COVID-19 pandemic in the Gambia


The COVID-19 pandemic was confirmed to have reached The Gambia in March 2020.

Background

The largest hospital in the Gambia is Edward Francis Small Teaching Hospital, which is a tertiary referral hospital in the capital city Banjul. In 2012 it was reported that there were three other tertiary hospitals, 38 health centres, and 492 primary health posts. The leading causes of mortality in the country are malaria and tuberculosis. There are two medical schools in the country, at the University of the Gambia and the American International University West Africa, as well as MRC Unit The Gambia, formerly run by the United Kingdom's Medical Research Council, and now run by the London School of Hygiene & Tropical Medicine. Political health leadership is provided by the Minister of Health and Social Care, who is currently Ahmadou Lamin Samateh, the former Chief Medical Director of EFSTH.

Disease prevention

According to the National Health Sector Strategy Plan 2014–2020, disease control and prevention in The Gambia is the responsibility of Epidemiology and Disease Control. EDC is the focal point for integrated disease surveillance and response. It emphasises notifiable diseases and diseases of epidemic potential.

Timeline

WHO response

On 31 December 2019, the World Health Organization was informed of a cluster of pneumonia cases of an unknown cause in the city of Wuhan, China. This outbreak was declared a Public Health Emergency of International Concern on 30 January 2020, and in turn was characterised as a pandemic by the WHO from 11 March.

March 2020

The first case of COVID-19 in The Gambia was reported on 17 March and received treatment at MRC Unit The Gambia's specialist clinic in Fajara. The patient was a woman in her thirties who had travelled to The Gambia from the United Kingdom on 15 March, and had gone into self-isolation after feeling feverish. The Ministry of Health said it was in the process of contacting and isolating all the passengers on the flight.
The first death in The Gambia took place on 23 March. By the end of March there had been 4 confirmed cases, 3 of whom remained active.

April 2020

At the end of April there were 11 confirmed cases, 7 more than at the end of March. Eight patients had recovered, the death toll remained 1, and there were two active cases.

May 2020

In May there were 14 confirmed cases, bringing the total number of confirmed cases to 25. The death toll remained unchanged. By the end of the month 20 patients had recovered, leaving 4 active cases.

June 2020

In June there were 24 confirmed cases, bringing the total number of confirmed cases to 49. The death toll rose to 2. By the end of the month 27 patients had recovered, leaving 20 active cases. Model-based simulations indicate that the 95% confidence interval for the time-varying reproduction number Rt has been stable above 1.0 since early June.

July 2020

On 1 July, 7 July and 15 July respectively, the State House of The Gambia announced via Twitter further extensions of lockdown, each for seven days. The country is expected to reopen on 22 July if there is no further extension.
In response to an increase in the rate of infection, the country made wearing face masks compulsory effective from 24 July.
During the month there were 449 new cases, raising the total number of confirmed cases to 498. The death toll rose to 9. The number of recovered patients increased by 41 to 68, leaving 421 active cases at the end of the month.

Government measures

Overseas travel by public officials was suspended by a circular issued by President Adama Barrow on 13 March. Barrow ordered all universities to close and for all gatherings to cease on 17 March. On 18 March, sessions of the National Assembly and hearings for the Truth, Reconciliation and Reparations Commission were suspended. Flights from 13 countries were suspended on 19 March. Passengers arriving from a further 47 countries would have to undergo a mandatory 14-day quarantine.
The only facility with capacity for COVID-19 testing in the country is MRC Unit The Gambia. According to their website, testing is arranged by appointment only, organised through a Ministry of Health specialist phone number.

Response

The governments of The Gambia and its sole neighbor, Senegal, agreed to close their border for 21 days starting 23 March, with exceptions for "essential services" and transporting food and medicine. The Gambia's airspace was also closed, with exceptions for medical flights and transporting goods. Health minister Ahmadou Lamin Samateh acknowledged that enforcing the border closure was challenging, but said that the closure was important for fighting COVID-19.
On 27 March, President Adama Barrow declared a state of emergency, ordering places of worship and non-essential businesses, prohibiting gatherings of more than 10 people, and limiting passengers on public transportation.
On 28 March, the Jack Ma and Alibaba Foundations donated test kits and personal protective equipment to the Gambia to help fight the pandemic.
As of 30 March, business-people were being arrested for price gouging.

Impact

The tourism industry was affected by the pandemic, causing hardship for Gambians who depend on tourism for their incomes. Many restaurants and hotels were closed, with only a few hotels remaining open for tourists stranded by travel restrictions.