Unmasking the realities of COVID-19

OPINION HEALTH   COVID-19

The coronavirus, first identified in China in December last year, has ravaged all countries of the world, causing socio-economic devastation in many countries. Within seven months, the death toll is close to 660,000 people and over 17,000,000 infections. 

In March, President Yoweri Museveni instituted the first lockdown in Uganda after the first case was confirmed. The idea, at the time, was to assess where the cases are, trace contacts and identify possible alert cases. 

Fortunately, there were no alerts, truck drivers from neighbouring countries were the main source, who initially were allowed to continue with their journey after extracting samples, only leaving behind their telephone contacts, to be contacted if their results turned out positive. They would then get admitted to the nearest designated hospital for treatment. President Museveni's position of ensuring that trucks continue despite the lockdown was a perfect position as Uganda had to continue to avoid economic collapse. 

With truck drivers identified as the main source of the coronavirus, new measures allowed them to proceed after testing negative for COVID-19, a decision that has saved Uganda from a catastrophe. 

The President has re-opened the economy except schools, gyms, borders, places of worship and large gatherings. Political activities are also up with national elections for February 2021. The reopening is a "new normal" that we should comprehend. 

To avoid the coronavirus and avert the pandemic, the health ministry has issued standard operating procedures (SOPs) that include frequent washing of hands, social-distancing up to two metres and wearing of masks, if we are in public. 

However, a good number of people are obstinate and ignore these guidelines. Some wear the mask like necklaces or simply cover the mouth. This is unfortunate. With 1,154 cases as of July 31, 123 active cases and two fatal alert cases, Ugandan health workers are doing extremely well, but the situation can get out of hand. If, out of nonadherence that happens, we must know the implications of the disease to the health infrastructure and to ourselves. 

By not adhering to the SOPs, we endanger our health workers who are not replaceable on short notice. Training of doctors and nurses take years. Let us not endanger them through our reckless behaviour. The worst situation is community transmissions which gain momentum through a multiplier function where one positive person infects 10, each of the 10 also infect 10 and within one month, 10,000 cases can be registered, making contact tracing impossible. 

This can overstretch hospitals and doctors earmarked for COVID-19 treatment. In Greater Kampala, (Kampala, Wakiso and Mukono districts), the treatment centres are Mulago and Nagulu hospitals, whereas Namboole stadium was mentioned as a possible treatment centre in case the situation gets worse. 

If a person tests positive after being attended to at another hospital or clinic outside the designated ones, all health workers that interacted with that patient are taken into institutional quarantine to avoid transmitting it to patients and their families.

This can drastically reduce the number of health workers and may overwork those who remain. Remember that no foreign country offers help with doctors because they are also handling the situation in their own countries. 

The existence of COVID-19 does not take away other diseases that have to continue to be treated. In such a situation, patients with sickness such as malaria or bacterial-induced sore throat infections may be chased away at other clinics to avoid contracting the virus. 

With a huge increase in the virus infections and designated COVID-19 hospital beds get full, in-patient admissions start to replace those who have died, as intensive care beds or ventilators are not easily installed. Ventilators are operated 24 hours by trained medical personnel who also need years of training. Intensive care patients that survive take between five and 21 days before transfer to the general ward. Even if the Government was to put up another field hospital, there might be no health workers to deploy there. 

The result, like in other countries, becomes home treatment where you keep health workers informed of your condition on phone and your own people start to distance themselves from you. Unavoidable delayed treatment may be dangerous because by the time the overstretched health workers reach you, the situation may not be reversible. 

Out of obstinate, negligent or unfortunate behaviour, one may take COVID-19 home, infect their family or neighbours who are vulnerable like the diabetic, hypertensive, asthmatic, cancer and HIV patients. We must know that all ages are equally vulnerable. You cannot know who will survive or die. It could be you or your loved one, parents or the entire family.

Upon positive confirmation, one is taken to a designated health facility alone and your loved ones wait for updates from health workers. Do we ever imagine if the person taken to quarantine is your five-year-old child whom you cannot take care of as a parent? 

As the situation worsens and deaths become overwhelming, family members may only be informed and attendance of burial is by one or two members of the family. I believe that is not what we want.

As President Museveni said right at the beginning, COVID-19 can be defeated, if we adhere to SOPs. We know how the disease is spread. The choice to avoid it. Take personal responsibility, wear the mask, stay safe.

The writer is the director of Confucius Institute and the head of Department of African Languages at Makerere University.