Covid-19: Contact tracing overwhelms govt

Tuesday September 22 2020
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An aspirant is lifted shoulder high by supporters during the NRM primaries for LC3 councillors at Mbuya in Nakawa Division, Kampala, last week. Some of the preventive guidelines such as social distancing were not observed in the elections. PHOTO | ALEX ESAGALA

By Tonny Abet

The Ministry of Health has said the high prevalence of Covid-19 in Kampala has overstretched its surveillance team, affecting contact tracing and evacuation of positive cases from communities.
The large number of patients that should be evacuated coupled with limited number of ambulances, and shortage of human resource to do contact tracing are some of the key challenges cited by the ministry.
Kampala City progressed from phase three to phase four of the pandemic in August where the spread of the virus is uncontrollable.
Out of the 6,287 Covid-19 cases recorded in Uganda, 2,097 are from Kampala, according to the ministry.
Mr Emmanuel Ainebyoona, the ministry’s spokesperson, told Daily Monitor at the weekend that although the ministry saw this dangerous phase coming, it is presenting a huge challenge.
“It is now everyone’s responsibility to protect themselves from contracting Covid-19. The Ministry of Health had anticipated this [phase 4] through the modelling by our scientists. But also as a health system, we are looking at all the dynamics that come with phase 4,” he said.
Dr Henry Kyobe, the Covid-19 incident manager at Ministry of Health, said more than 400 cases have not been evacuated.
He said many patients give a poor description of their location, affecting effort to evacuate them.
Dr Kyobe said at phase 4, the government surveillance system can only detect 10 to 15 per cent of the Covid-19 cases because contacts become too many to be efficiently followed up.

Community infections
“The larger population (85 per cent) of Covid-19 cases remain in the community and keep transmitting to other people. The current stage called phase 4 is where we are having hugely diffused transmission from various transmission lines and the biggest proportion is usually unknown. Unlike in phases 1 to 3 where we talk about containment, here we talk about mitigation,” he told Daily Monitor.
Dr Kyobe said the fact that a number of the positive cases are asymptomatic means most of them don’t report to the hospital for the transmission belt to be interrupted.
Dr Monica Musenero, the senior presidential adviser on epidemics, said: “In Kampala, if you try to do contact tracing, you will have half of the city in quarantine.”
Dr Musenero said the city ambulances can evacuate around 65 cases per day and yet there are days when over a hundred patients in community are waiting to be picked.
She said the city progressed to this phase because some people were escaping from quarantine facilities and taking the infection to their families.

Virus in 86 districts
Dr Monica Musenero said Covid-19 cases have so far been reported in 86 districts, adding that all other parts of the country are in phase three and phase two of the pandemic.  “In phase three, we have control and we know where the virus is, we are finding it and we are containing it. Phase 2 is where we majorly have few imported cases and community spread,” she said. Dr Bruce Kirenga, the director of Makerere Lung Institute, who is also involved in Covid-19 case management, said the high prevalence of the virus in the community is making more people develop severe diseases.
 

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