The 2014 Ebola Virus outbreak in West Africa wreaked havoc on a number of already fragile states — Liberia, Sierra Leone, Guinea, and the Democratic Republic of Congo. At the peak, people were lying dead in the streets and in their homes. It felt like the end of the world. No country wants a repeat of that sort of horror. The justifiable haste to avert that sort of scenario has led many Sub-Saharan Africa states to copy the lockdown approach in responding to the COVID-19 pandemic.
There have been debates about the workability of the lockdown on the largely informal economies of Sub-Saharan Africa (SSA). The concern is that the majority of the population in these countries are informal sector workers who essentially live from hand-to-mouth. Furthermore, the absence of reliable databases of individual and family incomes, traceable home and business addresses make it nearly impossible to effectively deploy government palliatives to those who really need them. Added to the debates is the weak capacity of health systems in SSA countries.
It does appear that the virus is not as transmissible in Sub-Saharan Africa as it is in North America and Europe. Experts have sought to explain why this is so. However, it is not only because of inadequate testing. As of April 27, 2020, Ghana has conducted 100,622 tests, 1,550 of which are positive. Ghana has recorded 11 deaths so far. We would be seeing an upsurge in unexplained Ebola outbreak-style deaths in communities if the low numbers of cases and low case fatality ratio could be explained by low test numbers alone.
So, what should these countries do? Do they relax movement restrictions and risk unrestrained spread of the virus, or do they maintain lockdowns and risk civil unrest? I propose a different approach that combines containment (COVID-19 control measures with minimal disruption of economic activity) and suppression (a total lockdown, driven by local context at the state level and governed by appropriate authorities).
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