Thread by @ElyabT

PART I

Facts: (I) Median age of Ethiopians is 17.9 years - The youngest in the world. (II) Based on world health data, smoking rate in Ethiopia is approx. 12% - lowest in the world and sharp contrast to the population of China.

Data from over 20,000 COVID-19 Chinese patients indicate that if you look at those with severe and critical illness (the ones that require critical care and support) the most prevalent risk factors and (frequency) included Hypertension (50%),

..Diabetes (30%), cardiovascular disease (25%) and lung disease (20%). While these risk factors are not rare in Ethiopia, clearly they are not that common in those 25 year olds and younger which account for an astounding 65% of the population.

95% of Ethiopians are younger than 55. (IV) Finally, recognize the fact that once you take the religious centers (BIG FACTOR!), @unitypark, schools, Merkato and few cinemas out of the way,

...large venues such as the hundreds of stadiums, gymnasiums, movies, concert halls and nursing homes that are luxuries (and now liabilities) of the wealthy nations are not a risk for us Ethiopians.(Dr. Woubeshet Ayenew, MD,FACC)

So the bad news (I hope to be wrong) is that there are numerous youth in Addis that have the virus but are walking around with very mild disease owing to their youth and relatively good health. They may be in the hundreds or in the thousands or even more.

These mild and moderate cases of COVID-19 that amounted to 80% of cases in China, will completely resolve on their own (good news!) The big challenge will be if this minimally symptomatic youth start to spread the disease..

to the elderly and to the group with the above mentioned risk factors - such disaster, Ethiopia and most African nations won't be able to address. The 9 people we have under quarantine are least of our concerns as far as disease burden and spread is concerned if we are serious.

For the most part, the same way that a significant majority of Chinese have recovered from the illness, most infected Ethiopians will also recover with NO medical intervention. The elderly/high risk folks may not.

The most practical solution that puts into account the available resources,absence of proven immunization and pharmaceuticals as well as the absence of abundant critical care medicine will be to impose targeted mitigation to protect the elderly& the high risk citizens. Dr. Wube

PART II
POSSIBLE SOLUTION
1- Complete saturation of social medial& mass media w the message of segregating the elderly from the high risk youth is a must. People 65+ yo are 3%/3 million of the total population. Protecting these folks is easier& higher yield than with 100Million

Thee elderly, probably those even 55 and older and with many risk factors, should not be at church or using mass transport. Neither at Merkato or visiting with a coughing grand child.

Buy them grocery, stand at the door and greet them, drop grocery at the door, take zenbil with infected handle with you and leave the kissing and hugs for another day, etc etc.

2. Emphasize and repeat the social distancing the PM and MOH recently introduced. Again, start the day using mass medial and social media, do it all day long, and end the day with same messages. Do it even more than Trump, but now for good cause.

3. Educate the youth until exhaustion about the tricky nature of COVID-19 and the big misconception the prevails even in the western world. It is indeed gunfan and easily defeated in the healthy youth. Yet, is is pneumonia, ARDS and death in the elderly and high risk.

This misunderstanding of the seriousness and very different impact of COVID-19 in different risk groups appeared to have played a big role in the Italian disaster. Educate, educate, educate...

4. Educate and encourage the youth against moving freely from the city to the rural areas of Ethiopia until the end of the pandemic. Not only are the rural areas likely naive to the disease, but rural Ethiopia also harbors many of our elderly citizens who will not survive.

5. Convince and use the most potent messengers of Ethiopia, the religious leaders, to use mass media and preach the above messages. The religious leaders should step up and provide significant guidance now.

Elders and any high risk or sick individual should be given the permission to pray from home. With Good Friday/Easter a month away and Ramadan/Eid coming in rapid order, immediate action is necessary for successful mitigation.

6. The assumption that me and you, the energetic, surviving this pandemic, in part heavily relies on that us being immune, competent and well protected. Keep it that way for the sake of our elders.
#Ethiopia
@Marthinolly @Selam_Mussie

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