Scientists speak out on easing lockdown

As President Museveni weighs options for easing a nation-wide lockdown after 12 days, some scientists have asked government to tread cautiously on easing lockdown forced by the Covid-19 pandemic.
While Mr Museveni on Monday night eased some sectors to resume operations, he extended the current lockdown by 14 more days and said this would help the government to study the situation and then take the next step in easing other sectors.

But the scientists have called for a gradual process to safeguard the gains achieved during the fight against the Covid-19 pandemic. At least 55 out of 100 confirmed cases of people who had contracted the virus healed and have been discharged. Uganda, unlike its neighbouring countries of Kenya and Tanzania, has not registered any death.
The scientists advise to government, however, comes at a time when many Ugandans are eager to return to work after enduring 58 days of mandatory lockdown. The experts say government must ensure the country doesn’t slide into a crisis when lifting the lockdown.

Prof Rhoda Wanyenze, the Dean of School of Public Health at Makerere University, says easing the lockdown has to be done with caution. She has advised government to use the 14 days window to evaluate and assess what needs to be done.

“Lifting lockdowns is one of the most complex processes to deal with in the Covid-19 response and there are no straight guidelines on the how to do it at the moment. Some countries have lifted and then reinstated lockdowns when the numbers of infected individuals go up again. Lifting too soon or lifting abruptly can reverse the gains—the timing and the process is critical..,” Prof Wanyenze says.

According to Prof Wanyenze, lockdowns are the most extreme of the measures and have been given so much emphasis at the expense of other very useful precautions.

“We need to balance our messages to address all Covid-19 prevention measures in tandem to ensure good results—we must emphasise hygiene—hand hygiene, hygiene of the environment including cleaning surfaces that are frequently used around us, cough etiquette etc. Social distancing is very important,” she says.

Prof Christine Dranzoa, the Vice Chancellor of Muni University, says as pressure is building on government to ease the current lockdown after the remaining 12 days, Ugandan must adhere to the strict guidelines set by the health officials.

“For us to stay safe and work towards easing the lockdown, we must follow the guidelines provided by the President, Ministry of Health and other experts. This disease is not a joke and we need to take extra precautions to stop further spread,” Prof Dranzoa says.

A May 1, report by the scientists at the Infectious Disease Institute of Makerere University has recommended that the government eases the lockdown in a phased manner.
The scientists led by Ms Agnes N. Kiragga, the lead author, however, says lifting the lockdown may not be that disastrous as long as people adhere to the preventive mechanisms.

“Given the nature of the Uganda Covid-19 epidemic, lifting the lockdown and opening the borders may not be disastrous, as long as there are effective measures which prevent interaction between imported cases, particularly truck drivers and the local community,” the report reads in part.

The experts also argue that enforcing the mitigation measures that stop penetration and interaction of imported cases with the local community can allow the country open the economy.
They also highlighted the need for continued rigorous surveillance and testing for Covid-19 case at all border points. Dr Andrew Kambugu, the executive director of the institute, says there is need to build additional capacity to isolate and treat cases for safer lifting of the lockdown.

“We need to ensure our ability to test more people is in place then we can lift the lockdown,” he says.

Compliance gaps
The percentage of people in Uganda who own and are wearing masks and adhering to preventive mechanisms is still arguably low, especially when rural communities are factored in.

Dr Richard Idro, the president of Uganda Medical Association (UMA), however, argues that there has been change in habits among some people. He says Ugandans must not only demand the removal of the lockdown but do their part to ensure the country does not regress into a Covid-19 crisis.

“I think we will survive Covid-19. But within the country, we have to take care of ourselves and deal with things coming through the borders. Right now there have been some changes in the habit of people and in administrative measures for work places. If the offices will enforce these measures, then required change will take place,” Dr Idro explains.

Prof Freddie Ssengooba, a health policy expert at Makerere University School of Public Health, says people should be thinking about protecting themselves if the lockdown is to be lifted after the 14 days.

“In countries that are getting out of lockdown, use of masks in public places is becoming more important. Markets, taxis, buses and boda bodas are going to be key. The issue of how to ensure users of the transport means put on face masks and adhere to guidelines will be crucial,” he says.

Health ministry’s plan
Dr Diana Atwine, the permanent secretary at the Ministry of Health says the current focus is reducing the time of getting results, tracing internal community infections and contacts to planned next course of action and sensitisation.
“The first one is to strengthen the testing capacity at the borders. That will reduce on the waiting time but at the same time it will help us trace the people who are sick before they interact with the public,” she says.
Dr Atwine says the ministry is already setting up laboratory equipment in Busia, Malaba and Mutukula to speed up the process of testing. Currently, all the samples collected are tested either at Uganda Virus Research Institute (UVRI) at Entebbe or at Makerere University.
“The second thing we want to focus on as a matter of priority is getting to know internally where the pockets of community transmissions are. We have already those three people whom we identified in the community and we want to get everybody with whom they had contact with and test them,” she says.
Dr Atwine explains that before the President reveals the next step, as a ministry, they are engaging in massive sensitisation against the pandemic.