What next after 30-day lockdown?

Deserted. Women walk past closed shopping arcades on Lumum Street, Kampala, recently. Before the lockdown, this area was one of the busiest business hubs in Kampala. PHOTO BY ISMAIL KEZAALA

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Perspective. The most enduring fight against coronavirus has been the lockdown that is being embraced globally. Eriasa Mukiibi Sserunjogi looks at what other countries have done and whether Uganda may follow the same footsteps when the lockdown ends.

President Museveni, in his televised addresses over the past weeks, has explained that the various lockdown measures that his government has imposed are to enable the country to stop and ‘listen to the footsteps’ of the Covid-19 disease so that it can be exterminated from Uganda. It makes sense.
But, if you think about it, bringing the country to a virtual standstill is the easy part. It is a very different proposition when it comes to bringing life and the economy back to normal.
Speaking to different government officials, it is difficult to form an opinion on whether the lockdown as announced by the government will be reviewed or extended when the allotted days expire. Everyone seems to be waiting on what the Pesident will say next.
The 14-day ban on private vehicles ends on Monday. The month-long closure of schools, congregational worship, communal weddings, burials and other gatherings also expires on April 20.
At the moment, Uganda finds itself in the best possible place among the countries that have registered positive cases of Covid-19. Although 53 positive cases had been recorded in Uganda by the close of Thursday, none of these cases has proved complicated as to require to be admitted in intensive care, and no Covid-19 related death has been recorded so far.
In the four days leading to Thursday, only one Covid-19 positive case was recorded, out of a total of 821 individuals tested during the four days.
Although it has been noted that too few (3,862) Ugandans have been tested so far to reach meaningful conclusions, it is also worthy of note that the testing has been targeted at the most at-risk individuals, particularly those who recently travelled from countries that are heavily hit by the virus, their contacts and those who show symptoms. The only point of worry is that there has been no tracking of those who entered the country by road and water.
Debate rages on expanding the reach of the testing, with observers like Opposition activist Dr Kizza Besigye calling for mass testing to ascertain the gravity of the problem. President Museveni, although he acknowledges the need for further clarity on the reach of the virus within the country, argues that mass testing is impractical because the tests are expensive ($65 or Shs250,000 per test according to his numbers) and would be a drain on the resources which the country has very little of.

Which way now?
The more than 30 restrictive measures that President Museveni issued incrementally were meant to ensure extreme social distancing, by breaking up large groups of people and keeping as many Ugandans as possible in their homes.
Markets, shopping arcades, hotels, schools, bars, lodges, taxi and bus parks, and many other workplaces remain closed. Offices like law firms, tour and travel companies and others are also closed. Those which remain open, like banks and media houses, have scaled down significantly and operate at the bare minimum. Even most government offices remain frozen.
Millions of working Ugandans have been asked to stay in their homes. Those who run petty businesses are consuming their little capital, and those who are employed worry about their jobs. Different business owners have appealed to the government for reprieve in different ways to ensure that they don’t go under.
Given this state of affairs, and in view of the fact that official reports show the spread of the virus has not reached worrying levels and appears to still be manageable, how will the government proceed when the prescribed lockdown period expires?
Mr Gabriel Leung, an epidemiologist and dean of medicine at the University of Hong Kong, advises the governments of China and Hong Kong on the coronavirus. Epidemiologists study patterns of frequency and the causes and effects of diseases in human populations.
On April 6, Mr Leung wrote an Opinion in the New York Times entitled “Lockdown cannot last forever. Here’s how to lift it.” He predicted that the world will experience a number of waves of Covid-19 attacks. In particular, he warned societies that have not been hard hit by the first wave that subsequent attacks could be more severe.
Whereas the decision makers in Uganda will hope that this is misplaced fear mongering, they will be best advised to tread carefully as they plan the path into the future.
Mr Leung makes another projection which doesn’t sound great to the ear either; that the world will have to wait for at least a year for a vaccine for Covid-19 to be developed and made available for everyone.
During the coming year or more, therefore, human beings will be preoccupied with hiding from the virus.
Mr Leung then adds: “And so to see us through the next year or more, we must all prepare for several cycles of a “suppress and lift” policy — cycles during which restrictions are applied and relaxed, applied again and relaxed again, in ways that can keep the pandemic under control but at an acceptable economic and social cost.”
If Uganda’s case were placed before Mr Leung, he would perhaps recommend that at this point the government should lift some of the restrictions while it continues to monitor the situation, and be ready to swiftly reinstate the controls if (or when) infections start to rise again.
We put it to former presidential candidate, Prof Venansius Baryamureeba, on what he would do at the expiry of the current lockdown period and in light of how things have played out.
Prof Baryamureeba said: “I would allow private cars to move but limit the number of persons per car to two, including the driver. But they (occupants) must wear masks. I would allow boda bodas (to move) as long as the passenger and driver have masks. I would allow all businesses to reopen but exercise social distancing. I would keep the borders closed.”
But when all businesses reopen, we put it to Prof Baryamureeba, places like downtown Kampala would be so crowded that social distancing cannot be achieved.
He retorted: “You reopen slowly, by leaving out those selling items that are not so urgent like clothes. Reopen, for example, hardware shops.”
But then, those who deal in items which are ‘not so urgent’ also have livelihoods to sustain, and have their lifetime savings locked up in shops in form of stock. Many took loans to set up the businesses. The government cannot keep them out of work for months lest the economic situation worsens.
We also put the question of how to proceed after the lockdown days to Dr Besigye, he said: “The biggest problem is that we do not have needed information to have a considered opinion. Only very few people have been tested; we really do not know (scientifically) the situation. It is easier to relax internal travel but there is also external travel – what indicators can be used?”

Unpopular proposals
President Cyril Ramaphosa of South Africa on Thursday announced that the national lockdown he declared starting on March 27, initially for 21 days, would continue for a further 14 days until the end of April.
Saddled by the highest number of confirmed Covid-19 cases in Africa - 1,934, with 89 new ones reported on Thursday – South Africa is feared to be on the brink. At least on the political front, there is consensus that the lockdown needs to continue to save the country.
But then there is another view, expressed by six top professors from the University of the Witwatersrand in an article entitled ‘South Africa needs to end the lockdown: here is a blueprint for its replacement’.
The academics, drawn from disciplines as disparate as medicine, economics and the social sciences, argue that their country faces a trio of interrelated problems; “the public health threat from the Covi-19 pandemic, the economic and health effects of the lockdown, and a range of intractable economic problems not directly due to the current pandemic. These include high unemployment, low economic growth and falling per capita income.”
They add: “Any potentially viable response to Covid-19 needs to address all three aspects in concert. This is particularly important as the country plans for the next stage of its response after the lockdown. Focusing only on the health challenges and not paying attention to the economic issues will result in significantly higher economic costs, and will also undermine the health imperatives.”
They then argue: “Decisions on differential opening of the economy should be made in line with the criteria proposed in a recent paper by German researchers. This includes, for example, opening sectors with low risk of infection (highly automated factories) and less vulnerable populations (child-care facilities) first. It could also include areas with lower infection rates and less potential for the spread of Covid-19.”
These arguments are being made in a country with a worrying growth rate of infections and whose president said only on Thursday that the lockdown which has been in place for over two weeks has not worked to reduce infections.
Uganda does not have highly automated factories to speak of, but the argument about letting less vulnerable populations mix has been forcefully made by many scientists.
From Western Europe to the United States and now to South Africa, different scientists have argued, for instance, that schools should reopen and the children left to mingle. This is based on the observed fact that young people are less likely to be severely affected by Covid-19 than older people.
And a number of scientists have projected advantages that could result in such a move. They argue that for the potency of the coronavirus to be neutralised, at least half of a society’s population will have to first develop what they call herd immunity for the virus.
This implies that they will have either caught and recovered from it, with their bodies developing anti-bodies to fight it; or they will have been vaccinated against it.
With a vaccine not expected until at least after a year, the idea of building herd immunity has been presented by some scientists as a possible short-term solution.
The government of the Netherlands was at first minded to let some young people with strong immunity to mix and contract the virus with the view of generating herd immunity. The idea had been to ask the older people and those with low immunity to keep away from the rest. But the Netherlands backtracked from the policy when infections started to rise too fast for their liking.
In the end, it is difficult to gamble with lives, especially when the consequences are not certain since the virus could mutate into a more dangerous strain. The most viable option before a vaccine emerges, therefore, is to keep hiding from the virus.
How to do that on the one hand and ensure that people get back to work is the delicate balancing act in which the government is involved.

Opposition activist Dr Kizza Besigye: “The biggest problem is that we do not have needed information to have a considered opinion. Only very few people have been tested; we really do not know (scientifically) the situation. It is easier to relax internal travel but there is also external travel – what indicators can be used?”

Epidemiologist Gabriel Leung: “Lockdown cannot last forever. And so to see us through the next year or more, we must all prepare for several cycles of a “suppress and lift” policy — cycles during which restrictions are applied and relaxed, applied again and relaxed again, in ways that can keep the pandemic under control.”

Prof of Computer Science Venansius Baryamureeba: “I would allow private cars to move but limit the number of persons per car to two, including the driver. But they (occupants) must wear masks. I would allow boda bodas (to move) as long as the passenger and driver have masks.”

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