To tackle Covid-19 you need to focus on 4 things - 1) where are the high concentrations of people at a local level with Covid-19 and what are their demographic characteristics, 2) where are the laboratories where people can be tested, 3) where are hospitals with enough health practitioners & respirators to deal with the sick and 4) how many additional laboratories and hospitals are needed and where should they be located. This is not to ignore the critical other factors that the government will have to consider, such as the redirecting of sufficient financial resources to tackle the pandemic and macro-economic strategies to make space to enable the economy to survive, and more.
Geospatial mapping is the only way to understand Covid-19 to its fullest extent. It is also a powerful technology to monitor the disease and to enable immediate decisions to be made about the impact and where resources need to be allocated. Without this information one will be unable to determine if facilities like Covid-19 testing laboratories and hospitals will be able to deal with the load.
This prompted me to wonder where the testing laboratories are in South Africa. A colleague of mine that was statistically analyzing information on cases provided a list of the laboratories. A quick glimpse of the mapped data made me wonder if this was a more comprehensive list. A search on the Internet did not bring up a website that had one comprehensive list, including the national Department of Health.
By painstakingly reviewing the potential service providers, a list of the Covid-19 testing laboratories were obtained from the websites of companies like Ampath and Lancet. Many Drive Through laboratories have been opened. Are these and the other existing laboratories open for people to come in and be tested, whether they have symptoms or not - I am not sure. Even if they have to seek medical advise first, they will have to know the location of the laboratories to get there and be tested.
Having reviewed all the Covid-19 laboratories many of them had insufficient address information for therm to be accurately mapped. So people would find it difficult to find these laboratories if they were using the address. The mapping of this information assists in correcting most of the problems by using many secondary geospatial data sources to improve the accuracy of the data. This information on Covid-19 laboratories should be a fundamental geospatial dataset and stored in a readily available archive by an identified data custodian.
Although the data on testing laboratories may not be complete or accurate because it comes from disparate sources that had no spatial dimension to it, it immediately points to areas where there are no facilities or too few. For example, it would seem that there are no permanent or Drive Through testing sites in the townships of the City of Cape Town. Is this the case, even now that cases have been detected in KIhayelitsha, Mitchell's Plain and Alexandra.
By having the data, geospatial analysis can be done to define the unique geographic area of each Covid-19 laboratory service. This will initially indicate the size of the population and the potential cases that it will need to handle. Knowing the actual cases being handled by a laboratory will also enable more resources to be allocated or new Drive Through laboratories to be established. Knowing the characteristics of the population and number of cases will allow the optimum number and location of new laboratories to be identified. Projections on the number of cases should also be made to ensure that we remain one step ahead of the disease.
This would equally be the case for whether there are enough hospital beds and specialist equipment like respirators. Additional resources in terms of health practitioners can also be allocated. Accessibility studies should be conducted to identify where new laboratories or hospitals should be established. This requires geospatial information on concentrations of Covid-19 cases (both existing and projected), location of laboratories and hospitals, preferred sites to locate new facilities (eg shopping malls, military bases) as well as norms on travel time and capacity of the new facilities to handle cases.
The reality is that this can be done and quite quickly. However, it needs to be a collaborative effort. The Minister of Higher Education, Science & Technology, Dr Blade Nzimande, is working with the CSIR on a geospatial technology. This needs to be inclusive and involve key institutions such as the medical and social science councils, geospatial specialists and data scientists. Although important for monitoring purposes, the solution is much more than a geospatial dashboard. It requires projections on the incidence and deaths from Covid-19 at a local level, accessibility studies to optimize the number and location of new testing laboratories and hospitals with sufficient resources as well the ability to effectively operationalize the decisions. A "war room" if you must name it, such as those established by University of KwaZlul-Natal is key.
In any form of initiative like this communication is critical. Government must play a balancing roll ensuring that citizens are given enough information on a regular basis but ensuring that it does not cause people to lose control and start breaking out of their communities and spreading the disease further. Communication must be rational, especially focusing on what the government and people in the private sector are doing to tackle Covid-19.