By Irene Atuhairwe

Walking through the streets of Kampala, one can feel the sense of relief from people who survived the recent 42-day lockdown and second wave of COVID-19.

Unfortunately, despite the ongoing pandemic, sights of unmasked and improperly masked individuals remain common. Social distancing seems to have completely eluded us, especially in the city centre and downtown area.

One cannot help but wonder the repercussions this level of laxity will have on us. The sense of fear about the life-threatening impact of contracting COVID-19 seems to have waned momentarily.

At the height of the second wave, many of us had either friends, family, or acquaintances contract and even die of COVID-19. Our fragile health system was overwhelmed as hospital admissions rose from 10-20 per day to an average of 120 cases per day.

Due to limited resources, hospitals could only admit severe cases and even then, there wasn’t enough capacity in the high dependence units and intensive care units (ICUs) to accommodate everyone that needed critical care.

One fateful Saturday, I was tasked with finding an ICU bed for a family member.

My family had high hopes that I would help since I am a health professional. I called over five hospitals and none of them had any beds available.

There are no words to describe the helplessness and brokenness I felt in that moment. I am sure many of us found ourselves in a similar situation during that period.

Despite the challenging experiences we collectively had, we seem to have forgotten our immediate past. We are not yet out of the woods. With approximately 3% of the Ugandan population vaccinated, we are still a long way from achieving population immunity — the indirect protection from an infectious disease that happens when a population is immune, either through vaccination or immunity developed through previous infection. Like other countries, it is imminent that we will have a third wave of COVID-19. Our neighbour, Kenya, is currently experiencing its fourth wave.

The parliamentary COVID-19 task force recently traversed the country to understand how districts have managed the pandemic. They identified several challenges, including accountability concerns, lack of isolation facilities at hospitals, lack of Personal Protective Equipment for frontline health workers, and inadequate ICUs and emergency facilities.

These are all issues that were also highlighted a couple of months ago in a local television show segment titled, “How Uganda sleepwalked into the second wave of COVID-19.”

The parliamentary taskforce recommended that the central government works strongly with local governments to solve these persistent challenges.

In a media address on August 20, this year, the Minister of Health, Dr Jane Ruth Aceng, said scientists project the third wave of the pandemic will likely peak at 4,000 laboratory-confirmed cases per day, over two times higher than the second wave. Of the confirmed cases, 15% will require hospital admissions and 9,331 patients may need high dependence units or ICUs.

We know what our challenges are and what the future holds, so we cannot afford to sleepwalk into another wave. We need to act now to ensure we are adequately prepared to deal with the coming wave.

We need to strengthen and empower community structures by adequately resourcing them to fight against the pandemic. The involvement of communities is critical for the success of all public health interventions as evidenced in the fight against diseases such as HIV and tuberculosis.

The community engagement strategy for COVID-19 was launched in October last year — a positive step in tackling the pandemic.

However, to achieve its goals, there needs to be sustained support for trusted community members, such as religious and local leaders, to champion the fight in their communities.

We need to ramp up our vaccination efforts across the country. While the required percentage for population immunity varies from 50% to 95% for various infectious diseases, the exact percentage required for COVID-19 is still unknown.

However, it is safe to say that at least 50% of the population should be vaccinated to achieve population immunity. The Ministry of Health stated that we need to vaccinate at least 22 million Ugandans to achieve this.

Despite global vaccine access challenges, there must be a more aggressive strategy to obtain vaccines and better administrative preparations to make vaccines more accessible to Ugandans.

Lastly, we must ensure that our hospitals are well-equipped and health workers readied to handle the possible 9,331 severe and critical cases and save lives. This will require us to functionalise more ICUs, invest in medical oxygen, and ensure the wellbeing and protection of health workers, among other measures.

Let us use this period with fewer cases to put our house in order and prepare our health system and country for a third and possibly fourth wave of the pandemic. The fight is not yet over.

The writer is the deputy country director of Seed Global Health, Uganda