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Fighting COVID-19: Fear and Internal Conflict among Older Adults in Ghana

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Razak Gyasi at African Population and Health Research Center
Razak Gyasi
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Abstract

The novel Coronavirus disease 2019 (COVID-19) has upended the social lives and health of all people globally. The debilitating brunt of the infection and mortality has been huge for older adults with comorbidities. The exponential rate of COVID-19 cases and deaths in Ghana have engendered intense fear and anxiety among the at-risk populations with serious implications for mental health and well-being of older people. In this letter, I call on the government to implement innovative interventions to contain the spread of COVID-19 to older people. The health system should realign to deliver geriatric care and psychological support for older people in these extraordinary times.
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Journal of Gerontological Social Work
ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/wger20
Fighting COVID-19: Fear and Internal Conflict
among Older Adults in Ghana
Razak M Gyasi
To cite this article: Razak M Gyasi (2020): Fighting COVID-19: Fear and Internal Conflict among
Older Adults in Ghana, Journal of Gerontological Social Work
To link to this article: https://doi.org/10.1080/01634372.2020.1766630
Published online: 19 Jun 2020.
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LETTER
Fighting COVID-19: Fear and Internal Conflict among Older
Adults in Ghana
ABSTRACT
The novel Coronavirus disease 2019 (COVID-19) has upended the
social lives and health of all people globally. The debilitating brunt
of the infection and mortality has been huge for older adults with
comorbidities. The exponential rate of COVID-19 cases and deaths
in Ghana have engendered intense fear and anxiety among the at-
risk populations with serious implications for mental health and
well-being of older people. In this letter, I call on the government
to implement innovative interventions to contain the spread of
COVID-19 to older people. The health system should realign to
deliver geriatric care and psychological support for older people in
these extraordinary times.
KEY WORDS
Coronavirus; COVID-19; older
people; fear; social distan-
cing; Ghana
Dear Professor Michelle Putnam,
Upon the World Health Organization’s declaration as a Public Health Emergency of
International Concern (WHO, 2020), the novel coronavirus has taken a global tour and
Africa is envisaged as the next epicenter of the infection. Ghana’sfirst two cases of COVID-
19 were confirmed on 12 March 2020. These individuals had returned to Ghana from
Norway and Turkey and a few days later became ill. After these index cases, Ministry of
Health deployed mechanisms to scale-up contact tracing and tesing for potential cases. The
number of COVID-19 confirmed cases have been increasing exponentially over the past two
months (5735 case and 29 deaths as of 17 May 2020), and these are perhaps substantial
underestimates (Ghana Health Service, 2020).
Like the global situation, it is highly melancholic that older adults 60 years or over in Ghana
have faced higher infection and mortality rates compared to the general population. The trends
are even gloomy for those with comorbidities such as cardiovascular diseases, chronic
respiratory disease, active cancers, and diabetes (Kang et al., 2020). The mortality rate of
COVID-19 is 15% for older people 80 years or over compared to 0.2% for those under 20 years
(Worldometer, 2020a). Age is, therefore, a critical variable posing a major risk for COVID-19
mortality and has created serious emotional disturbances and insecurity and major anxiety and
depressive disorders among older people. At the same time, these vulnerable older people are
being imperiled with ageism in the thoughts and discourse of the public. They face neglect and
experience domestic abuse at home and also suffer age discriminations even in health care
access and use. These circumstances present crucial implications for social policies, public
health, and clinical response particularly in resource constrained countries such as Ghana.
Given the heightened public health burden of COVID-19, the Government of Ghana (GoG)
like many other political leaders in Africa implemented interventions to prevent the potential
importation and subsequent community spread of the virus. On 30 March 2020, the GoG
announced closure of borders and partial lockdowninthehotspotsofCOVID-19infections.
The GoG also placed a nationwide ban on social gathering by closing down educational
JOURNAL OF GERONTOLOGICAL SOCIAL WORK
https://doi.org/10.1080/01634372.2020.1766630
© 2020 Taylor & Francis Group, LLC
institutions, religious activities and provided stringent directives on the use of public transport.
Like many low-income settings, lockdown and the concomitant social and physical distancing
deepen poverty and hunger particularly among the poor in Ghana. It also stimulated a sudden
separation of older people from loved ones, casused a shortage of living supplies, loss of
freedom, and uncertainty over disease status.
On 19 April 2020, the GoG indicated a lift of the lockdown regulations instituted to
enhance physical and social distancing protocols. At the same time, COVID-19 cases in the
country had been skyrocketing, placing Ghana at the fifth position in the continent (after
South Africa, Egypt, Morocco, and Algeria) (Worldometer, 2020b). Whilst many have
described the action of GoG as premature, others contend that it is a way to reduce hardships
associated with lockdown and restrictions on movement. The Director-General of WHO,
Dr Tedros Adhanom Ghebreyesus warned all countries that Coronavirus could re-surge if the
lockdown restrictions are lifted too early. Gilbert et al. (2020) have earlier cautioned that the
ability of Ghana and other African countries to manage community spread of the virus after
importation will depend upon the application of stern measures of detection, prevention, and
control. These scuffles caused serious “moral panic”engulfed with fear and aggravated anxiety
and psychological insecurity among the at-risk older people, creating a deleterious impacts on
their mental health and quality of life.
Now that COVID-19 has no vaccine or standardized treatment modality, a critical
question remains, that would Ghana’s health system be able to contain the alarming cases
of COVID-19 and adjust appropriately to deal with the specific needs of older people? Like
many countries in the continent, the capacity of Ghana to provide sufficient infrastructure,
personnel, and clinical care to support those who will test positive through the local cycles
of transmission of COVID-19 has been questioned vehemently and declared highly
vulnerable (Gilbert et al., 2020).
The considerations and modalities to fight COVID-19 should be backed by science
and not mere speculations. Effectively translating and incorporating data and science into
both operational and policy action should be a universal priority. I strongly propose that the
health system should be realigned and prepare for a geriatric care and support for older
people who are highly at-risk of the pandemic. Moreover, a complete enforcement of
stringent preventive measures such as mandatory use of facial masks in public places will
be golden to stop the spread of COVID-19 especially to older people. Besides, culturally
oriented educational interventions and platforms for psychological counseling services and
care for older adults in general as well as COVID-19 infected, at-risk and affected popula-
tions specifically will increase public understanding and also safeguard mental health of
those vulnerable to the pandemic. A multi-sectoral synergies are urgently needed to effec-
tively address the huge impact of COVID-19 in Ghana particularly among older adults. We
cannot afford to ignore older adults especially those with non-communicable diseases in the
fight against COVID-19.
Sincerely,
Razak M Gyasi
References
Ghana Health Service. (2020). Situation update, confirmed Covid-19 cases in Ghana as at 25 April 2020,
22:00hrs. COVID-19: Ghana’s outbreak response management updates., Ghana Health Service and
Ministry of Health. https://ghanahealthservice.org/covid19/
Gilbert, M., Pullano, G., Pinotti, F., Valdano, E., Poletto, C., Boëlle, P.-Y., D’Ortenzio, E.,
Yazdanpanah, Y., Eholie, S. P., Altmann, M., Gutierrez, B., Kraemer, M. U. G., & Colizza, V.
(2020). Preparedness and vulnerability of African countries against importations of COVID-19:
Amodellingstudy.The Lancet,395(10227), 871–877. https://doi.org/10.1016/S0140–6736(20)
30411–6
2LETTER
Kang, C., Yang, S., Yuan, J., Xu, L., Zhao, X., & Yang, J. (2020). Patients with chronic illness urgently
need integrated physical and psychological care during the COVID-19 outbreak. Asian Journal of
Psychiatry,51, 102081. https://doi.org/10.1016/j.ajp.2020.102081
WHO. (2020). WHO Emergency Committee Statement on the second meeting of the International Health
Regulations, 2005. Emergency Committee regarding the outbreak of novel coronavirus (COVID-19).
The World Health Organization, Geneva. https://www.who.int/news-room/detail/30-01-2020-state
ment-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-
regarding-the-outbreak-of-novel-coronavirus-(COVID-19)
Worldometer. (2020a). Age, sex, existing conditions of COVID-19 cases and deaths. The World Health
Organization, Geneva. Retrieved April, 25, 2020, from https://www.worldometers.info/coronavirus/
coronavirus-age-sex-demographics/
Worldometer. (2020b). Countries where COVID-19 has spread. The World Health Organization, Geneva.
Retrieved April, 25, 2020, from https://www.worldometers.info/coronavirus/countries-where-corona
virus-has-spread/
Razak M Gyasi
Aging and Development Unit, African Population and Health Research Center (APHRC),
Nairobi, Kenya
RGyasi@aphrc.org
JOURNAL OF GERONTOLOGICAL SOCIAL WORK 3
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COVID-19: Ghana's outbreak response management updates., Ghana Health Service and Ministry of Health
  • Apr 2020
  • 0
Ghana Health Service. (2020). Situation update, confirmed Covid-19 cases in Ghana as at 25 April 2020, 22:00hrs. COVID-19: Ghana's outbreak response management updates., Ghana Health Service and Ministry of Health. https://ghanahealthservice.org/covid19/
Age, sex, existing conditions of COVID-19 cases and deaths. The World Health Organization
  • Jan 2020
  • Worldometer
Worldometer. (2020a). Age, sex, existing conditions of COVID-19 cases and deaths. The World Health Organization, Geneva. Retrieved April, 25, 2020, from https://www.worldometers.info/coronavirus/ coronavirus-age-sex-demographics/
Countries where COVID-19 has spread. The World Health Organization
  • Jan 2020
  • Worldometer
Worldometer. (2020b). Countries where COVID-19 has spread. The World Health Organization, Geneva. Retrieved April, 25, 2020, from https://www.worldometers.info/coronavirus/countries-where-corona virus-has-spread/
Aging and Development Unit
  • M Razak
  • Gyasi
Razak M Gyasi Aging and Development Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya RGyasi@aphrc.org
The World Health Organization
  • Worldometer