COVID-19: Doctors now advocate herd immunity

This will not only save the government money and lessen the burden on hospitals, but also increase immunity in the community, according to the medics.

"We are spending so much money on asymptomatic cases yet they can be cared for while at home. Over 80% of those who test COVID-19 positive do not have any symptoms. About 15% have mild symptoms; colds and sore throat. In other words, close to 95% of the people with COVID-19, do not need to be in hospitals.

"We should stop admitting asymptomatic COVID-19 positive persons to COVID-19 treatment units. Only admit those with moderate and severe symptoms. This will save resources," Dr Richard Idro, the president of UMA, said.

He was addressing journalists at Kampala Club in Kampala recently.

  

Dr Frank Asiimwe called for the application of ‘Triage'; a medical principle that determines the priority of patients' treatments by the severity of their condition or likelihood of recovery with and without treatment.

The principle ratios patients'treatment when resources are insuffi cient, infl uencing the order and priority of emergency treatment, emergency transport or transport destination for the patient.

He, therefore, suggested that, "instead of having 200 casualties, zero down to the 10 who must go to Intensive Care Unit (ICU), 20 who must be admitted on the ward and let the 180 with mild injuries go home and stay with the two who are likely to die.

"We should stop admitting every person who tests positive for COVID-19. I can be positive, but alright. As long as all of us can treat our neighbour as though they are infected by observing the SOPs; washing hands, wearing face masks, social distancing and refraining from touching soft spots, we shall all be safe."

Asiimwe cited Mulago National Specialised Hospital where "there are fi ve in ICU, 10 on the ward that need attention and about 300 asymptomatic cases on the ward, catching up on social media platforms, playing cards and wasting government resources."

He said the cost of admission ranges between sh150,00 and sh300,000 per day, yet they are kept in hospital not less than 21 days.

He urged the Government to instead save that money and buy Personal Protective Equipment for medical workers. 

"The N95 mask (recommended for medical workers) costs sh20,000. How many of these can one asymptomatic COVID-19 patient who spends 21 days on the ward playing cards, have bought?" he wondered.

How to deal with community infections

In addition to saving government resources and lessening the burden in hospitals, Asiimwe said the rate of community infections can also be lowered by mixing people who are infected with the community.

This is what is known as herd immunity, a form of indirect protection from infectious disease that occurs when a sufficient percentage of a population has become immune to an infection, whether through vaccination or previous infections, thereby reducing the likelihood of infection for individuals who lack immunity. 

Recently, Ugandan experts denounced this approach on grounds that most Ugandans lack the discipline and means to observe the requisite guidelines in case they are asked to keep home after testing positive.

"To leave dry fi rewood in heaps where it can ignite fi re is unwise; so there is a need for wet wood to reduce the possibility of fi re ignition.

"But how can this be done? I get infected without any symptoms. I stay in my family. The version of the virus we have in Uganda so far does not give us severe disease in most people. So, if someone is at home, even if they infect their family member at the end of the 21 days, you will have a family which has some immunity," Asiimwe said.

"United States of America has authorized the use of convalescent plasma. This is blood from people who have been sick and have recovered. That blood is taken off to treat people who are sick because they have developed immunity," Asiimwe explained. 

He added that if someone has recovered, they are now wet wood and can lessen community infection transmission.

According to Asiimwe, most people are dying not because they have not reached hospitals, but because hospitals are not well equipped.