How Covid SOPs helped suppress other diseases

Primary Three pupils of Buganda Road Primary School attend class on January 11, following the reopening of schools. PHOTO / ISAAC KASAMANI

What you need to know:

  • Many medical workers—including Kampala-based paediatrician Dr Sabrina Kitaka—last year said their workload greatly reduced due to fewer children presenting with hygiene-related diseases.

Statistics from the Ministry of Health indicate a general decline in hospitalisation due to infectious diseases between 2018 and 2021, signalling a reduction in private expenditure on health in the country. 

The number of admissions due to acute diarrhoea reduced from 70,177 in 2018/2019 financial year to 56,467 in 2020/2021 financial year, according to separate Health sector performance reports.

The decline was equally noted in admission from other respiratory diseases such as pneumonia. Pneumonia admissions reduced from 133,019 in 2018/2019 financial year to 104,890 in 2020/2021 financial year.

Dr Deo Munube, the president of the Uganda Paediatric Association, told Saturday Monitor that the Covid-19 prevention rules curbed the spread of airborne diseases and those contracted through contact.

“Some of these diseases are exposed by contact and touching. We also now know that most people are not handshaking, they are ‘bongering’ (a fist bump as a way of greeting) and this helps us to reduce the spread,” he said.

“For diarrhoea, it has generally reduced because our children have learnt how to wash hands and how to avoid people who are unwell and they have also learnt how to wear masks,” he added.

Reduced workload

Many medical workers—including Kampala-based paediatrician Dr Sabrina Kitaka—last year said their workload greatly reduced due to fewer children presenting with hygiene-related diseases like diarrhoea.

While Covid-19 prevention rules no doubt contributed to the dip in hospital visits, they are also widely believed to have forced many people into poverty.

However, early this year, health facilities such as Mulago hospital, reported spikes in the number of children presenting with respiratory diseases. This was just a few weeks after schools were reopened fully in January after a Covid-19 shutdown that straddled nearly two years. These cases of flu and cough were also reported in adults.

Dr Daniel Kyabayinze, the director of public health services at the Ministry of Health, told Saturday Monitor that the spike was partly a result of the violation of preventive measures.

“Measures such as handwashing and wearing of face masks are for personal protection. Others have not been falling sick until recently when they started throwing out the masks,” he said. 

Dr Munube on his part opined that the spike was caused by Covid-19 prevention measures such as lockdown and social distancing. He reasoned that these limited the interaction of children with people and the environment.

“There is something called hygiene theory,” he said, adding, “When you are so clean all the time, when something affects you, you get a severe form.”

He further noted: “Our children lost their body immunity because of being home for a long time. And when they came back to school, this immunity couldn’t allow them to fight off infections and this caused the increases in common colds and flu.”

Thankfully, the cases of flu and cough have since reduced as children got exposed to the diseases and built immunity.

All said, admissions due to cough or cold (no pneumonia) reduced from 78,614 in the 2018/19 financial year to 70,511 in the 2020/21 financial year.

Non-communicable diseases

Dr Herbert Luswata, the secretary-general of the Uganda Medical Association, said the efforts to increase adherence to wearing masks and handwashing played a significant role in minimising the development of non-communicable diseases and related deaths. 

“There are people who were previously pre-diabetic, but when they got Covid-19, they crossed and got diabetes. Those who are fat are at risk of getting hypertension, when they get Covid-19 they cross and become hypertensive. We got very many of these patients and we lost them,” he revealed.

There are many organs in the body, the pancreas is the one that produces hormones that control sugars in our body. When Covid-19 attacks, it affects this organ and it loses control.

“That is what causes the problem because the body can no longer control the sugar. It is true that the spread of diseases like TB reduced because of Covid-19. So if everyone has a mask it can’t spread,” he said.

Preventive measures also ushered in lockdowns and suspension of public transport to minimise crowing affected people who are already affected with TB and other chronic conditions that require uninterrupted medication. The government later lifted the measures and has promised not to institute another lockdown to control the Covid-19 spread, banking on protection from vaccines.

Currently, there are barely any Covid-19 hospitalisations. Health experts have attributed this to increased vaccination coverage for high-risk groups such as the elderly. They also say the Omicron variant, which is driving infections, is mild unlike the Delta variant that blindsided the country during the second wave.


Wearing face masks



Despite the evident benefits of measures such as wearing masks, the public feels exhausted about adherence and many have dropped the masks.

“Measures such as handwashing and wearing of face masks are for personal protection. They will be lifted when 70 percent of the population is vaccinated against Covid-19 when there is no current running wave, and when people can do other measures like washing hands so they will not wear masks, especially when they are outdoors,” Dr Kyabayinze said.

But he also said with no clear end to the pandemic and the evident benefits, “masks have come to stay because they protect us against other infections such as TB and flu.”

While addressing the media afortnight ago, Health minister Jane Ruth Aceng said “fully vaccinated individuals will not be required to wear masks when they are outdoors provided there are no crowds.” She added that where physical distancing is not possible, masking up will be recommended regardless of whether one is fully inoculated or not.

Dr Kyabayinze says pandemic restrictions are only being dropped “because of what we call risk perception.”

 He elaborates that “somebody knowing that things are not okay forces you to do something that is life-saving” and that complacency can only “take us backwards.”

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