By Mina Hosseinipour, MD, MPH
Officials announced the first confirmed case of COVID-19 in Malawi on April 2, 2020. At UNC Project Malawi, we’d been working for a month to carefully review and prepare for the virus. We established COVID preventive procedures and clinical management guidelines and planning for staff and staff relatives. We enhanced our oxygen supply through concentrators and obtained more oxygen cylinders. We worked with Kamuzu Central Hospital (KCH) to assist in training and preparations for the onslaught.
And then we waited for the cases to come. A series of events came and went, activities that should have prompted community spread of COVID-19 but didn’t. The month of June brought election campaigning and by early July, we saw a significant increase in cases in the country. The KCH COVID unit filled with patients. This wave lasted approximately two months and then, nearly as suddenly and without appreciable mitigation measures, the cases seemed to go away. Many of us wondered why the incidence of COVID fell so rapidly and nearly completely — we had no admissions, the COVID units closed, we saw less than 1 percent positivity rate among tested individuals, and seemingly no increased admissions, deaths or otherwise in the communities. Malawi was spared, it seemed, and the country seemed to rejoice. Through October and November, things seemed to be back to our usual existence.
In early December, we could see the epidemic picking up in South Africa and we knew there was constant traffic between our two countries. Countries throughout the region were seeing an uptick. Many of us recognized the threat and issued warnings to maintain vigilance, but with so few cases to point to, it was difficult to convey the potential seriousness to communities and our staff.
Read more in the UNC Institute for Global Health and Infectious Diseases Newsroom.