Eritrea: Policy considerations and precepts on COVID-19

ASMARA (HAN) October 12. 2020. Public Diplomacy and Regional Stability Initiatives News. Monitoring Regional Issues. 1.The Government of Eritrea’s central, two-track policy framework was anchored, from the outset, on a robust preventive strategy that encompassed the full arsenal of standard and customized tools of suppression to pre-empt, and in the case of the first outbreak, sever and abort the transmission of the pandemic. In tandem with this primary approach, a Mitigation Strategy was also mapped out – with all the requisite preparations – to provide effective treatment for those who may contract the disease.

2. Within this framework, calibrated preventive Non-Pharmaceutical Measures (NPHs) adopted by the Government ranged from voluntary foreign travel ban from and to the country in the early weeks – from March 11 onwards – prior to the occurrence of the first case, to rigorous, stay-at-home, policies throughout the country on 2 April, 2020. Appropriate exemptions were made, from the outset, for vital and indispensable economic sectors whose operations were allowed to continue under strict compliance and observance of all standard preventive measures.  Among other things, the agricultural/fisheries sectors – household and commercial farming, artisanal and commercial fishing – the manufacturing sector; banking and financial services, the retail food and clothing sectors, the food supply chains; freight trucks were exempted from the restrictive guidelines.

3. Some of the restrictive measures have now been relaxed with time – retail shops for miscellaneous merchandise; resumption of 11^th/12^th grades and tertiary education etc. – on the basis of rigorous evaluation of the prevailing reality. The situation also remains under constant review for further, judicious and continuous relaxation of the restrictive measures still in force.

4. Comprehensive and mandatory quarantine of all travelers to Eritrea; targeted testing of quarantined individuals, febrile and other patients with COVID-19 symptoms in all clinics and hospitals throughout the country; as well as Aggressive Contact Tracing continue to constitute the three key pillars of the Preventive Strategy. The underlying rationale is palpable as the primary sources of contagion are infected individuals who travel to the country from abroad. (The attached table illustrates the number of quarantine centers and total tally of persons quarantined to-date).

5. Targeted and efficient testing policy is moreover bolstered by two additional measures: i) random and representative testing in selected areas of potential COVID-19 incidence and transmission; ii) close monitoring of patterns and trends of out-patient and in-patient services in all the clinics and hospitals of the country as a proxy metric to gauge incidence and rate of transmission of the pandemic.

6. The first Random Testing was carried out in Asmara from 17 May until June 2^nd, 2020. The random sampling and testing carried out fulfilled the standard criterion in terms of size of representative sample, urban density, demographic composition, gender and other determinant variables.  The tests covered 4659 households or 15% of the residents with one representative of the household undergoing the actual nasal and throat swab tests.   In view of clustered neighborhoods and median family size of seven, the outreach of the random testing in Asmara is estimated as much greater than the minimum required sample size computed on the basis of standard variables.  In this respect, the tests in Asmara represent 150,000 per a million population while the current figure for the country as a whole stands at 11,250 tests per a million population.

7. With the enforcement of the ban of commercial Flights, the points of entry remain the long and porous land and sea borders of the country with the Sudan, Ethiopia, Djibouti, and Yemen. More than 18,000 Eritreans have returned through irregular routes in the past four months from these countries to-date. The GOE has established numerous quarantine centers (92 at its peak) along or in the environs of these entry points.  Rigorous testing routinely carried out in these quarantine centers will be bolstered by random, periodic and representative testing in all the border towns and villages to gauge the rate, if any, of potential transmission of the pandemic.

8. The total number of confirmed cases to-date is 414 out of 41,100 tests. The positivity rate remains small.  In the random and representative tests in Asmara, there was only one positive case out of 4659 tests; i.e.  a paltry 0.02%.

9. In terms of GOE’s mitigation strategy, the approach involves hospitalization and provision of necessary medicament to all patients. As it happens, the severity of the positive cases has remained invariably mild so far for all patients.  And, out of 414 confirmed cases to-date, 372 patients have recovered fully.  The median period of hospitalization remains at 21 days. In this respect, the recovery rate stands at 100% so far within the three weeks convalescence bracket while the mortality rate to-date is zero.

10. The closure of various businesses, especially in the service and hospitality sectors, and the ban on domestic public passenger transport have inevitably entailed substantial economic hardships to various segments of Eritrean society throughout the country. For obvious reasons, the Government could not allocate substantial budgetary appropriations to provide regular, financial, disbursements to affected urban/rural households or wage-earners in the private sector who have been affected by the temporary closure of relevant enterprises.  But the various Guidelines issued by the GOE have provisions against layoffs as well as for payment of continued salaries by the enterprises concerned for all their employees.  The Government is naturally shouldering full payment of monthly salaries to all employees of the Civil Service as well as para-statal enterprises even in instances where some institutions perform their functions with temporary reduction of staff and/or weekly hours.

11. Moreover, the Government has tapped traditional coping mechanisms to marshal community support to vulnerable groups that fall outside the categories described above through mechanisms that are implemented in the respective localities.  In this respect, Eritrean communities inside the country and in the Diaspora have and continue to contribute substantial financial contributions in the fight against COVID-10 and to provide assistance to those in need in their specific neighborhoods.   These initiatives remain substantive and creative to even include waivers of two-three months of rent by landlords to private tenants who may be in financial bind. These tools constitute critical components in the GOE’s multi-layered strategy of combating the pandemic.

12. The GOE’s strategy of prevention has also incorporated an extensive and comprehensive media campaign (through TV, Radio and mobile telephone platforms) to sensitize the population on the various facets of the pandemic as well as the individual/community measures of social distancing, sanitation and other tools that all citizens ought to observe to enhance the well-being of their communities and the nation as a whole.

Ministry of Health

Asmara

12 October 2020

1 Status of Quarantine

            Table 1 Number of Quarantine Sites & Quarantined from 01/02-09/10/2020