Lessons from malaria: more than "test and trace"

COVID-19 poses definite challenges, but they are familiar to those of us who work in the malaria field. Just like malaria, a majority of COVID-19 carriers will have mild symptoms or none at all, making it difficult to detect and contain. By contrast, Ebola is a much deadlier disease. That makes detection easier through epidemiological surveillance. Furthermore, mild COVID-19 symptoms will overlap with other, very common pathogens. In Ireland, if testing was rolled out massively to everyone with a mild cough or a runny nose, we would be testing at least 5% of the population at any given time. So, the interventions we usually think of – test, treat, trace contacts – are not going to work. This is the case with malaria. We must consider a more preventative approach, which means stopping the epidemic before it starts, and dealing with outbreak clusters before they arise. Because you cannot know for sure who is infected, you ask people to protect themselves – and, in doing so, protect others around them. In this instance, with COVID-19, that means not going to the shops or the office, even though you may feel fine. That being said, in such an unprecedented crisis, it is easy to see the glass as half-empty, rather than half full. It is important to focus on the successes that have occurred in public health. Working in Africa, the odds always seem to be stacked against you. But I have witnessed the distribution of ten million mosquito nets distributed in a single day, and cholera outbreaks contained. The African continent has lived in the shadow of Ebola threats - Nigeria saved the world back in 2014 when, during the Ebola outbreak in Lagos it managed to track down around 500 people from a single imported index case to halt the spread of the disease.