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Why Rwanda Is Far Smarter Than the US –

Dealing with COVID-19

By Shlomo Maital

   Consider Rwanda. This small African country in south-central Africa, landlocked, has about 12 million people, with GDP per capita of about $2,600. This is only 4% of America’s per capita GDP. So Americans are 25 times wealthier than Rwandans…. But – is the US leader as smart as Rwanda’s, Paul Kagame?   4% as smart?

   Rwanda has struggled to move beyond the terrible massacre/genocide that occurred between April and July 1994, which killed between half a million and a million Tutsi – 70% of the total Tutsi population in Rwanda.

   Here is how Jason Beaubien, National Public Radio, described Rwanda’s success in controlling COVID-19. First the numbers:

Cases

4,789

Recovered

3,080

Deaths

29

Now Beaubien:

   “A robot introduces itself to patients in Kigali, Rwanda. The robots, used in Rwanda’s treatment centers, can screen people for COVID-19 and deliver food and medication, among other tasks. The robots were donated by the United Nations Development Program and the Rwanda Ministry of ICT and Innovation.

     “In some places in the world right now, getting tested for COVID-19 remains difficult or nearly impossible. In Rwanda, you might just get tested randomly as you’re going down the street.

     “So whenever someone is driving a vehicle, bicycle, motorcycle or even walking, everyone is asked if you wish to get tested,” says Sabin Nsanzimana, director general of the Rwanda Biomedical Center, which is the arm of the ministry of health that’s in charge of tackling COVID-19. Health officials in personal protective equipment administer the test. Nsanzimana says the testing is voluntary, although some others say refusal is frowned upon.

“The sample collection — from a swab up the nose — and filling out the contact information paperwork takes about five minutes.

“All these samples are sent that day to the lab,” Nsanzimana says. “We have a big lab here in Kigali. We have also six other labs in the other provinces.”

   “Despite being classified by the World Bank as a low-income country, and despite its limited resources, Rwanda has vowed to identify every coronavirus case. Anyone who tests positive is immediately quarantined at a dedicated COVID-19 clinic. Any contacts of that case who are deemed at high risk are also quarantined, either at a clinic or at home, until they can be tested.

     Kagame is controversial; he is accused of being dictatorial and anti-democratic. That may be.   But he and his country have done much much better than the wealthy United States, in protecting its citizens.

     Remember what President Trump called some African countries?   In 2018?   S???hole countries? Hmmm.  

Pooled Testing for COVID-19: Africa Leads!

By Shlomo Maital

One of my favorite quotes is by former Curitiba, Brazil mayor Jaime Levin: “if you want real creativity, known a few zero’s off your budget”.

   COVID-19 testing is very expensive, and African countries have very limited budgets. Solution? Pooling. Pool the samples, say 10 at a time. See if the coronavirus is present. If so, go back and check which sample was positive.   The logic: Infection rates are, say, 1%, 3%, 5% …and in very very hot spots, 25-30%. At worst, 1 in 3. So, in low-infection-rate countries, checking every sample means searching for a 1-in-100 needle in the haystack. Time consuming (and time is of the essence), and very expensive.

     This idea — pooling —  is currently NOT widely used in the US. Even though the top expert, Dr. Fauci, now advocates it, and as US numbers reach record levels, 60,000 cases a day, and as tests are again becoming in short supply:

   “Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, recently announced that health officials are considering pooled testing for COVID-19 in response to the recent surge.”

   Dr. Fauci:   Ghana is way ahead of you. America can learn from Ghana:

   “When the first batch of specimens came for testing, in early March, the Noguchi Memorial Institute for Medical Research (NMIMR) was the only facility capable of testing for COVID-19 in Ghana. Moreover, it had a very limited supply of test kits.   Faced with the harsh reality, scientists decided to exploit a standard testing methodology in which individual specimens are combined into pools and tested. When a pool tests positive, then each individual specimen of that particular pool is tested. The NMIMR started with a pool size of fives, which was later increased to ten as the testing needs and the understanding of test sensitivity parameters improved.”

   So let’s be clear. Ghana has been doing pooling of tests since early March.  Rwanda, too.  The US is now considering it.

   America – open your windows. There are very clever people, outside your borders.  Maybe, the Trump administration should stop trying to keep foreigners out, or kick them out if they’re in, and listen to their ideas…..  and President Trump?  What was that profanity you used, to describe African nations?  Shxxxholes? 

Blog entries written by Prof. Shlomo Maital

Shlomo Maital

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