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The truth lies buried

Caligula

A  few weeks ago, around the start of Lockdown, it was reported that an expatriate woman was to be prosecuted for sharing a false report on  Corona on a local Whatsapp group.  Having not seen a follow-up, that may very well have also been ‘Fake news’!  It is so hard to tell these days.

For example, this morning I woke up to a post on our work Whatsapp group announcing a change to the government order lifting certain lockdown restrictions, namely free movement within zones, potentially causing a flurry of problems, angst and cancelled plans.   It looked legitimate enough and I guess feasible, but one member questioned its authenticity because she had not seen the same information verified in any other news feeds.

In this instance her suspicion was warranted because the information turned out to be false.  This is where we are today – where the possibility of fake news and our awareness of it is so high that we have become suspicious of much of what we read and hear.

It all too common. Earlier this month a video of an elderly woman with coronavirus being put into a body bag whilst still alive went viral. The video showed her on top of plastic sheeting struggling to breathe with a caption claiming her family had been told she was dead. It originated in Brazil and spread on WhatsApp and Facebook where various versions were shared hundreds of thousands of times, including in large,  English-language conspiracy groups.

The truth was not quite as dramatic.  BBC News Brazil was told by director of the Abelardo Santos Hospital in northern Brazil that the protective sheeting she was lying on was indeed a body bag, but it was used as a makeshift stretcher to transfer her to another bed. “It’s a common practice in hospitals,” he said, “especially during a pandemic which forces us to adapt”. So, the picture was genuine, but the interpretation was not just misleading, it was malicious and even mendacious.

False reporting is not new although the term ‘Fake news’ has certainly been so popularised and promoted by Donald Trump it has moved into common usage in our everyday language. With Trump, of course, it appears to be that when he sees or hears something that does not fit his narrative, he immediately declares it ‘fake news’ and simply ignores it! But as I said, this is not a new phenomenon.

In the late 1930s when the now famous Orson Wells’ War of the World’ radio play  was broadcast on American radio it was reported that it had resulted in mass hysteria with tens of thousands of people fleeing their home believing  it to be news reportage of a genuine alien  invasion. These reports turned out to be untrue, though the myth was disseminated for decades.

While there may have been a handful of people who thought that the airing of the drama was the real thing,  the panic story was “almost entirely anecdotal and largely based on sketch wire service round-ups that emphasized breadth over in-depth detail” .   Yet the myth that this really had happened was kept alive until as recently as 2010 when it was debunked in a study cleverly called ‘The War of the Words Panic’.

Today our media may be markedly different, but the issue remains the same. Last year on a CIGI-Ipsos Global Survey on Internet Security and Trust ,  a majority admitted to falling for fake news at least once – citing Facebook as the leading, offending source:

86% said they had fallen for fake news at least once, with 44% saying they sometimes or frequently did.

Only 14% said they had “never” been duped by fake news.

Facebook was the most commonly cited source of fake news, with 77%  users saying they had personally seen fake news there, followed by 62% of Twitter users and 74% of social media users in general. Also, in the study social media companies emerged as the leading source of user distrust in the internet — surpassed only by cybercriminals — with 75% of those surveyed citing social media platforms as contributing to their lack of trust.

One thing which I have struggled with during this period is being regulated as to when I can exercise, shop, go to work, meet friends or not.  While I am appreciative of governments’ need to protect its citizens and health care systems,  it is at odds with my need to make personal determinations about my health, safety and how I go about my life.  It the same feeling I get when I feel manipulated, duped or lied to in the media.

Surely it is time that governments and internet companies make more effort and take more responsibility to combat fake news from social media and video sharing platforms by deleting fake news posts, videos and offending  accounts and  adopting  consensual automated approaches to content removal and censorship?

However, just as I am torn with being controlled during a lockdown and the obvious need for the measure, I am also sensitive to the idea of controlling news as the question arises ‘where does freedom of speech start and end?’

Independent and uncontrolled media and the independence of the Fifth Estate  is the cornerstone of democracy and free choice.  But here’s the rub.  The untrammelled phenomenon of social media means that where once press accreditation was  a privilege granted only to the few, no such entry requirement is required to sign up to social media; where once an astute editor would proof and censor written copy or broadcast news reports,  no such supervision  and second opinion is required  to post in Cyberspace.  In other words, any Twit can Tweet on Twitter!  There are no checks and balances, no –one to put a metaphorical red pen through cant, crudeness, crassness, propaganda or prejudice.  The likes of Bill Gates, Steve Jobs and Mark Zucherberg opened up Pandora’s box , removed the filter at the top and let the  opinions  of the masses loose.

There is an answer but you won’t like it and you’re holding it in your hands right now!  Believe nothing and accept nothing not appearing in the mainstream press or in an old-fashioned, hard-copy book.

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Government Should Restrict State Lottery Participation To Citizens

30th June 2020

The announcement on June 5 that Botswana finally had a national lottery was received with a fair amount of fanfare. There was no frenzied fist pumping or some such joyous acclamation or ululation but the mood of anticipatory excitement was palpable, more so on social media.

The euphoria, albeit a muted one, is understandable: we have at long last come to the party too, when many of our fellow African countries have had state lotteries for decades now. Zambia’s, for example, has been in existence since the early 70s. As the all-too-familiar but counter-productive adage goes, there’s no hurry in Botswana, with some people adding the rather hollow and vainglorious boast, “We are very rich”, which certainly is a side-splitting stretch of the truth.

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Moses was Joseph’s Grandson

30th June 2020

… and he was not encountered on a water course

Exactly how did Joseph (Yuya to the Egyptians) look like, General Atiku? The answer is not a difficult one as his well-preserved mummy, along with that of his wife Tuya, was found in a tomb of the Valley of the Kings in Egypt in 1905.

He does not remotely look like the Egyptians of the day, General, who were Negroid, but comes across as a white Jew. One description characterises him thus: “He was a person of commanding presence, whose powerful character showed itself in his face.

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The case against COVID-19 mass community testing

30th June 2020

There is a school of thought which holds the view that mass community testing is a necessity if we are to win the war against the COVID-19 pandemic. Another holds the view that targeted testing is sufficient. I subscribe to the latter view for reasons I shall discuss herein.

First is the issue of the cost of the tests as opposed to their value. Unfortunately, I am not aware of the cost per test in Botswana. I shall use the case of South Africa for two reasons.

Firstly, at the beginning of the pandemic, our samples were taken there for testing. Secondly, though the Botswana Pula is stronger than the South African Rand, the cost of the COVID-19 test is unlikely to vary much because of the proximity of the two countries.

According to Dr. Nathi Mdladla, Associate Professor and Head of Intensive Care Unit (ICU) at Sefako Makgatho University, the cost of a COVID-19 test in South Africa per capita is ZAR 1 200.00. This is equivalent to BWP 811.63.

To put the issue of cost into perspective, we need to consider Botswana’s COVID-19 statistics. As at 23rd June 2020, Botswana had 33919 tests performed and resulted; 33830 negative cases; 89 confirmed cases; 10 new confirmed cases; 1 death and 25 recoveries.

If we use the amount of BWP 811.63 per test, it means we spent BWP 27, 529,677.97 on tests out of which there were only 89 confirmed cases and the rest were negative. From these 89 confirmed cases, only 1 died.

If we had been conducting mass community testing as some people suggest, we could have tested, say, 120,000 people by now at a staggering cost of BWP 97, 395,600.00.

According to Dr. Mdladla, when embarking on a medical test of any sort regard must be had to, inter alia, the indication of the test, that is is there any value derived from testing? Here, the question is: are you testing for a particular value or you are testing for the sake of testing?

It is common cause that COVID-19 neither has a vaccine nor a cure. If you take HIV/AIDS for instance, though it has no cure, it has treatment in the form of Anti-Retroviral (ARVs) drugs.

So, if there were to be mass community testing for HIV/AIDS, for instance, one of the values of such tests would be to enrol those who test positive on ARV treatment.

The fact is, due to resource constraints, the hundreds or thousands who may test positive for COVID-19 from mass community testing cannot even all be put in quarantine or isolation even if they are symptomatic. No country can have such capacity.

In my view, the only benefit that can be derived from mass community testing is awareness of the prevalence of the pandemic, and perhaps the most affected areas. The question is: what further value can be derived from that?

Proponents of mass community testing argue that this information is useful for the country to decide on its allocation of resources for procurement of ventilators, PPE equipment and hospital beds.

In my view, a country does not need to spend millions in mass community testing for such a purpose. The same result can be achieved through scenario planning and modelling, something which all countries have done or ought to have done.

In my view, instead of spending millions in mass community testing, the country should assume the worst-case scenario and use such money to procure ventilators, PPE equipment and hospital beds. In any case, even if the worst case scenario does not materialise, such resources can be used for future medical eventualities.

The other consideration which Dr. Mdladla says should be taken into account when conducting medical tests is accuracy of a test . That is, the test must have a high specificity and high sensitivity. It must have very low false negatives and low false positives.

In early April, the President, Vice President, some cabinet ministers, Members of Parliament and some journalists were put in quarantine following a case involving a nurse who had contact with them, which some argue may have been a false positive.

About one week ago, the Greater Gaborone COVID-19 zone was put on lock down because of false positive results at a private hospital.

In my view, given the possible false COVID-19 results, it would not be prudent to conduct mass community testing. Imagine if the tests return thousands of false positives!

The other consideration which Dr. Mdladla says should be taken into account when conducting medical tests is that the test must be meaningful for wide-spread use, for instance, if a cure exists and where knowing the status has impact on disease/population management then the test is useful.

We have already argued that since COVID-19 has no cure, mass community testing would be of little value, if any. Dr. Mdladla argues that knowing that one’s status is positive does not change anything for the majority of patients who are not sick as the disease is self-limiting, but it is useful in those presenting with moderate to severe symptoms.

He also argues that even if one tests negative there is a possibility that this could be wrong and one need not drop their guard. In his view, therefore, it is better to assume that everyone is positive and to test only those who are symptomatic for focused management. I agree.

He posits the question: if 80% of the population has mild disease that does not require admission, what is the value of knowing that people are positive when they can’t be treated, especially in the face of high false negatives?

In his view, it would be cost effective to assume that everyone is positive and continue practices aimed at limiting the spread of the virus. I agree. This is where our resources should go to, not to mass community testing.

The other consideration which Dr. Mdladla says should be taken into account when conducting medical tests is that they must be cheap and easy to perform and interpret.

In my view, if a single COVID-19 test can cost about BWP 811.63, it is not cheap. Some people earn that much as a monthly salary which takes care of an entire household. The fact that the test is so costly suggests that it is not easy to perform and interpret.

The other consideration which Dr. Mdladla says should be taken into account when conducting medical tests is that they should require minimal expertise in the remote population settings.

Clearly, considering the cost of a COVID-19 test, and the fact that the tests can only be conducted by experts using specialised equipment, it can be safely concluded that the test requires high expertise, making it difficult to conduct in remote population settings.

It is common cause that Botswana’s population is mainly based in rural and remote arears, posing a challenge for mass community testing if it were ever to be government policy.

The other consideration which Dr. Mdladla says should be taken into account when conducting medical tests is that they should be less invasive, giving an example of a pregnancy test which one can conduct on their own. It appears to me that the COVID-19 test fails this test since it must be conducted by an expert.

The other consideration which Dr. Mdladla says should be taken into account when conducting medical tests is that they should entail short processing time to allow an appropriate intervention in the shortest time.

It appears to me that the COVID-19 test passes this test since the results can be available within 48 hours though a second test must be made about two days apart to confirm the initial result.

In view of the aforegoing, I conclude that government of Botswana’s decision to conduct targeted COVID-19 testing as opposed to mass community testing is well advised.

*Ndulamo Anthony Morima, LLM(NWU); LLB(UNISA); DSE(UB); CoP (BAC); CoP (IISA) is the proprietor of Morima Attorneys. He can be contacted at 71410352 or anmorima@gmail.com

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