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People with no symptoms pose a challenge in COVID-19 fight

By Jacky Achan

Added 12th May 2020 07:27 PM

A 64-year-old businessman Emmanuel Safali is one of those to have the virus but show no symptoms. He never knew he had the dreaded coronavirus diseases (COVID-19).

People with no symptoms pose a challenge in COVID-19 fight

A health worker wearing protective gear takes care of a patient at the intensive care unit, treating COVID-19 patients, of the Tor vergata hospital in Rome, on May 12, 2020, as the country is under lockdown to stop the spread of the Covid-19 disease caused by the novel coronavirus. AFP PHOTO

A 64-year-old businessman Emmanuel Safali is one of those to have the virus but show no symptoms. He never knew he had the dreaded coronavirus diseases (COVID-19).

"It's scary that someone can have COVID-19, but with no signs and symptoms," because even without the symptoms they have the virus and are infecting people they come in contact with, warned Dr. Richard Kabanda who is the Commissioner In-Charge of Health Promotion, Education and Communication at the ministry health, and coordinating the coronavirus diseases communication in Uganda.

A 64-year-old businessman Emmanuel Safali is one of those to have the virus but show no symptoms. He never knew he had the dreaded coronavirus diseases (COVID-19).

But, on March 20, 2020, Safali and his grandson had returned to Uganda from Dubai a key shopping destination in the United Arab Emirates (UAE) where they had gone to buy second-hand photocopiers and hardware materials for their business.

‘'On return, we were cleared at the airport to go home, Dubai still had the green flag,'' he said.  Dubai at the time was still one of those destinations not considered a hot spot for COVID-19.

‘'Also, we thought we had been extra careful as the virus spread, we moved with hand sanitizers to ensure we keep the virus at bay,'' recollects Safali.

 But, things changed when on March 22, 2020, Uganda reported its first case of COVID-19 who had returned to the country from Dubai aboard Ethiopian Airlines.

Safali felt they had been lucky and survived the virus. After all, they had come in earlier. Also, he had used Emirates to fly, he felt safe.

Then on the days that followed the ministry of health asked all those who had returned from Dubai to come for tests as more positive cases were registered from Dubai.

On hearing the announcement, Safali called a high ranking friend of his in the ministry of health who sent a nurse to his home.

Safali's COVID-19 test sample and that of his grandson with whom they travelled were collected from his home on March 25, 2020 by the lady nurse sent to his home.

On following up later he was told the test was negative to his relief and he asked for a certificate but there was none.

On March 28, 2020 Safali was picked from his home and taken to Mulago National Referral hospital for treatment, he was told his test had turned out positive.

‘'An ambulance team and one Dr. Kissa all dressed up in protective gear came to pick me up at my home. It was queer they did not have any document to show me I was positive, but they were keeping distance.  All the doctor said was that they have orders to pick me and my attempts to say no was futile, they had orders from above,'' he said.

It was on March 31, 2020, while already in hospital receiving treatment that Safali was sent a WhatsApp message to show he was positive.

But he had not shown any signs of COVID-19 despite testing positive. I did not develop symptoms apart from a small cough that could have resulted from swab used to get his nasal sample for test, he disclosed.

Worrying about those with no symptoms

There are patients with signs and symptoms who are under isolation and treatment which is okay because their status is known, then there are patients with no signs and symptoms but found to be positive (asymptomatic) with COVID-19.

They may turn out to have signs and symptoms later others may never develop symptoms. Those expected to be positive but with no signs and symptoms are the biggest challenge, we call them carriers, said Dr. Kabanda.

Recent studies from different countries have shown that asymptomatic transmission of COVID-19 is taking place.

One such study published on April 1, 2020, in the Center for Disease Control Journal Morbidity and Mortality weekly report found that of over 150 non-travel related COVID-19 cases in Singapore 6.4% appeared to involve the asymptomatic transmission of the virus.

Another study published on March 19, 2020 in the journal Emerging Infectious Diseases, Scientists reviewed COVID-19 data in China outside Hubei province and found that 12.6% of cases appeared to involve the asymptomatic transmission

Dr. Kabanda said symptoms can come depending on individuals, and may not even show. However, because COVID-19 is still a new disease some of the symptoms are not even known or documented and could be missed, he added.

Even if we wash hands and keep getting in contact with COVID-19 positive persons, with no symptoms we end up getting the virus. It's important we keep social distancing and wash hands to avert getting the coronavirus disease, said Kabanda.

Dr. Misaki Wayengera a Clinical Geneticist, Immunologist, and Virologist, also said people should comply with health guidelines given by the government to overcome COVID-19.

How does it feel testing positive test?

‘'It was a terrible feeling being picked up, my pressure shot up which has ever been the cases, I had always just dealt with diabetes, I was hyper! the medics put me in a vegetative state to deal with my agitated reaction,'' disclosed Safali.

From my good home environment, I was being brought to a hospital. Going to a place with many positive cases is not a joke. With COVID-19 one can shudder even the doctor didn't want to reach where there were positive cases,'' he further disclosed.

Life under treatment

I was being given among other drugs Vitamin C, Sodium Valproate, and Cetapin, during my treatment, disclosed Safali.

Also, because he had diabetes (an underlying disease), it had to be managed to avert a worse outcome from COVID-19.

Report from China and Italy indicated that risk factors for severe diseases like (COVID-19) included old age and at least one overall underlying condition commonly diabetes, chronic lung disease, and heart disease.

‘'The medical staff did a fantastic job managing my diabetic condition which I have had for 10 years lowering it to 5.2, it is almost gone which is commendable I must say.

‘' Also, the medical care I received at Mulago National Hospital was top-notch. I can frankly say I last received such treatment in 1959 at Kilembe Hospital when I still worked at Kilembe mines and broke an arm. The medical care was of the highest quality, but when I mention it people think I'm becoming pro-government, but the hospital has to be commended for quality healthcare,'' said Safali.

To cope during treatment

‘'I had a construction work going on and in my absence, I feared it would all collapse,'' said Safali and he felt uneasy.  Safali is also a salesman and transporter who owns a fleet of trucks that move to Juba, South Sudan, and owns a hardware business in Najanakumbi.

To cope with treatment amid his fear ‘'I had to accept whatever had come had come, there was nothing I could do to change it. After 18 days in treatment, I'm now back home in good health. But, I continue managing my diabetes because its a routine, but I am free of COVID19.

Going back to the community, is there a stigma?

‘'There was no stigma, actually, I was well received by my immediate family of about 7-10 including my wife children and grandchildren, they had also been placed under home quarantine and monitored and turns out they are negative, they were also expecting me having been informed by the hospital,'' said Safali.

‘'The area leaders including the LC 1 chairman, the secretary, and many people have warmly welcomed me back home,'' he added.

Safali is also Chairman Fathers Union at St Paul's Church Najjanankumbi. He hails from Kisoro district, in Southern Uganda, but resides in Church Zone Najja 1, Rubaga division.

When all has settled, Safali aims to tackle the issue of being placed on treatment even when he showed no symptoms.

I think my ex daughter in law a veterinary doctor who works for prison service had a hand in it.  I believed I was okay,'' he said

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