Abstract
Marie-Roseline Darnycka Bélizaire of the WHO tells Jessica Hamzelou about the challenges of fighting coronavirus in the face of limited resources
WHEN the new coronavirus began to spread around the world earlier this year, Marie-Roseline Darnycka Bélizaire of the World Health Organization (WHO) was heavily involved in the fight against Ebola in the Democratic Republic of the Congo (DRC).
She was recently relocated to the Central African Republic (CAR) to advise on and assist the country's response to covid-19.
Jessica Hamzelou: What was your first job on arriving in CAR in March?
Marie-Roseline Darnycka Bélizaire: When I arrived, I was posted within the ministry of health, which helped strengthen the relationship between the WHO and the country.
The starting point was to review the national preparedness and response plan. At the time, there were only around six confirmed coronavirus cases in the country. The response was already in shape – they had been preparing since January. One covid-19 treatment centre was already functional.
But we adapted the plan to several different scenarios that might present in the country. We proposed reinforcing the healthcare system. And we began systematic testing in the community to understand the transmission of the virus.
How did the systematic community testing pan out?
The strategy at the beginning was to test, isolate, treat and trace contacts. So far, around 1298 contacts have been diagnosed with the virus.
We had screening at the border and that was how we found that most of the early cases were being imported into the country. We tested all truck drivers entering CAR. If a driver tested positive, they were placed in isolation and underwent treatment.
How has the strategy changed since then?
In June, the number of community cases overtook that of imported cases, so we changed the strategy. We are limited in the number of tests that we can perform. So now we only give tests to people with fever or with flu or covid-19-like symptoms.
At the start of the covid-19 outbreak, you were based in DRC, aiding the response to Ebola. What was it like watching events unfold from there?
I was worried that the pandemic would come to DRC while we were in the final stages of the Ebola epidemic. I was also worried because some local communities believed that the team working on Ebola had introduced covid-19 to the country in order to stay for longer. We had to convince them that this was a worldwide outbreak, and not related to us.
Has the covid-19 pandemic affected efforts to control Ebola in DRC?
DRC has a new Ebola outbreak, but we can't say that covid-19 has increased Ebola. The pandemic can make the response to Ebola difficult, though. While both pathogens are dreadful and some preventative measures are the same, the speed of the spread of the viruses is very different, and requires a different approach.
What are the current challenges you face in CAR?
The behaviour of some people hasn't changed to avoid the spread of covid-19. People continue to hold street markets and attend funeral services, which are a very important part of the culture here, for example. People still don't want to wear masks.
Part of the community doesn't even believe in the existence of covid-19. Some are saying it is something invented by the government. And as we have a very low mortality rate here for covid-19 so far, the population doesn't see the risk of the disease.
How can you overcome those challenges?
We cannot easily change people's minds, but we are increasing awareness in order for them to understand that the disease is real, and that they are being exposed to major risks by not observing the preventative measures. We are working with community leaders and vulnerable groups who have a higher risk of dying, so those individuals can be aware and protect themselves.
Cases across Africa more widely seem to be lower than other parts of the world. Why is that?
The exponential increase in cases seen in the European region hasn't been observed in Africa. But as containment measures are eased, we expect more cases will be detected in areas that have previously been less affected.
Are you worried about the access that countries like CAR might have to an eventual vaccine?
While there are over 160 vaccine candidates in the pipeline and we are cautiously optimistic, we mustn't rely on a future vaccine to fight this pandemic.
Profile.
Marie-Roseline Darnycka Bélizaire is a country preparedness and international health regulations officer for the WHO