Severe COVID-19 cases going up

Medics have expressed concern over the rising cases of people suffering from COVID-19 reaching hospitals when the disease has reached severe stage.

Dr Moses Muwanga, the Entebbe Grade B hospital director, says the implication of presenting late is that more severe cases will be reported, unlike in the past when Uganda's COVID-19 cases were mostly mild and manageable.

Muwanga told the New Vision on Thursday that the hospital registered many severe cases in the past few weeks, attributing it to the increase in community transmissions in various places.

"The problem is that people are reporting late. When people experience symptoms such as respiratory problems or chest pain, they keep quiet, until it gets out of hand. Come to hospital the moment you feel unwell," Muwanga said.


He also decried the fact that many people have stopped practising the measures that the health ministry put in place to contain the spread of the disease.  "This is not the time to relax on any measure because community transmission is dangerous."

Prof. Moses Joloba, the dean of the school of biomedical sciences at Makerere University's College of Health Sciences, said the current severe cases we are seeing are due to disease progression.

"You will recall that when Uganda registered its fi rst COVID-19 case, his contacts were tracked before they fell sick. But when you go beyond where the disease can no longer be tracked easily, we are bound to have cases where the disease will progress and many will present to health facilities late," he explained.

He added that many times, when a patient gets to the severe stage, there is almost no chance of recovery.

The other scenario Jolob presented is that most of the people who present late are very sick, have a huge load of the virus in their bodies and are very infectious.

"Whereas there is no evidence of a mixed strain so far, you cannot rule out this possibility," Joloba said.

He said the practical thing to do now is emphasise prevention like it was done in the fight against HIV/AIDS.

"It is important that people change their behaviour and listen to the guidelines given because behavioural change is the only shield that will save us," he explained.

Dr. Charles Olaro, the director of clinical services at the health ministry, said receiving more severe cases has implications in terms of the care needed.

He said the risk of these getting into acute respiratory syndrome is high because they will experience difficulty in breathing and, as such, will require assisted ventilation and incubation.

The situation, he added, gets worse for patients with other underlying health complications, such as cancer, HIV/AIDS or diabetes whose chances of survival is next to none.

"Most of the deaths in Uganda have been from severe cases because these were mostly picked from ICUs and delayed to present to health facilities," Olaro said.

He emphasised heightening alerts, to ensure those with signs and symptoms of COVID-19 seek care early.

While Uganda's capacity to handle severe cases is not overwhelming, Olaro said there will come a time when even the severe cases will have to wait for close to a week, to get into the ICU, like it was witnessed in other countries, should the cases increase.

"If you have no urgent reason going to town, stay home. Offices should also continuously downsize their staff to promote social Health ministry spokesperson Emmanuel Ainebyoona said five out of the 12 COVID-19 patients admitted at the Mulago Hospital's Intensive Care Unit died.

Five have since been discharged, while two are still admitted. Before COVID-19, Uganda had 135 ventilators. The health ministry is installing an additional 145, to boost the capacity of health facilities in handling severe cases.

The government is also installing an oxygen plant in Mulago, Entebbe, and Bombo hospitals, to ensure the constant supply of oxygen in case of emergencies.

The health ministry yesterday registered 176 new COVID-19 cases from samples tested on September 2. This brings the number of confirmed cases to 3,288, according to Dr. Henry Mwebesa, the director-general of health services.

Uganda also registered one new death, bringing the number of deaths to 33. This was a Ugandan male aged 40 and a resident of Wakiso district.

So far, 1,532 people have recovered from the disease.