COVID hotspots worry experts

Focus on schools, campaigns, Christmas travellers

Kampala, Uganda | RONALD MUSOKE | As the number of deaths due to COVID-19 nears 200, health officials and experts appear frustrated, worried and unsure of how to proceed.

Dr. Joyce Moriku Kaducu, the Minister of State for Primary Health Care, says more patients with severe forms of COVID-19 and accompanying higher deaths have been witnessed this November.

Kaducu revealed this recently when updating the country on the status of the COVID-19 pandemic. She sounded frustrated and worried about the trend the disease is taking and said vulnerable people such as the elderly (above 60) and those with other health complications like diabetes and high blood pressure were at highest risk.

“We are experiencing spikes in some districts and institutions of learning, “she said, “This situation requires consideration and special focus to reduce the increasing number of infections.”

She mentioned schools that have recently had clusters of COVID-19 infection, including Bishop Cipriano Kihangire SSS, Luzira (32), Masaka College of Health Sciences, Masaka (28), Vine Paramedical School, Masaka (30) and Kabale School of Nursing and Midwifery (30).

Among the districts, she said, Kampala has had the highest number of cases (about 30% of nationwide infections) but the West Nile in northwestern Uganda, Elgon in eastern Uganda and northern Uganda remain “transmission hotspots.”

“We are reporting on average 1,900 cases weekly emerging from 127 districts,” she said. According to the Ministry of Health, as of Nov. 22, only nine districts had not reported a single case of COVID-19.

Kaducu blamed the rising number of COVID-19 on reduced fear of the disease, lack of discipline among the population, and failure to practice the preventive Standard Operating Procedures (SOPs).

On Nov.20, the Ministry of Health said it had recorded 10 deaths, the single highest number of COVID-19 fatalities since July when Uganda registered its first death. As of Nov.25, the country had registered 19,115 cumulative confirmed cases of COVID-19 with about 190 cumulative deaths.

At least one of every two COVID-19 patients admitted to the Intensive Care Unit (ICU) at Mulago National Referral Hospital, the top-most facility in the country dies, according to medics at the facility.

According to records, the facility has lost at least 41 out of the 77 patients admitted with breathing difficulties. On Nov.15, Judith Nabakooba, the ICT and National Guidance Minister urged Ugandans to stop taking COVID-19 as a simple thing amidst the 2021 general election campaign period.

“Apart from those who are already gone, hundreds of others continue to fight for their lives every day in the Intensive Care Units. Information from the Ministry of Health is that our ICUs are actually full to capacity,” Nabakooba said.

Nabakooba added that people need to understand that if one becomes critically ill from COVID-19 today, access to the ICU might be difficult and yet without it, chances of survival are very low.

“COVID-19 is a clear and present danger waiting to strike anyone anytime,” she said and urged citizens to take SOPs very personally to protect themselves and their loved ones.

But officials at the Ministry of Health say the ever rising death toll is sad but not surprising. Uganda is currently in Phase-4 of the pandemic and there is disseminated and diffuse community transmission.

Robinah Nabbanja, the Minister of Health for General Duties said early this month that this phase means that people are getting infected without knowing how they got infected. The death toll is expected to rise in this phase.

Dr. Jane Nakibuuka, a senior consultant physician and head of the ICU at Mulago Hospital told Uganda Radio Network early this month that the numbers started surging at the end of August when admissions went up.

At the time, there were 70 severe patients being treated in Mulago’s High Dependence Unit COVID-19 treatment centre. She said the numbers of deaths from mid-September to that point were twice those of discharge patients, with figures showing that 53.2% of all admitted COVID-19 patients at the hospital died.

“Initially the patients were very few but towards the end of August, the numbers significantly increased and we started registering high mortality,” she said.

Dr. Rose Byanyima, the deputy executive director of Mulago Hospital who also doubles as the head of COVID-19 management at the hospital also told Uganda Radio Network that it is not surprising that the country is now grappling with a high number of deaths. Byanyima said the higher the cases of severe forms of COVID-19, the more deaths will occur.

In one of the signs of government resignation, officials said early this month that the burden of burying of COVID-19 victims will now be borne by family. Previously, only health ministry officials and volunteers from the Red Cross were allowed to bury confirmed and suspected cases. However, the Red Cross pulled out early November, owing to insufficient resources.

The officials said government hospitals will stop at preparing the bodies before being handed over to the bereaved families. Under the new guidelines, families of COVID-19 are supposed to be present at the treatment of the body to confirm that the body is indeed that of their relatives. But Uganda being a deeply religious country with strong traditional values, this is proving difficult to implement and many people are getting infected during burial ceremonies.

Health workers on the frontline are also being hit hard. As of Nov. 22, up to 1,238 cases of infected health workers had been confirmed and out of these, 10 deaths had been reported in different categories of medical workers.

Kaducu said her ministry will continue to prioritize the safety of health workers. Some of the ongoing interventions include; intensified risk communication of infection and control measures within hospital settings and availability of adequate supplies of personal protective equipment.