Doctors list options to avoid lockdown

Doctors under their umbrella Uganda Medical Association (UMA) are discussing options for government to undertake in order to mitigate the Covid-19 crisis and avert escalation of infections without reverting to a lockdown.

The UMA president, Dr Richard Idro, said the seven options being discussed by the country’s doctors were presented by one of their members, Dr Frank Asiimwe, but that many of his colleagues agree with him.

Dr Asiimwe is UMA’s chief of welfare. Dr Idro said the doctors are analysing Dr Asiimwe’s strategy for Covid-19 and the final decision will be communicated to government.
“It is being discussed and there is quite a number of doctors who think like that. We will come up with a position on that,” Dr I dro said yesterday.

The lockdown option
Dr Asiimwe told Daily Monitor that the first lockdown achieved its objectives such as time to prepare minds of the public and reduce influx of infection from beyond borders. He said the country cannot keep running away from the coronavirus because it will be with us for a long time.

There has been public speculation that following the rapid rise in the number of Covid-19 community infections, the President will announce a second lockdown after the one announced in March was relaxed early June with the reopening of public and private transport, albeit with some restrictions.
Dr Asiimwe said a second lockdown would cause an astronomical human, economic and public relations costs ‘not be worth’ the gamble.

In the Covid-19 prevention options Dr Asiimwe submitted to the doctors association for discussion, he proposes to government to continue the current public awareness messaging and strengthen enforcement of the Standard Operating Procedures.

He says government should stop admitting every person infected with Covid-19 to Covid-19 treatment centres and instead admit persons with moderate to severe symptoms. He says as soon as the admitted person becomes asymptomatic in hospital, they should be discharged to continue care from their respective homes.

Other proposals include creation of mobile Covid-19 treatment and rapid response teams, upgrading Covid-19 evacuation ambulances to the level of Intensive Care Unit ambulances, accompany each ambulance with military police or regular police lead car, and the ambulances should respond to calls from coronavirus patients that have been getting care from homes.

He also proposes to government to increase the number of Covid-19 treatment centres, well stocked with personal protective equipment for health workers, oxygen and other supportive medical supplies.

Dr Asiimwe reasons that by taking care of asymptomatic patients at home, this would ease the burden on the limited resources available in hospitals.
“Asymptomatic patients in hospital require care from doctors and even if they have no symptoms, as a doctor, I have to go there and make sure they do not have any symptom so they will take up my time …,” Dr Asiimwe said.

“With robust monitoring, evacuation mechanism and ambulances equipped to an equivalent of an ICU, you can sustain a life there...,” he added.
He said if these proposals are agreed on by the doctors’ association, they will then be submitted to the Ministry of Health for consideration.

The fear of a second lockdown has gripped the population so much that since Monday, some members of the public, especially taxi and boda boda operators, were spotted intercepting people who were found without wearing masks and encouraging them to do so in various parts of the city centre so as to avoid another lockdown.

However, Dr Jane Ruth Aceng, the Health minister, has since dispelled the claims of another lockdown, saying government had not discussed it.
Dr Idro said the doctors association has already agreed on some of the proposals on how the ministry can change its Covid-19 prevention strategy.

He said the options include implementation of the agreed plans such as tents in regional referral hospitals, opening Namboole stadium to some of the patients, training all health workers in private and public hospitals, creating a partnership with or support private health facilities to establish patients holding units, and provide them with infection prevention and control materials.
As of yesterday, Uganda’s coronavirus cases stood at 2,426 cases, with 1,267 recoveries and 25 deaths.

Proposed options
● Continue current public awareness messaging and enforce hand hygiene, wearing of facemasks and social distancing in public spaces.
● Stop admission of every coronavirus positive person to Covid-19 treatment centres; only admit persons with moderate or severe symptoms

● Immediately a Covid-19 person becomes asymptomatic, discharge them from hospital to continue care from home.
● Stock up on personal protective equipment for health workers, oxygen and other supportive medical supplies at Covid-19 treatment centres. Increase Turn Around Time (TAT) for tests.

● Increase number of Covid-19 treatment centres and upgrade them to the levels described in 4 above.
● Upgrade Covid-19 evacuation ambulances to ICU-level ambulances. Ambulances should respond to calls from coronavirus positive patients who are receiving care from home and require evacuation to the treatment centre or require check-up.

● Create mobile Covid-19 treatment and rapid response teams. Station them in the equipped ambulances and each team must have a Covid-19 trained doctor, nurse and Emergency Rescue Technician.
The doctors said investment in the above measures would allow the rest of the country continue to open up steadily with further guidance from the Ministry of Health.

Namboole to receive Covid-19 patients

Meanwhile, Mild Covid-19 patients, especially those from Kampala, will be handled at a Covid-19 treatment centre at Namboole stadium starting next week, and leave moderate and more severe Covid-19 cases to hospitals.
Dr Charles Olaro, the director of curative services at the Ministry of Health, said the preparatory work at Namboole was interrupted by the repatriation of Ugandans abroad. However, he said the work should be completed by this week.

“The work was initially interrupted when we had to accommodate the people who had been repatriated,” Dr Olaro said in telephone interview yesterday.
In April, the Health ministry said they had planned to turn part of the national stadium into a health facility if the number of Covid-19 cases increased. Government says the facility is to have 40,000 beds for managing Covid-19 patients in the country.
Dr Olaro said the teams are already trained and the leading team for Namboole is headed by the management of Kiruddu Hospital.

Dr Olaro said they will start with 1,200 beds.
This comes at a time when there is a spike in the number of cases and deaths in Kampala. As of Monday, Kampala had registered at least 650 Covid-19 cases of the total 2,362 cases registered in the country.

Over the past few months, there has been an increase in the number of cases following the easing of the lockdown.
Globally, at least 23,834,257 coronavirus cases had been reported, with 817,474 deaths and 16,377,700 recoveries.

[email protected]