Seven gaps government must fix before easing lockdown

As government plans to ease the Covid-19 lockdown that has kept the country’s businesses shut and residents at home since March 22, experts at the frontline have warned that if the processes are not done with “extreme care”, a more severe secondary wave of Covid-19 infection may hit the country.

According to experts, the deadly virus may still be around until a vaccine or cure is availed and that the government must ensure that individuals strongly adhere to safeguard themselves from situations that expose them or loved ones to the infection.

In his televised address to the nation on Tuesday, President Museveni hinted at the possibility of easing on the lockdown restrictions, saying that the government was still collecting information on local transmission to inform the decision of whether to lift the lockdown or not.

“We shall let you know what to do before May 5, the day when the lockdown has been slated to end, after we do a study on what is taking place in the community,” Mr Museveni said.

This followed a Cabinet meeting chaired by the President on Monday that agreed to lift the lockdown but in a phased manner.
The ministers were tasked to present sector plans next week [May 2].

Scientists including experts at the frontline in the war against the pandemic have, however, pointed out seven critical “soft spots” that government should urgently address before easing on the Covid-19 lockdown.

Truck drivers
Prof Freddie Ssengooba, a health policy expert and director of the SPEED Project, asked the government to fully address the issue of truck drivers before thinking of relaxing the lockdown.

Speed refers to Support for Policy Engagements for Evidence-based Decisions for universal health coverage in Uganda.

Prof Ssengooba, who is also a member of the Ministry of Health scientific advisory committee, said although closing the supply line is a “suicidal,” action, the risk truck drivers present still remains the biggest challenge in the fight against coronavirus.

He said health ministers in the East African region should consider bringing their heads together as a group to address the latest problem of truck drivers.

“We have managed to curb the local cases in a number of ways but the truck drivers [from neighbouring countries] are bringing the infections into the country. There has been some system put in place to monitor and regulate movement of the truck drivers but the risk is big but containable,” he added.

Prof Ssengooba also explained that if the regulations on truck drivers are enforced, it can minismise their mixing with community members and reduce the risk of infection going to communities.

Dr Joyce Moriku Kaducu, the State minister for Primary Healthcare, however, said government is working to provide rapid diagnostic kits that can be used to test the truck drivers.

The minister also talked of an on-going strategic engagements at East African Community level to make truck drivers come with certified test results from their countries.

“The tests are being validated and we shall have it soon. You know the tests done by Uganda Virus Research Institute take time because it is more complex, it being a gold standard. We already have mobile laboratory that will be in position to do test,” Dr Kaducu added.
Public transport

Dr Misaki Wayengera, the chairperson of the Ministry of Health scientific advisory committee on Covid-19 and other scientists, argued that government should think carefully before opening some sectors or else “we burn our fingers”.

Dr Wayengera maintains that the regulation on disinfecting, wearing of masks and social distancing should be strongly enforced by authorities.

“If taxis should come back, there should be only three or four passengers per taxi which is largely not feasible. They should not come back. We should rather have a bus which carries one passenger per seat and everyone should be [compelled to] wear masks,” he said.

He said if the reopening is not done properly, then the country should prepare for severe consequences.
“These guidelines were put in place to protect lives. We also understand that people cannot stay in a lockdown forever otherwise they will start rioting [but we are protecting lives],” Dr Wayengera said.

He said there were discussions on critical sectors that government should go slow on when it comes to lifting the Covid-19 lockdown.
Prof Ssengooba also contends that if public transport is to operate, enforcement on the number of passengers, sanitising and wearing of masks should be strongly enforced or we risk mass infections and death.

Local transmission
One of the greenlights for lifting the lockdown according to World Health Organisation (WHO) guidelines, is when the country considers that the transmission has been controlled.

But Dr Richard Idro, a neurologist and president of Uganda Medical Association (UMA), told Daily Monitor yesterday that the government should first confirm whether there is no local transmission of the disease.

“Fortunately, the Ministry of Health has sent a team of 500 epidemiologists to try to detect whether the disease is not in the communities,” he said. He added that government should prioritise the result of that study to determine whether to lift the lockdown or not.

Anxiety and stigma
According to Prof Ssengooba and other experts, if the issue of fear and stigma about the disease is not addressed, the sectors that shall be opened will undoubtedly have hardship in functioning.

“Children will run away from schools because someone coughed in class and yet some of these are normal conditions we had been experiencing before Covid-19,” Prof Ssengooba said.

Government should focus on addressing the issue of anxiety and other psychological disorders associated with coronavirus, according to Prof Ssengooba.
“We should not be too scared even if we hear that 100 people test positive. As we have seen the portion of people who get severely sick because of the infection is very small, less than 1 per cent,” he said.

“90 per cent of people who get infected may even recover without knowing they were infected. We should stop getting anxious about the number of cases going high every day,” he said.

Porous border

Border crisis. Experts have advised that any attempts to lift the Covid-19 lockdown without beefing security at the porous borders will be suicidal and asked the government to deploy soldiers at all the border points.

A number of positive cases were got from refugees and traders who were crossing into the country through such borders. Daily Monitor also established that security personnel were taking bribes from foreigners to grant them entry.

According to Dr Diana Atwine, the Permanent Secretary at the Health ministry, government has directed efforts to curb the continued entry.

Cabinet last week discussed the matter and cited what sources called leaky borders as one of the red flags in the war against coronavirus. Dr Atwine explained that the government is “now escalating the fight [against Covid-19] to the districts and concentrating on the various points of entry into the country.”

She said community members around porous borders were being sensitised to report cases of illegal entrants. Earlier, Gen Elly Tumwine, the Security minister told this newspaper that the few security personnel who were taking bribes were being followed up and would be brought to book.

Testing issue

Diagnosis. According to Prof Freddie Ssengooba, government should not be restrained by shortage in supply of testing kits from foreign countries.

“We can do verbal testing where you go and ask people if they have had symptoms such as coughing, sneezing and other signs of covid-19 among members of their community,” he said. He said that from the information gathered, few samples of blood or nose swab can be picked from members of that community for laboratory analysis to ascertain whether they got exposed to the virus.

“In the study I did in a number of schools, many health workers in schools, said there was a strong wave of unusual cough that disturbed students and pupils [before they were suspended],” he said.

Prof Ssengooba said day schools have more risks because of the contacts students or pupils may make on the road every day. “Boarding schools are, however, not a big issue because they are almost self-contained and external people like visitors can be easily restricted,” he said.

Personal protective equipment (PPE)

Safeguarding. Before easing on the lockdown, Dr Richard Idro, a neurologist, and other scientists have asked the government to protect health workers- the men and women at the frontline in the war against the deadly virus.

Dr Idro said most health workers in the various parts of the country do not have personal protective equipment (PPE). He said these gears are essential in protecting health workers and patients they handle.

“Around the world, 10 per cent of people who have got infected [by Covid-19] are health workers. Fortunately, no Ugandan healthcare worker has been infected,” he said.

The shortage of PPEs given by government to health workers has left a large number of medical workers out of duty, according to the UMA boss.

“The majority of health workers, especially in lower hospitals, have not been provided with. The percentage reached is way below 30 per cent,” he said.

“The treatment centres are covered and government has been releasing some equipment to regional referral hospitals,” he added.