Are we ready for more COVID dead?

INEVITABLE COVID DEATHS: Here’s why government thinks it is ready

Kampala, Uganda | THE INDEPENDENT | Case. Fatality. Rate. That is a measure of how many people die when struck by a disease. And it is one of the most important numbers the Ministry of Health is now looking at to lift the COVID -19 lockdown on schools, churches, sports activities and more.

According to experts, almost each and every Ugandan stands the risk of catching the coronavirus that causes COVID-19. The question is “when” not “if” it will happen.

According to the same experts, the next important question is how many Ugandans will die when they catch COVID-19. The experts believe more people will die if the lockdown is lifted too quickly while fewer will die if the opening is gradual.

Those considerations influenced the Ministry of Health’s early COVID-19 Preparedness and Response Plan. The strategy was “reduction of importation, transmission, morbidity and mortality in a bid to minimize the social economic disruption that might result from this pandemic”.

Based on that, the government implemented  a  series  of  vulnerability  reduction  and  containment  measures  to  curtail  transmission  of  COVID-19.  Some  of  the  measures  included  closure  of  Entebbe International  Airport  and  all ground  borders   for  passengers,  closure  of  schools  and  other  high  congregation  points,  freeze  of  public  and  private  transport,  outlawing  all  mass  gathering  events,  including for worship, overnight curfew, and a nationwide lockdown.

The government has not announced a shift in strategy but the gradual opening up, including the increasing re-opening of educational institutions suggests a shift from the initial response plan.

Cases rise as strategy shifts

Most of the earlier restrictions are gone. The national lockdown was lifted in most of the country, public transport is open, markets, shops, and restaurants are open, and political activity which involves large gatherings is in full gear ahead of the early 2021 general elections.

The result has been a surge in COVID-19 cases. The country is reporting over 100 confirmed cases daily. By Aug.31, the country had reported 2972 confirmed cases and 32 deaths since the first case was reported on March 21. That is over five-month period. But in just two weeks, from Sept.01 to Sept.16, the cumulative confirmed cases jumped to 5266 and 60 deaths. That is a 100% jump in both cumulative cases and deaths or 30 deaths per week. At that rate, crude calculation shows that about 500 people will have died in the next 17 weeks to December 31, 2020.

But even as the new cases of COVID-19 surge, the Ministry of Health maintains there is nothing to worry about.

“What is happening now is not a surprise. We anticipated it and our projections even made bigger numbers than this. So, we are still doing very well,” says Dr. Henry Mwebesa, the director-general of health services. He says the surge in cases was anticipated and planned for.

So what is going on?

The Minister of Health, Dr. Jane Ruth Aceng, says Uganda has reached Phase 4 of the pandemic which is widespread community transmission of COVID-19. Community transmission is alarming because new cases pop-up anywhere, at any time without any known contact with someone from an infected area.

“We can longer control (the spread), we can only mitigate,” Aceng says.

Although Uganda is still reporting fewer death cases of COVID-19 than in other countries, that could change rapidly if large numbers get infected and health facilities get overwhelmed.

On Sept.16, while speaking as chief guest at the launch of the Uganda COVID-19 Convalescent Plasma Investigational New Drug at Makerere University in Kampala, Dr. Aceng said COVID-19 is killing 2-3 people every day on average.

At the time, Uganda had confirmed a total of 5, 123 cases, 2, 333 recoveries and 58 deaths. It was a continuation of a surge in infection cases and death that led the World Health Organisation (WHO), in its Aug.26 update, to report Uganda to have the highest percentage increase in the new COVID 19 cases in Africa.

It was the second time Uganda was featured among African countries with the highest percentage increase in new recorded COVID 19 cases in one week.

But even as the numbers surge worryingly, more lifting of lockdown measures and opening of the country to business as usual is happening.  Lifting the ban on sporting activities, re-opening places of worship, allowing schools to operate, and lifting the night curfew are all in play now.