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Healthcare nightmare: COVID-19 and ‘State of Emergency’ declaration

By Dr Alphonsus St Rose

The caption speaks to a framework, the components of which are not mutually exclusive to each other. The extent to which these components work effectively will depend on the validity of the evidence-based data driving decision making and the timing of implementation measures preferably ahead of the COVID-19 pandemic curve.

So, COVID-19 is here; it’s highly transmissible, it’s infectious and deadly to humankind and crippling to national economies. This is nothing short of a life and death situation and must be treated as such. Any tardiness in the response mechanism to preparation, prevention and/or containment (early testing for quick identification and rapid isolation) and mitigation will place a severe social, humanitarian and economic cost burden on any state. What we do preemptively or fail to do will determine our fate, plain and simple.

Every country will create guidelines (rules and laws) to suit its particular circumstances during this COVID-19 emergency pandemic. We also have to learn and draw references from the data and experiences of other countries as to how they have attempted to flatten their COVID-19 pandemic curve. Evidence-based data is what must drive public policy decisions. The metaphor of the canary in the coal mine is applicable here.

At the best of times, our healthcare service delivery system is broken, stressed and overwhelmed. Given the lack of built-in redundancy and our human and financial resource capacity constraints, any major escalation in the number of cases though baseline spread (which is to be expected but for which we are not testing) has the potential for both human and economic disaster.

In addition, there is great uncertainty about the natural history and evolution of COVID-19, making public health policy decisions fluid and difficult. At this point, COVID-19 controls the agenda. We must now take charge by activating a quick response and testing mechanism. In the future, we hope for the approval of a trialed vaccine and drugs to prepare us to combat a potential second wave of COVID-19.

One of our important yet humbling lessons learned from this pandemic is the challenge of depending on individuals (leaders as well as citizens) to align their behavior (social distancing/isolation) by doing the right things and strictly adhering to the public health guidelines in order to save lives.

This is critical to breaking the COVID-19 transmission chain through enhanced containment and mitigation measures aimed at quickly flattening the pandemic curve. For the government, this is in no way akin to preparing for a hurricane or waiting it out “doggie style” as the prime minister described it, while for the citizens, this is no public holiday.

Our constitution provides for the issuance of a proclamation by the governor-general declaring a State of Emergency (like this COVID-19 pandemic) and under the Emergency Powers (Disaster) Act, the prime minister is empowered to make subsidiary legislation to give the government the necessary legal authority to act under extraordinary circumstances to protect the citizens and the homeland.

The constitution appropriately prescribes the conditions under which such a declaration can be invoked. I humbly submit that in the setting of a global pandemic like COVID-19, neither the Public Health Act nor the Quarantine Act can provide sufficient coverage to allow any administration the necessary leverage to deal with the scope of a COVID-19 pandemic.

The declaration of a state of emergency was a national imperative at that time as any action to prepare and contain a pandemic can never be premature. It will allow the government flexibility to regain a measure of control and more appropriately to enable the task-force team to lead and manage the response to the COVID-19 pandemic. Both the government and the citizens can now pause, internalize COVID-19 and its impact and focus on the important task of containing its spread.

However, the scope of authority granted to any prime minister or state officials under the State of Emergency Declaration while legal is not without a valid reason for concern, from abuse of power to malfeasance to corruption and therefore mandates some measure of oversight, transparency, and public accountability.

It must be worthwhile to consider the need to include somewhere in the declaration instrument or parliamentary resolution an accountability clause whereby the government is required to lay in parliament a detailed accountability package at the termination of the said State of Emergency Declaration for parliamentary and public oversight.




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