Coronavirus in Senegal: two steps forward, one step back

Text by: Charlotte Idrac Follow

Since the announcement of the first positive test for Covid-19 on March 2, the country has quickly taken a series of measures, without instituting containment. A graduated response that has helped limit the spread of the epidemic. The priority: preventive action, to avoid an overflow of the health system. But while the number of cases continues to increase, the head of state announced a relaxation of the restrictions.

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From our correspondent in Dakar,

Every morning, it's the same ritual. At 10 a.m., the press point of the Ministry of Health is broadcast live on its Facebook page. New positive cases. Contacts, community cases. Let's heal. Death. Reminder of prevention measures.

Since the announcement of the first case on March 2 , Senegal registers on Wednesday May 13 2,105 positive cases, including 1,301 under treatment, and 22 deaths. Deaths in infinitely lower proportion, compared to what happened in Europe or the United States. In Senegal, the Covid-19 attacks a younger population, but also a different social organization.

Two months ago, this pandemic was still considered by a majority of Senegalese as a "distant disease". Today, "Corona", as it is simply called here, has changed everyday life. Wearing a mask is compulsory . In the streets of Dakar, almost everyone wears one, in fabric or in paper. Protections sewn in record time in neighborhood workshops, or bought at gold prices in pharmacies.

At roundabouts, the police and the gendarmerie ensure compliance with the travel ban between regions. The internal security forces are also responsible for enforcing the curfew, which is first implemented from 8 p.m. to 6 a.m. and then from 9 p.m. to 5 a.m. Week after week, the authorities have implemented a response in stages, to prevent the health system from being saturated. This May 11, President Macky Sall, however, returned to certain measures. Reopening of places of worship, schools for students who take exams, lifting of restrictions on the opening of markets and shops ... the Head of State now calls on the Senegalese to "  learn to live with the virus  ".

The choice of hydroxychloroquine

Faced with Covid-19, Senegal has real capacities - even if limited - in terms of health, and solid institutions. As of February 25, delegations from fifteen African countries are going precisely to the Pasteur Institute in Dakar to try to coordinate the African response. Senegal can take advantage of the experience of the fight against Ebola, and renowned specialists, such as Doctor Amadou Sall, who heads the Institut Pasteur in Dakar, or even Professor Souleymane Mboup , co-discoverer of HIV-2. and founder of the Institute for Health Research, Epidemiological Surveillance and Training (Iressef). 

► Read also: Coronavirus : the Institut Pasteur de Dakar's approach to clinical trials

From Fann's hospital in Dakar, it is Professor Moussa Seydi , head of the Infectious and Tropical Diseases Service, who informs the Head of State "live" about the evolution of the situation. The specialist very early made the choice to introduce into the treatment protocol hydroxychloroquine , praised by Professor Didier Raoult  in France. The theses of the Marseilles doctor, native of Dakar, find a particular echo in Senegal where he has relays. "  There is an emergency,  " said Moussa Seydi in an interview with RFI, "to free up places and take care of other patients  ". It is this balance between “  admitted patients and cured patients  ” which must - in principle - allow the health system to keep its head above water. According to a Senegalese study released in early May, this treatment with hydroxychloroquine would have saved approximately 48 hours over the duration of hospitalization for the most serious cases.

► Also read: Coronavirus: first assessment of the use of hydroxychloroquine in Senegal:

However, room for maneuver remains limited in the country's hospitals, with wide disparities between the capital and the regions. In terms of equipment, the number of 50 respirators in working order was circulating at the start of the crisis, but health authorities have since announced that they have placed a new order. The number of beds available, 500 at the start, has been increased, but some patients are now being treated outside hospitals. As for "contact cases", the relatives of confirmed patients, they were isolated from the start in requisitioned hotels. In Dakar, around thirty sites are now able to accommodate them.

Cut connections with Europe

While Italy, soon overtaken by France, Spain and Great Britain, was already crumbling under the cases, Senegal quickly sought to take the problem to the source. The "patient zero" is a Frenchman established in Senegal, who returned to Dakar a few days earlier. The first 4 cases are all so-called “imported” cases. On March 12, the alert came this time from Touba , 200 km from Dakar, a holy city for the Mourides brotherhood. A Senegalese national working in Italy ("a modou modou  ", in Wolof), has just contaminated his family and a good part of the nursing staff of the Darou Marnane health center where he was taken care of. The army flies to the rescue of the holy city of Mourides, and announces the deployment of a military field hospital in Touba. It will emerge from the ground in 48 hours.  

Faced with the rise in "imported cases", the authorities are closing the borders . From March 18 for certain countries including France, Italy, Spain, Algeria and Tunisia. On March 20, at 11.59 p.m., all flights to and from Senegal were suspended. The measure is extended - for now - until May 31.

With the closing of the borders, more "imported cases". But the epidemic is entering a new stage with the multiplication of so-called “community” cases (which cannot be linked to an identified case), and the appearance of several outbreaks in the regions: In a few weeks, Dakar, Rufisque, Touba, Louga, Diourbel, Ziguinchor, Popenguine, Saint-Louis and Fatick will be affected to varying degrees. "  The virus is becoming Senegalese  " headlines the press.

Composing with religious leaders

Since President Macky Sall's first speech on March 14, all public demonstrations have been banned nationwide . Schools and universities have closed. A partial re-entry is planned for June 2 for students in examination classes. From the start, the government had to deal with religious leaders. The decision to close places of worship is being challenged by some Muslim officials. On March 20 in Touba , the caliph general of the Mouride brotherhood participated in the collective Friday prayer. In Dakar, a demonstration broke out in the district of Yoff, after the arrest of an Imam who had just defied the ban by leading the prayer. Religious gatherings scheduled for late March are canceled in extremis. At the start of Ramadan, on April 25, voices were raised to demand the reopening of the mosques. Finally, this May 11, the Head of State announces the reopening of places of worship . The ban on gatherings also comes up against a social reality, in many very dense districts. The slogan "stay at home" remains for many difficult to apply.

State of emergency and omnipresent presidential speech

Senegal has been under a state of emergency since March 23. From the start of the crisis, President Macky Sall multiplied interventions. In messages to the Nation, as in the international press ( exclusive interview on RFI April 17 ), he strives to explain and detail the health measures and economic support decided at the head of the State. The message sent is intended to be clear: "  The president holds the bar securely,  " assures someone close to the file. For its part, the opposition has no choice but to join forces, or at least a low profile. "  The water which is intended to put out the fire does not need to be filtered  ", said at the end of March Idrissa Seck of the Rewmi party, "  we do not have time to debate too much, it is a general mobilization  ”. On April 1, the National Assembly will vote on the enabling law allowing the Head of State to legislate by ordinances.

On the first evening of the curfew, in Dakar, the police did not go hand in hand with the latecomers. From the first night, videos of police violence circulate on social networks. The next day, the police recognized " excessive intervention " , but the warning was heard: the curfew will be strictly enforced. With the State of emergency, now extended until June 2, we are witnessing an awareness. On March 31, the news shook the capital: Pape Diouf , the former president of Olympique de Marseille, a well-known and recognized personality, died of Covid-19 in Dakar, at the age of 68. He is the first victim in the country. In Senegal, the dead of Coronavirus now have a face.

Covid-19 and empty pockets

Curfew, but no total containment . The option has been ruled out in Senegal. In a country where the vast majority of activity comes from the informal sector, this measure appears to be inappropriate and very difficult to apply. Every day, a procession of "  goorlu goorlu  " (resourceful in Wolof) come to work on the markets, sell their goods in the street, or find a place on the many construction sites of the capital.

A report by around thirty experts, under the coordination of pharmacist Serigne Oumar Sarr, also raises doubts about the implementation of "total containment" in Senegal. He particularly points to the perverse effects and the economic, social and even health repercussions of such a measure. Rather, the report recommends "  the easing of certain collective restrictions, targeted action to protect the elderly and mass screening of populations  ".

On the economic level, Senegal should lose some precious points of growth, going from an annual forecast of 6.8% to 3% in 2021. The State has tried to "cushion" the crisis, by means of a " Solidarity response fund against the effects of the Covid-19 ”, endowed with 1,000 billion CFA francs according to the Senegalese presidency, or around 1.5 billion euros. In his first ordinance, the head of state prohibited dismissals during the pandemic period, and asked companies to guarantee 70% of wages in the event of technical unemployment. Measure welcomed by unions. But "  unrealistic  " for the National Employers Council.

President Macky Sall also takes the opportunity to put the issue of debt cancellation for African countries back at the heart of the discussions . The risk of tensions on foodstuffs and basic necessities such as gas or electricity has been anticipated. In early April, food distributions to the most vulnerable began in Senegal. 5,000 tonnes of rice, 500 tonnes of sugar, or 10,000 liters of oil must be provided to assist one million vulnerable households, half the country's population. A program whose start was marred by suspicions of fraud, involving those close to the head of state. Allegations rejected as a whole by the Senegalese presidency.

In a note entitled “  The pangolin effect. The storm coming to Africa?  ", The French Ministry of Foreign Affairs evoked the solidity of the institutions of Senegal in the context of the pandemic, but feared"  phenomena of urban panics  ", which have not yet reached Senegal.

► Also read : "Whenever Africa is mentioned, it is a disaster"

With the easing of measures announced on May 11, the country has "  adapted its strategy  " and is entering "  a new phase  ", which remains very uncertain. The head of state warned: "  in the best of cases, the virus will circulate in Senegal until August, or even September  ".

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