I have delayed writing a post about COVID-19 because, truthfully there has been so much really good information out there and I don’t think I have anything to add. I would encourage you to continue to seek out reliable sources such as Centers for Disease Control, World Health Organization, and Malawi’s Ministry of Health for disease specific information. The purpose of this article is to offer my thoughts on how to care for yourself, your family, and friends during this second wave of the pandemic in Malawi (though a lot of information will be helpful to others in a similar limited resource setting.)
When the pandemic first started making its way around the world and airports started closing, we did not know what to do. A lot of international companies called their employees back to their home countries. Many global families rely on medical evacuations for serious illnesses that require ICU care. I have heard of a couple of isolated evacuations to Nairobi, but for now it is still a limited option. So, if you find yourself in a limited resource setting during a pandemic here are some tips that may help you.
It’s important to know that at this time COVID is still a risk in Malawi. There was a large spike in cases and the medical system is finding ways to keep up with the medical needs. Resources are limited. Only the sickest patients are being transferred to the government facilities. Please take prevention seriously.
Prevention remains the best option for Malawi
- Carry hand sanitizer with you at all times. Use it before you go into a store or place of business and after you get back in your car. Wash your hands with soap and water as soon as you get home.
- Wear a mask. It’s really difficult to wear a mask when 90% of the people you pass on the streets are not wearing masks. The truth is that the more people see us wearing them, the more likely others are going to mask up as well. Keep in mind that many cloth masks do not stop the spread of all respiratory droplets, so keep 2 meters distance even if you are wearing a mask.
- If you’re out at work or out all day, take a shower as soon as you arrive home and put your clothes immediately into the washing machine. When I worked at the emergency room as a nurse and had little kids at home I did this regularly to keep from spreading germs I had picked up at work.
- Social distance as much as you can. I used to host kids’ hangouts at my house. It has been SO difficult for me to put off hosting a party, but I would feel incredibly guilty if someone got sick from a hang out at my house! Keep your socializing down to a minimal number of people, outdoors, in masks, and sitting apart.
- Take advantage of the beautiful outdoor weather we have in Malawi! Meeting outside, in masks, and sitting 2 meters apart is much lower risk than sitting in an air conditioned room.
- Stay at home if you are sick, whether or not you have been tested for COVID-19. Most COVID-19 cases are so mild that it’s difficult to distinguish them from other viral illnesses such as a cold, flu, or even malaria. If you’re careful to stay home for the least little sore throat, cough, or fever then the virus won’t spread as rapidly. If you are sick, you can be around others after 10 days since symptoms first appeared and 24 hours with no fever without the use of fever-reducing medications and other symptoms of COVID-19 are improving.
- Tell your house helpers to stay home. Consider giving your house helpers paid leave so they don’t have to ride public transport during peaks in the number of cases.
- Respect others’ isolation needs. Some people have medical conditions that would put them at high risk if exposed to the virus. Stay in touch with them by phone, but do not put them at risk with face to face contact.
What if I have mild COVID-19 symptoms?
Most COVID-19 cases are mild. You can expect to have a cough, sore throat, body aches, and/or a fever as your body battles the virus. So, like when you have any virus, do the following: Rest, stay hydrated drinking water or juice, and take Panadol as needed for pain or fever. Also, monitor your symptoms. If you think you might have COVID, avoid brufen and avoid strenuous physical activity. Let other people know about your symptoms, and avoid spending time with others. No one should take any medication to treat COVID-19 unless ordered by a health care provider. Contact your doctor or go to a private clinic if your symptoms worsen.
Here is the most updated list of numbers you can call if you have COVID-19 symptoms. They will advise how to or if needed to proceed with testing.
Rapid testing is an option for a quick diagnosis
CMED in Lilongwe has a green and white tent set up in the back of the clinic. Testing is rapid. The information is shared with the ministry of health. This is not PCR testing, so is not an option for travel. Know that false negatives are possible, so it is still wise to isolate if you have a lot of symptoms.
Avoid clinics unless symptoms worsen
The hospitals are busy right now because it is also peak malaria season. In African culture place is very important, so many Malawians feel like they haven’t been properly cared for if they haven’t been seen in person. For this reason, the waiting rooms of any clinic could be filled with undiagnosed COVID-19 patients. Fortunately, many facilities have a screening procedure and those with COVID-19 symptoms are sent to a separate area. Though the ministry of health has listed several clinics as having testing capacity please note that these are reserved for the sickest patients that need to be transferred to government hospitals. Most minor cases are not getting testing at clinics. If you have minor symptoms it is best to stay home. Since hospital waiting rooms are high risk areas, call your doctor for advice when possible. Some conditions can be cared for over the phone. Keep some malaria test kits at home in case you have a fever. Once you rule out malaria, a lot of fevers for adults can be watched from home. A positive malaria test or other conditions may require you to go to the clinic. If you go to a clinic be sure to wear a mask and sit at least 2 meters away from other patients. If possible, make an appointment to minimize your time in the waiting room.
There is a rare post infectious process that is found in children, called MIS-C. These kids have a fever lasting more than 24 hours within a few weeks of either symptomatic or asymptomatic COVID-19, are quite sick, and often have abdominal pain or other symptoms. See your doctor right away if you suspect this. (I don’t know of any reported cases of MIS-C in Africa)
Here is a minor respiratory home care information sheet that can help you know how to care for mild respiratory conditions from home and when to go to the clinic. Feel free to print it and share with others.
Children should continue to receive routine childhood immunizations. You can contact me directly to schedule an appointment. At this time I am seeing well children on Mondays only.
What if I have trouble breathing?
If your symptoms are worsening and you have trouble breathing, then you need to be seen in person. I am so grateful for Malawian clinicians and nurses that have not shied away from caring for sick patients. While most private clinics in town are not equipped to admit COVID positive patients, they are willing to diagnose and treat all sick patients. Once you have a COVID positive diagnosis, you need to expect to be transferred to one of the COVID facilities if your condition is critical.
What if I have emergency symptoms?
A lot of trouble breathing
Persistent chest pain
New confusion or trouble waking up
Blue lips or face
The government facilities are equipped to receive the sickest patients. There is also a private ICU near Lilongwe that your doctor could refer you to that accepts international insurance and charges American rates.
At reception at ABC clinic we have the phrase “Man treats, but God heals.” We draw a lot of comfort in the fact that our lives ultimately rest in the hands of the loving Father. Let’s be faithful to pray for each other. Please contact me if you want me to pray for you or your family or want to learn more about Jesus.
*In the midst of the pandemic the situation is constantly changing. I will do my best to keep this article updated and remove it when no longer valid. None of the above information replaces the advice of a trusted healthcare provider that knows you and your situation.
updated March 6, 2021