Magufuli the maverick strikes again

The President’s sting operation prompted the head of the Africa Centres for Disease Control and Prevention (Africa CDC), John Nkengasong, who is coordinating the continental COVID-19 response to issue a statement.

“The tests that Tanzania and all African countries are using are tests that we have validated and we know that they are performing very well,” said John Nkengasong, director of the Africa CDC on May 07.

“We are very instrumental in training, providing training to nearly all countries and providing them with test kits. We’ve also in the last couple of weeks and months distributed tests from the Jack Ma Foundation that have been validated and proven to be very, very reliable.”

In apparent reference to Magufuli’s peculiar handling of the COVID-19 outbreak in Tanzania, Nkengasong told journalists on May 07 that African governments needed to co-operate, co-ordinate and collaborate if the fight against Covid-19 was to be successful.

“No country in Africa is an island” when it comes to dealing with the virus,” Nkengasong said.

Magufuli has led his government to respond to the COVID-19 pandemic in a manner at odds with most of the global community.

Where most governments have adopted some form of lockdown to slow the spread and recommended wearing of face masks and keeping physically apart when in public, Magufuli has remained skeptical and disregarded the WHO recommendations.

Magufuli has refused to impose a lockdown on the capital Dar es Salaam, and has allowed markets and places of worship to remain open to congregants. He is also contemplating allowing football matches in national stadia.

Magufuli, who is a Christian, insists people need to go to places of worship to find “true healing” instead of focusing on social distancing. Magufuli appears more concerned about keeping the economy strong even as COVID-19 claims lives; including those of three MPs.

Wrong testing results elsewhere

Proper testing is key for diagnosing and for tracking COVID-19. It allows public health authorities to gather data to make appropriate policy decisions. The only thing worse than no test is a test that’s wrong.

But Tanzania is not the only country to encounter challenges with COVID-testing. The Health Ministry in Spain twice canceled entire orders of antigen kits from Chinese company Bioeasy and demanded a refund of the money paid. The Spanish authorities found that the kits did not have the sensitivity required to detect the virus, meaning that there was a high chance that they would not detect the coronavirus in a person who has been infected.

The fiasco involved what appears to be a dubious local supplier not registered with the Spanish trade association for medical and health material and Bioeasy, which the Chinese government says is not licensed in China.

But earlier reports from China had suggested that the most common form of COVID-19 test produces “false negatives” up to 30 percent of the time. Apparently, there has not been time to test them rigorously before deploying them in the field.

In Russia, officials of Moscow’s department of health said on May 07 that tests used throughout the country to determine if someone has COVID-19 or not often give the wrong result. They said that test kits often wrongly say that people with late stage COVID-19 are free of the disease.

According to an elaborate article in the BBC entitled “Why are coronavirus tests so difficult to produce?” by experts Sheldon Campbell, a professor of laboratory medicine at Yale and Randi Hutter Epstein, writer in residence of Yale School of Medicine, testing for a new disease will always have teething problems.

The experts say laboratories can only start testing patients after they have done sufficient studies to ensure reliability. But several factors, including timing, logistics, and the complexity of collecting samples, obtaining the raw materials and equipment for testing, and having the expertise to do the tests accurately pose challenges.

The process of accurate Covid-19 testing requires coordination of a number of processes. First, you must acquire the test kits – the long nasal swabs and chemicals required to process them. These are then sent to expertly-trained laboratory technicians who analyse the samples using a PCR machine, which can be laborious. The testing raw materials need to be pure and mixed in the right amounts. Each brand of test has its own unique blend of about 20 chemicals.

The pre-test begins with a nasal swab. This is not an ordinary cotton ear-bud but a long, skinny stick that is flexible enough to extend to the ear. Once the swab gets to the laboratory, a highly-skilled laboratory technician, wearing the same protective clothing as nurses and doctors, places it into a biosafety hazard box – a glass box with controlled air flow to prevent the virus from escaping.

The experts say this process is dangerous. Laboratory work generates droplets. Just one droplet may contain a million or so viruses that can contaminate the laboratory worker or the laboratory. It can also land in another sample. If that happened, a patient who didn’t have Covid-19 would be told they did.

The testing phase requires two crucial steps. First, extraction – retrieving the potential virus from the muck of the mucus on the swab, and second, detection.

With garbed arms, technologists manipulate samples into tubes to be loaded onto an instrument where chemicals break open the viral coat (the “crown” of the coronavirus), and isolate the pure RNA, a single strand of genetic material.

Next, they pipette the RNA into a disc with tiny wells. Each has the reagent that hunts for particular pieces of the Covid-19 viral genome.

The discs are taken to a machine where chemicals multiply short pieces of the viral genome about a billion times. These short pieces are then detected by a fluorescent probe that glows if Covid-19 is there.

If the patient’s sample did not have the virus, then nothing happens. No multiplication. No glow. The technologist then checks the controls (the known positive and negative samples that prove the run worked), enters the results into the computer, and calls in the results.

Magufuli came to power in 2015 amid discontent over corruption under his predecessor and quickly gained popularity with an efficiency drive that weeded out graft among government officials. He appears set to win a new term in October elections.

****

CLICK TO READ ONLINE MAGAZINE HERE