Mulago hospital tells govt to lift lockdown

Authorities at Mulago National Referral Hospital have advised the government to lift the Covid-19 induced lockdown so that people can move freely or risk suffering devastating after-effects.

The doctors said Covid-19 is a mild disease that can be treated from home, warning that there are other serious illnesses that are not being given due attention.
Dr Baterana Byarugaba, the Mulago hospital executive director, while addressing members of the Rotary Club of Kololo yesterday, said Ugandans should stop fearing coronavirus because the strain in the country is a mild form of flu, which does not require hospital admission since it can be treated at home.

“l told Ugandans right from the beginning that the type of coronavirus we expect in Uganda is the mild one. It can be treated at health centre II, III, IV or the district hospital,” Dr Baterana said.

“Some cases can be treated at home and do not need referral unless the patient has other underlying sicknesses such as cancer, diabetes, and hypertension,” he added.

Dr Baterana was backed by his colleague, Dr Fred Nakwagala, the head of Covid-19 case management at Mulago hospital, who said more attention is being given to Covid-19 patients yet there are other ailments that are more dangerous and need urgent attention.
Giving a public health infection control perspective, Dr Nakwagala said lockdowns are effective for shorter periods but when they are prolonged, the after-effects are diverse and bear negative implications for the country.

He said in medical ethics, one has to balance between risks and benefits.

“It doesn’t make sense to lock down people permanently when preventing a mild disease. People are going to die of serious diseases. Uganda has 400,000 people with diabetes. Right now, they are not getting treatment because they are not going to hospital,” Dr Nakwagala stressed.

He explained that chances of getting more Ugandans dying now are high because beds for treating diabetic patients are being used by Covid-19 patients He said Covid-19 management diverted the general focus of Ministry of Health from the management of other equally important programmes such as reproductive health, non-communicable diseases, immunisation and HIV/Aids treatment.

Dr Baterana said since the hotspots for new infections are now known to be the borders, there is need to improve their management and release the rest of the country from the lockdown.

He said the increasing Covid-19 infections in the neighbouring countries and South Sudan cannot be compared to the Ugandan context because the approaches for the management of the disease in those countries are different from what Uganda is doing.

Government response
When contacted about her colleagues’ claim, Dr Joyce Moriku Kaducu, the State minister for Primary Healthcare, said they are reopening the lockdown in a phased manner to enable Ugandans return to normal life with precautions.

“We are reopening in a systematic phased and coordinated way. We need to give credit to our health workers for a very good job they are doing. A lot of studies are going on to find out why Uganda is doing very well,” she said.

Asked to confirm whether the strain of the virus in Uganda does not kill, Dr Moriku said they are also wondering why Covid-19 patients with illnesses such as diabetes, hypertension and advanced age were able to recover. Yesterday, the Rotary Club of Kololo donated 21 50-liter drums, 200 aprons and hand sanitisers to Mulago hospital.
Dr Christine Luttu, the club president, said the contribution is a direct intervention for the Covid-19 patients due lack of inadequate facilities at the hospital.

Research
Prof Freddie Ssengooba, an Associate Professor of Health Economics and Health Systems at Makerere University School of Public Health, said ful or partial lifting of the lockdown has to be examined carefully.
Citing Los Angeles in the United States of America, he said the state had an early lockdown and an early release while Florida delayed to reopen but are now the epicentres of infections.
He said the period a country decides to reopen matters a lot. Prof Ssengooba said high population groups such as churches, mosques, schools and night clubs enable social mixing.
“Now that we know that between 30 and 40 per cent of the population is asymptomatic, I am not saying that we should remain in the lockdown but we must balance the risk because these are bigger transmission centres,” he said on Tuesday.
Prof Ssengooba explained that the fact that Uganda has not registered a single death is no justification for fully reopening because if not carefully examined, fully opening up can overwhelm then country’s weak health system “and we shall not be able to cope up with the high number of people getting infected and admitted like in Kenya.”
He said under such situations, is when health workers get overstretched and infected with the disease.
[email protected]