This is VERY TRUE. It doesn’t appeal to the so called scientists or professionals but who cares? Who said whatever science said is right? And what is the evidence that advancement in technology and wealth means advancement in everything? There are many who don’t believe even in the existence of God unless they prove it in their own way! We take all appropriate measures and engage in fervent prayer, and the GOD OF ETHIOPIA WILL DELIVER THE NATION!!!

  8. Am I the only one confused with the numbers written here? we are almost approaching end of April, but it says about ‘235000people could be affected ‘ ! As far as official reports are considered, 117people are infected as of today (April 24) so how did they come up with this crazy projection? Not fair at all, misleading!

  9. The projections only serve to mobilize resources and guide our plan.I question the public health projection not only in our case but even for the US where they said 1st 240,000, and after couple of week they reduced it to 60,000. while I agree on some of the factor described by the author , I have the following point to raise!
    1. it is early to come up with this assumption given our current testing capacity. The number of COVID test Ethiopia conducted is close to what Djibouti did for population of under a million.

    2. While you looked the pick tourist visit as a factor, the other thing we also need to look at is Ethiopian returnees traveling back from Middle east , passengers who came from Dubai, and Djibouti took higher positive cases

    3. The Ethiopian border along with Djibouti and Somalia is porous and difficult to take the control measure that we do in other part and the Eastern part of the country will likely be a hots-post.

  10. Today is April 26. The article projected the number of infected people to be 235000 at the end of this month.

    Which is far from the reality.

  11. A very fair assessment. We can and should start learning lessons right now on how to reduce risks and be more robust (“anti-fragile” as Nassim Taleb puts it. Fragility as a risk of trade and travel should be given a higher weight in policy formation. Food and other essentials self sufficiency will probably get higher priority. Perhaps education in the trades and technology, importing of technology, industrialization for basic goods. Distance education. All with a view to create a more resilient population as the inevitable urbanization continues

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