No lockdown, few ventilators, but Ethiopia is beating Covid-19

The country has harnessed community healthcare to great effect to fight the pandemic

David Pilling, May 27, 2020

lockdown
Ethiopian doctors train to use ventilators for Covid-19 patients in Addis Ababa. Authorities have readied quarantine places for 50,000 people and 15,000 beds in isolation centres © Michael Tewelde/AFP/Getty

(ft) — Pick-up the phone in Ethiopia these days and you are greeted not by a ringtone but with a jingle urging the benefits of handwashing, social distancing and face masks. Churches and mosques are closed, with services conducted electronically. According to officials, community health workers have screened an astonishing 40m people in 11m households, verifying their travel history and conducting routine temperature checks.

Authorities have readied quarantine places for 50,000 people and 15,000 beds in isolation centres. Most of these have not been needed. For whatever reasons, Ethiopia has, thus far, avoided the worst of the coronavirus pandemic. According to official data, the east African country of 110m people, the continent’s second most populous, has recorded just 731cases of Covid-19 and six Covid-related deaths. True, the number has shot up in recent days, perhaps as a consequence of ramped-up testing or a sign that community transmission is gathering pace.

True, too, that not everyone will believe figures from a state with a history of authoritarian control, including of data. Yet there is little clear evidence of widespread outbreaks unaccounted for in official numbers, and even if the number of deaths were many times the state-sanctioned figure, they would still be small. The UK, a country with a little over half Ethiopia’s population, has recorded about 6,000 times more deaths.

Ethiopia’s technocratic government decided it could not afford a rich-country response to the virus. Though its economy has grown rapidly in recent decades, Ethiopia remains a poor country with a per capita income — adjusted for prices — of just $2,500. When the pandemic began, it had 22 ventilators dedicated to Covid.

Arkebe Oqubay, senior minister and special adviser to the prime minister, says the government concluded early it could not afford a lockdown that would be difficult to enforce and socially costly. Nor did it immediately stop direct flights from China, a stance for which it was much criticised. Instead, temperature checks were imposed at the international airport. Its first case came from Japan, he says, with later imported infections mainly from Europe.

Instead of strict lockdown, Ethiopia chose a response built around public messaging. “This is not a disease you fight by ventilators or intensive care units,” says Mr Arkebe, “90 per cent of the solution is hand washing and social distancing. The only way we can play and win is if we focus on prevention.”

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