Gaps in Ebola response stick out as cases grow
What you need to know:
- Latest statistics from the Health ministry indicate that there are seven confirmed cases of Ebola infection.
The government officials in the Ebola response team have warned that cases of infections may continue to rise because of the delayed response and limited knowledge about the extent of the spread of the disease.
Health workers, who are leading the investigations into the root cause of the outbreak, have neither determined the source of the outbreak nor the index case, at least by Friday.
This, besides affecting the accuracy of contact tracing, means unsuspecting infected persons could be spreading the disease in communities.
The latest statistics from the Health ministry indicate that there are 11 confirmed cases of Ebola infection and three confirmed Ebola deaths. Around six of the probable deaths happened in communities.
Dr Henry Kyobe, the Ebola incident commander, said in an interview on Thursday that the disease seems to have started at the beginning of this month. But the outbreak was confirmed on Tuesday, meaning the disease has been spreading for weeks.
“There is a little bit of a time lag from the earlier cases and the time we confirmed and declared the outbreak. Ebola symptoms are similar to that of malaria and typhoid. The infections can be mistaken for a common illness,” he said in an interview on Thursday.
He added: “It was until the individual (first case) went to the major public facility (Mubende Regional Referral Hospital) that the disease was identified. The person moved from one private facility to another.”
In a state of flux
Describing the situation as fluid, Dr Kyobe said authorities don’t know “the extent and scope of it” but that they “think cases may rise.”
Already, around 43 contacts of Ebola victims have been listed and some have not yet been followed, according to information from the Health ministry.
The outbreak was triggered by the Sudan Ebola virus whose death risk ranges from 25 percent to 90 percent for infected persons, according to the World Health Organisation (WHO). This is several times higher than the case fatality rate of Covid-19, which hovers around three percent.
“There is no evidence of the circulation of Sudan Ebola virus in Uganda. We last had an outbreak of the same type of Ebola 10 years ago, so we think this is a fresh spillover from the wild that is happening,” Dr Kyobe explained.
Besides the gaps in what the investigations team knows, there have also been reports of poor corporation in the communities.
The Mubende Resident District Commissioner, Ms Rosemary Byabashaija, said on Thursday that four Ebola suspects ran away from the health workers who had gone to evacuate them from the community on Wednesday.
The four were from the Madudu Sub-county in Mubende, the district where the outbreak was confirmed on Tuesday. They are the contacts of the 24-year-old man who passed on at Mubende Regional Referral Hospital on Monday.
“You can see that people don’t believe in the disease or are still ignorant about it, but we have decided to continue with sensitisation and we have formed the sub-county task force led by sub-county leaders to take a lead in sensitising the community after realising that people believe in their leaders,” Ms Byabashaija said.
Health workers hesitant
The Uganda Medical Association (UMA) leader, Dr Samuel Oledo, also said health workers are hesitant to join the response team because the government has not honoured its promise of compensating families of people who died in the line of duty during the Covid-19 response.
The health workers in Mubende reportedly went on strike on Friday because of fears that they will not be given their allowances as was experienced by Covid-19 health workers.
Information from the UMA indicates that at least 62 health workers died in the line of duty.
“They were meant to be compensated 60 months based on the salary rates that the deceased was getting. But if they have not been compensated, how do you convince the living?” Dr Oledo asked.
Mr Emmanuel Ainebyoona, the Health ministry spokesperson, said they are finalising plans to handle the compensation of families of health workers who died and also ensure those in the Ebola response are motivated.
Dr Kyobe on the other hand said they are working with communities and health workers are doing contact tracing.
“We have sufficient amounts of personal protective equipment (PPE) for the health workers. The WHO deployed Ebola kits, but we also had leftover PPEs from Covid-19 that we are still using,” he said.
Information from the Health ministry indicates that the majority of the cases are coming from five sub-counties within Mubende District.
“But one case came from the neighbouring district—Kyegegwa. Mubende District lies on a major highway that leads into Kampala from Democratic Republic Congo (DR Congo) and it has busy trading places and the gold mine on one side is very close to where the epicentre is,” Dr Kyobe explained.
The incident commander further revealed that they are repurposing and extending the treatment centre at Mubende Hospital, which had previously been used for Covid-19 treatment, to handle the cases.
“Uganda has a lot of experience in handling Ebola. This is the third Ebola Sudan outbreak in the country,” he said.
The Ebola Incident Management Team (IMT) report for Wednesday indicated they are deploying “national level technical support to establish triage and care, triage at health facility level and functionalise the Kampala isolation units in Mulago, Naguru and Entebbe hospitals”.
Dr Rosemary Byanyima, the acting executive director of Mulago National Referral Hospital, said the facility is on high alert and ready to handle cases.