First the Covid-19 headlines today:
- Johns Hopkins University’s Covid-19 map shows that the frontline in the war against the virus has shifted from Europe to the United States, whose infections have surpassed 400,000 and mortalities have risen above 13,000. Worse is feared as the US’s mortality rate is at 4 per 100,000 population, far below the worst hit nation, Spain, at over 30 and Italy at 28. On this measure, Belgium, France and the Netherlands are all well into double figures with the UK at 9.28 deaths per 100,000. China, which moved quickly to isolate the infected cases and enforce social distancing, appears to have won its battle with the source city of Wuhan reopening for business. China’s death rate was confined to a modest 0.24 per 100,000.
- While South Africa’s Covid-19 infections continue to surprise on the downside, there are concerns about the mini-pandemic at St Augustine’s Hospital in Durban where 66 people have tested positive, 48 of them staff. Three of the country’s 13 deaths were at the hospital, parts of which is likely to be closed down for a fumigation process.
- The Motsepe Foundation, Business for South Africa and the Solidarity Fund have secured 200,000 three ply masks, 100,000 KN95 masks, sterile gloves and surgical masks for frontline health workers. The stock has been distributed around the country and is immediately available for use in the public healthcare sector.
- A statement issued to shareholders Wednesday by oil-from coal and chemicals group Sasol says that due to the lockdown-instilled collapse of demand for petrol, the company and its partner Total have suspended production at the Natref refinery. Sasol has also cut production of synfuels at its Secunda plant by 25% and expects its sales of petrol and diesel to drop by the equivalent of around 7 million barrels – almost 15% of annual output.
- Social media posts have landed SA’s Minister of Communications and Digital Technologies Stella Ndabeni-Abrahams in hot water. They showed her lunching with former Deputy Higher Education Minister Mduduzi Manana. Ndabeni Abrahams was suspended for two months Wednesday – one of them without pay. She also issued a public apology. The pic led to a Twitter uproar with the errant cabinet member being summonsed by president Cyril Ramaphosa who found no extenuating circumstances. A statement from his office reiterated that no South African is exempted from the lockdown regulations.
Concern Worldwide, whose 3,900 staff operate in 25 of the world’s poorest countries, has been helping to address humanitarian crises for the past half century. But its experienced team has never seen anything like Covid-19. As you’ll hear from this fascinating discussion with chief executive Dominic MacSorley, this on-the-ground organisation is deeply concerned about what could happen when the virus really hits healthcare deficient nations on the African continent…
Dominic, you’re actually based in Ireland but your organisation is a global one – Concern Worldwide. Sounds like the kind of enterprise that most people who want to change the world would be involved in. How did you get there and become the managing director?
Well, I grew up in Ireland and I joined this organisation 38 years ago. It was founded in response to the famine in Biafra, which was the first televised famine. And so, when people in Ireland were watching this famine unfolding on their black and white screens – it resonated across the country because famine is part of our history and it produced this extraordinary reaction of people wanting to send aid, food and help to the children of Biafra. As a result of that – Concern started. And I grew up hearing about Concern and eventually decided as a young 26 year old – I didn’t just want to save the world – I wanted to travel the world. So it seemed like the right thing to do at the time. And eventually, after many years for the organisation, I was given the privilege of becoming its chief executive.
So it’s 50 years old – I see from your website. You must have had some interesting challenges in your 38 years and indeed for the organisation itself over that period?
Yes, I did – because the organisation is very much focused on two things. It’s very responsive to emergencies ( whether it’s war or natural disasters) – but it stays on and works to try and build up the resilience of communities. So it does both and I think that’s really important in this day and age. Much of my time was going from crisis to crisis; whether it was Cambodia – back when it was the Khmer Rouge, after that – Rwanda after the genocide (yesterday, we just marked the 26 anniversary), Kosovo, Iraq, Haiti after the earthquake. That’s really where I used to go in and set up teams and do that kind of response, and I think that’s one of the reasons I stayed with the organisation – because I felt it was very grounded. It really wanted to deliver, but it also did so in a way that put the dignity and respect of people at the centre of what it does. So we are now busier, unfortunately, than we’ve ever been and this latest pandemic has created massive, massive challenges for us – right across the 24 countries that we work in. I think it’s very different from the others; it’s very rare that you would get a situation where, actually our home offices – we have offices in New York, South Korea, London and the head office here in Ireland – which are the ones that have been hugely and firstly impacted by this. So we’ve never been in a situation where there is a scale of an emergency that is global – that is affecting the whole social economic fabric of the countries that we work in and also where we are trying to respond, while keeping the protection and safety of our staff as a priority. So, it is unprecedented and it is hugely challenging.
You were very involved with the Ebola crisis. What lessons did you learn from that which are able to be applied here with Covid-19?
The key lesson from that is around prevention and actually – we have to be very careful about equating Ebola with the Coronavirus. Ebola is much more deadly but harder to contract. But certainly in Sierra Leone, Liberia and most recently in the Democratic Republic of Congo – the same things about not shaking hands, not touching people, social distancing and prevention prevention prevention. But really, the key lessons that we got from that was that community mobilisation (volunteers going out and teaching people the basics) was really what stopped Ebola. And that’s really the similar methods that we’re using now across Africa. Remember – it’s only on the 17th of February that the last person with Ebola was discharged from the hospitals in the Democratic Republic of Congo. And we’ve now used the same teams that have basically been redeployed around coronavirus. And there’s a lot of thinking about – ‘how do you actually even manage social distancing, how do you refer people across countries where the health systems are totally degraded?’ – but there’s a huge amount of prevention work that can and is being done.
Take us through some of that because South Africa has similar challenges, not as desperate as in many of the other countries on the continent, but certainly we have many people who live in confined spaces, who live in shantytowns – where social distancing (in theory) would be a lot more difficult than in the rich north.
The reality is – social distancing in many of those contexts is not going to work. The key areas of concern for us are in refugee camps, displaced camps – look at the Rohingya population; there are 900 000 refugees crammed in on the side of hillsides and there is one case that’s been reported in the nearby village. Now what you can do in those kind of cases is; one – you can increase the amount of clean water, increase the amount of soap that people are getting. Social distancing is gonna be a problem but what we’re now looking at is shielding – can you get the most vulnerable (those with underlying issues, those that are older) into separate areas that are separated away – this is not easy to do. That’s the kind of approach that we’re having to take.
You have vast experience in crises. In this one – what we are not understanding in South Africa, is that it’s exploding or mushrooming in parts of Europe and in the United States – but here the growth has been, certainly of the past couple of weeks that we’ve been in a lockdown here, very modest – 4 percent, 3 percent today. Is this just the calm before the storm?
These are the key questions – is every country in Africa going to simply replicate what happened in China or what’s happening in Italy or the US – and I don’t think anybody knows for sure, to be honest. Now, we have been working with the London School of Tropical Medicine. They have put out a various model and they are saying that most countries in Africa will hit 1000 cases for sure in the next two to three weeks and that, potentially, could go up to 10000 by the middle of May. But this is just one model. It’s important to listen to these models – to look at various ones -but I don’t think we can exclusively lock down on one of them because, as you say, a number of these countries have low cases. Democratic Republic of Congo today has 154 reported cases, but we know that it’s largely a lack of testing and there are 19 million people in that country and something like 48 ventilators. So that’s an equation that just is not good. So what we’re saying is – you’ve got to really scale up on the prevention, prevention, prevention side – it may be the strongest tool, and in some respects – tools in the West won’t be as available in some of these contexts. I think we are just waiting to see – will it be as bad as everywhere else or will it be different elements of the problem. And hopefully, that will flatten that.
We’ve been paying a lot of attention in South Africa to the research done by the New York Institute of Technology on BCG vaccinations – which have been universal in this country, certainly since the 1960s, and there were a lot of them done from the 1940s. And it does appear as though the countries where there have been universal BCG’s have been less badly impacted than those countries which didn’t have them at all; Italy, the United States and so on. Have you looked at this?
I’ve heard of it. I’ve read some things about it. I think it’s encouraging if there is something there. This virus – the danger is that it won’t ever go away fully until we get a vaccine. So, any of these things are really worth looking into. I think our bigger concern at the minute is the ability to continue with other life saving interventions that are keeping people alive – whether it’s nutrition centres in Ethiopia or in Central African Republic, whether it’s basic health services – all of those things that are currently, in some cases, suspended – may actually have a greater mortality rate than coronavirus. We see that here in the West – is the cure economically going to leave democracies wrecked? So for us, that is a major concern and we are trying to the best of our ability to adapt programs, to continue them and pushing, in some of the contexts we’re working in, to say that the kind of work we do is an essential service – therefore, we have to have the freedom to be able to continue to have our offices open, to be able to drive around – providing food is as important as providing nursing care to frontline staff. I hope that the BCG thing proves to be helpful, and it’s important that that research is happening, but time will tell.
And we have to prepare for the worst. So, how are you managing to continue with your essential services; as you say – providing food on the one hand and secondly, to the medical staff who definitely need (we know from the deaths that have been recorded) this personal protection equipment?
Quite a lot of the stuff that we were doing isn’t able to be done – supporting schools and those kinds of things because education has been suspended largely across other countries we work in. But in other areas, we’re switching – so, we do a lot of cash transfers through mobile phones to families that are really experiencing food shortages and, remember – we’re quite used to working in war zones where insecurity prevents a lot of going out and going into communities. Inside Syria, we’re providing water and sanitation to a million people and we were doing that before the coronavirus. But there again, you have a situation where the conflict has left only 50 percent of health centres functioning. But – you can expand water. We work much more remotely. You can transfer cash directly into the hands of women so that they have enough to go out and buy food. So, that’s the stuff technology has advanced very significantly in terms of how aid organisations work and that’s now being used much more effectively. So again, it’s looking at what you can do and recognising what you have to give up.
Dominic, have you found that, as a result of this crisis, your donations have increased – that people are more aware of the need?
No, not yet. In Ireland (and we do a huge amount) the Irish people are extraordinarily generous – they are listed as probably one of the most generous nations in the world relative to the economy and to the size of the population, and people have continued to support us. I do think the narrative is shifting; as you know – it was China, Europe, the US, now it’s New York – it’s starting to shift to Africa now and I think when people start to see that, then I’m absolutely convinced they will support this necessary work. We’re in an interconnected world and the one thing that that is demonstrating is that we can’t let the problem fester on its own – even if it’s 5, 10 thousand miles away – it will come back to haunt us. Whether it’s Ebola, whether it’s the refugee migration into Europe in the last number of years – people are acutely aware of acting together to self protect.
Do you think any good will come out of this whole crisis?
I would like to think so. I think if anything – we have demonstrated in the last couple of weeks that we can move massive obstacles when it is required. Governments stepping in – trillions of money, the kind of legislation that has gone through has demonstrated this. But at the Security Council level, which has been the biggest block to what’s happening in Syria, we’re not seeing that level of change. This is the opportunity to really drive home very positive changes. In the end, coronavirus itself doesn’t discriminate but inequality and vulnerability – they do discriminate. And the poorest and those that have the least access to health care and those who are in sub-Saharan Africa will be the ones that suffer the most. So if we learn anything from this, it is that – if we don’t start striving towards a more equal world – we will continuously be having the repetition of these problems.
And in the short term – how do you see this all playing out if you take a six month view?
We’re just doing two, four, six month scenarios – we can’t think beyond six months. I’m very concerned about the collapse of economies; particularly in countries like Central African Republic, Ethiopia or the Democratic Republic of Congo – these are fragile economies at best and the potential long term impact on their recovery rate is going to be slow. But, maybe the bright side of this is that it has been the worst, biggest, global wakeup call to the world – much bigger than climate change – climate change has gone from the agenda – but there is nothing, nothing so startling as when you’re dealing with this at home – whether it’s your grandmother, whether it’s your relative – it is absolutely bringing home vulnerability and fragility at a level that is unprecedented and we can only hope that this will bring about a level of change that would reduce that for those that need it most.
While South Africa’s infection and mortality numbers continue to surprise on the downside, preparations for the expected wave are continuing apace. This week, Discovery put together a partnership with Capital Hotels to test whether it’s possible to turn its empty rooms into confinement areas. Here’s Capital’s founder and chief executive Marc Wachsberger …
Two weeks ago, we had isolation hotels where people who were returning from overseas would isolate themselves for 14 days in our hotel rooms. We realised that wasn’t a step enough and Discovery first contacted us, seeing how well we had done in the isolation space to say that, they unfortunately are preparing for a huge wave of Covid-19 positives coming. As a country, we’re hopeful that that doesn’t happen. They are planning and we are all realistic that unfortunately it is coming. All those people who become Covid-19 positive are just going to go home to their families and infect their families. Obviously that continues the spread. It’s not good for medical aides and insurance companies.
As a way to contribute to stopping the spread, we’ve joined this effort. Of course that puts our people in our hotel to work. We’re delighted to be in partnership with Discovery on this market.
You are creating hospitals out of your hotels not with ICUs, but certainly a place where people can recover. Are they going to be health care workers there?
There’s a nurse on site. We’re taking Covid-19 positive, but healthy clients only. It does look like a hospital. The protective nature of what we’ve done in terms of protecting our staff from contracting the virus from our guests is so significant that they’re down in their gowns, their goggles, their masks, gloves and the booties. It does look like a hospital, but that is to protect the staff – from a guest perspective – it’s like staying in a hotel where you have the ability to recuperate without infecting anyone else.
You still get those hotel services: the gyms closed, the restaurants closed, but everything’s done by room service. You stay in a room which you can still continue your work out, because this is for healthy Covid-19 positive people. These are people who are feeling some minor symptoms, but just stopping the spread.
In other words, they are sick, they are positive, but not let back into society to let the virus spread. So is there connectivity, or presumably there is meals?
We provide – including the right to three meals a day. Anyone wanting to upgrade their meals and have a full room service menu is welcome to do that. They have full connectivity: Netflix, wireless internet, they have balconies where they can get some fresh air. This is a good place to isolate in a hotel environment. The nurses are on standby, the minute they’ll check in with everyone, every day, the minute there’s any sign that their fever is escalating or that they’re in any distress, they will then be taken to hospital and then go into the Covid-19 wards in the hospital.
It’s a heck of a logistical exercise getting the personal protective equipment ability to provide food and just getting the nurses onsite. How did you go about that?
Thanks to Discovery. Discovery has been absolutely amazing. Firstly, this is their initiative they’ve started and they’ve supported us to roll it out. It’s been our ability to roll out but with their support in terms of the PPE and in terms of the training. The training has been absolutely extensive from Discovery to all of our staff. The nursing support is not exclusive for Discovery members. This is something that’s open to everybody who is a positive to come. The Discovery members are getting a discount.
Can you please tell us about those fees?
The room only rates are under a R1,000 a night, that is what we’re charging everyone and discovery members get R400 off that.
We’re trying to keep the system going for our staff’s benefit more than anything. This is not a rate that we would profit from. We have a package that is R1,350 per night for ordinary and non-Discovery members – including three meals. The value of those meals is in the region of R350- R400. A room only is under R1,000 a night. We do have apartments where some people will prefer to stay in our one bedroom apartments which obviously have more space, those are R2,000 a night, including all the meals. Some people will stay for 10 nights – this is what we’re expecting on average. We had a couple they’ve checked in yesterday – were towards the end of their Covid-19 positive stay in the hospital- and were discharged. They’ll probably stay for 3 or 4 days.
What is the take up like?
We just launched yesterday. We’ve only had the first trickle of clients come in. It’s unfortunate that we have a projection that in May his property will be full. The lockdown has worked well in terms of stopping the spread, there isn’t a lot of business now but who knows when this lockdown ends. We’re saying, let’s be prepared that the spread will widen and let’s have this property the Capital Empire, be a pilot study for how it works, that we would roll this out nationally across the country that’s just really important that other hotels get on board, because hotels have an important role to play in stopping the spread.
The idea is to use it as a test case, how many rooms do you have?
At the Capital Empire, we have 124 rooms. The projections are we’ll have national cases in the tens of thousands. How many of those will be able to just stay with their family in isolation? There’ll be many that won’t be able to afford to isolate in a hotel which we’re aware of. I’m working with industry to find other solutions to bring the price down even further. There’s going to be a national demand for this. We are piloting this and putting in a full manual of SOPs on how to operate. We just want to hand it out to all hotels nationally and say, please do the same.