OPINION | Coronavirus: regional operations centres key to stopping the spread

The county’s response to coronavirus, centralising marginalised groups at a structural and systemic level, should be a primary focus at this point, says the writer. (Getty Images)
The county’s response to coronavirus, centralising marginalised groups at a structural and systemic level, should be a primary focus at this point, says the writer. (Getty Images)

A regional operational centre will also bear great results in updating healthcare worker availability in correlation to patient demand and thus be at the disposal of the office of the Minister on command and regional assistance, writes Naledi Chirwa.


A heart-wrenching call from an elderly woman woke me up on the eve of the anticipated weekend of self-isolation #StayHome on the 20th of March 2020.

This when the number of reported coronavirus cases had just climbed to over 150 across the country.  

Although the assertion from the woman was quite simple to understand as a Zulu speaking person, if there was somebody eavesdropping on the conversation it would not be hard to notice the possibilities of the consequences of a language and geographical barrier had there been.

In the midst of the panic, anxiety and the peculiar alarm caused by rapid dissemination of false or in most cases insufficient information, the most vulnerable in our society stand on the sidewalks waiting to be told the details of the agitation erupting in the country and if their poverty has out-ruled them from redemption.  

The elderly woman had exhausted the communication trail offered by the Minister of Health, Dr Zweli Mkhize of a centralised call centre.

She had waited for over an hour for a call centre agent to take her call before hanging up and catching a taxi to her workplace before the taxis to the suburb she works at as a domestic worker ran out.

Her trouble being, "nginengculaza neTB. ICD-4 count yami iyanginyanzelekisa ukuthi ibenomthelela ekutholeni icoronavirus njengomsebenzi wasemakhishini?"

Loosely translated, "I am HIV positive and also have Tuberculosis. Will my CD-4 count influence my contracting of coronavirus as a domestic worker?"

An ordinarily simple question is thus immediately saturated with highlighting systemic inadequacies in fighting the virus to win against it when one is exposed to areas where most reported cases stem from (and some have argued a class difference influence), utilising public transport, and doing manually aggressive labour keeping the homes of the rich clean while wallowing in permanent poverty. 

The county’s response to coronavirus, centralising marginalised groups at a structural and systemic level, should be a primary focus at this point.

China is a focal case study by being one of the epicentres of this virus and is now currently sitting at a decreasing 5 000 active cases of coronavirus, far less than the United States of America and Italy.

Our efforts across Africa should be doubled and vigorously implemented without fear or favour.

More so because the liberties such as relieving exhausted frontline healthcare workers with robots, telemedicine and remote-controlled disinfection and food delivery robots in our hospitals are not at our disposal as it is the case in China.

All the aspirations of curbing the virus will disappear into thin air should our information systems; documenting, processing, recording and disseminating information not be interlinked with responsive mechanisms at a regional level.

The poor and uninformed will bear the brunt of any insufficiency that may arise. 

This suggestion to the Minister of Health who has been fervent in his tasks, is brought forward in light of the success as modelled in China thus far in relation to the importance of communication systems for response purposes. 

A recommendation to the Minister, Dr Zweli Mkhize, is the immediate establishment of regional operational centres across the country focused specifically on information, dissemination and collection.

A centralised call centre might have been ideal in a situation where not more than 30?000 coronavirus tests are the target on a weekly basis but will sadly fall short with a magnitude of tests to process efficiently.

These regional operational centres must be modified to suit the regional needs of the population in terms of language use, understanding of geographical placement and general communication etiquette of communities.

These are not general from province to province.

A centralised national station, that depend on incompetence and administratively absent provinces, will prove a timeous constraint where cases cannot be referred and responded to adequately.

In our case, more time spent, more lives compromised and lost. 

The National Department of Health should also devise regional based manuals for healthcare workers and facilities that are to deal with the pandemic that can be easily translated to local languages for walk-in patients in emergency cases suspected to be related to coronavirus.

Our hard-working professionals are complaining that they are not adequately capacitated to fully understand where in the value chain they fit in.

These must be disseminated without direct contact, at entry points of health facilities and linked to the regional operational centers established for processing and recording suspected and confirmed cases. 

A regional operational centre will also bear great results in updating healthcare worker availability in correlation to patient demand and thus be at the disposal of the office of the Minister on command and regional assistance. 

This modus operandi will also disturb the need for tender-ised procurement of services. 

Minister Mkhize made a strong assertion during a press conference that, "flattening the virus relies on information".

This is an aspect that the Minister is aware of, but has not responded to adequately with placing mechanisms that will assist in this regard. 

All other aspects that should suffice in containing the virus will depend on information and communication systems.

This from tracing of contacts, of publicising possible exposure to unsuspecting individuals and families, containing confusion and if needs be, extra efforts of implementing state intervention in ensuring lockdown even in areas where for argument sake, even the grocery shop has become a high infection and transmission site. 

Clinician and pathology sites will also benefit from regionalised operational centres as they can pre-empt capacity needs ahead of an announcement from the Minister of Health, the National Department of Health and the National Institute for Communicable Diseases. 

Regional based information and communication systems will also ease the burden on national operations and make planning and strategising on community infiltrations by the National Department of Health easier as the targets will be concise. 

Last but not least, with the tragic implications of fake news, regional operational systems will decipher and respond to fake news before they cause much harm, unnecessary panic and abuse of health systems and testing facilities caused by the eruption of fake news far much better than the national centre.  

It is upon the Minister of Health to heed the call and acknowledge the role of operational and communication systems during this period while our capacity is able to respond and effect the necessary measures.

- Naledi Chirwa, EFF Member of the Portfolio Committee on Health in Parliament 

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