Page - 547 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

547COVID-19 and Africa: Does “One Size Fit All” in Public Health Intervention? or total or partial lockdowns of cities, territories, and sub-national regions. These measures are designed to slow the degree and rapidity of spread in order to minimize morbidity and mortality and to avert overwhelming fragile health infrastructures. Because humans are super spreaders of COVID-19, self-isolation and quarantine of suspected carriers and infected persons, respec- tively, have also been mandated. Other measures include contact tracing of infected persons, physical or social distancing12 in public spaces, and promotion of time-tested basic hygiene through hand- washing, other forms of hand sanitization, and disinfecting of sur- faces in homes and workplaces. These measures are part of received public health wisdom for infectious disease control.13 However, the underlying assumptions for their viability are often taken for granted, and their implementation in African settings poses significant challenges. Among the core assump- tions: that average citizens have access to credible information from public health authorities, and access to basic amenities like running water, electricity, functional accommodation, public transportation, and personal identification details. However, Sub-Saharan Africa is largely deficient in three core dimensions of the multidimensional poverty index (MPI)—health, education, and standard of living—and is also deficient in other specific MPI elements: nutrition, sanitation, drinking water, electricity, housing, and assets.14 Effective implementation of COVID-19 pandemic awareness, physical distancing, hand sanitation, and disinfection of surfaces are implausible in the absence of the conditions that are basic assump- tions underlying infectious disease control.15 In a multitude of African contexts, the majority of people do not have reliable access to run- ning water, live in crowded spaces (especially the vulnerable urban and suburban slum populations), and are served by decrepit, over- crowded, and poorly regulated public transportation. Buying and sell- ing of goods is typically conducted in open-air community markets 12. Some jurisdictions prefer “physical distancing” to “social distancing” because of the nuances in meaning of the latter and unintended connotations. For the most part, the terms are used interchangeably. 13. See Dale Weston, Katherina Hauck & Richard Amlôt, “Infection Prevention Behaviour and Infectious Disease Modelling: A Review of the Literature and Recommendations for the Future” (2018) 18:1 BMC Public Health 336. 14. Ibid. 15. See Chidi Oguamanam, “Africa and COVID-19” (30 March 2020), online (blog): OpenAIR <https://bit.ly/2xSXd6J>.