Only cases with COVID-19 signs to be tested

Sep 26, 2020

COVID-19 |

Contacts of persons who have tested positive for COVID-19 will not be tested or quarantined, unless they show signs and symptoms, Dr Charles Olaro, the director of clinical services at the health ministry, has revealed.

Olaro made the revelation Friday, at the ministry headquarters in Kampala, after receiving a donation of 1,920 pieces of test kits and 10,020 pieces of medical face masks from Korea Expressway Corporation (KEC), which is involved in the design of the expressway.

He said the tests will only be limited to people who show signs and symptoms of the virus.

"We are going to change our criteria of people to test. We are going to limit it to only people who have symptoms. So, even if you are a contact and you do not have the signs or meet the test definition, you will not undergo the test," he said, adding that the fi nal-year students and candidates, who have been allowed to resume studies on October 15, will not be tested for COVID-19.

"We want to rationalise use of test kits," he said.

Kim Ki-Song, the deputy general manager of Korea Expressway Corporation, appreciated Uganda's efforts in combating the COVID-19 pandemic.

"COVID-19 can be overcome if we work together. This support is a contribution to the fight against COVID-19 in Uganda," he said. 

Uganda is currently in Phase Four of COVID-19, characterised by widespread community infection and it is hard to trace the source of these infections.

Recently, the health ministry permanent secretary, Dr Diana Atwine, said about 400 of the positive cases are receiving care from their homes. This is because the 14 hospitals that were designated as treatment centres have filled up.

The hospitals — Entebbe Hospital, Masaka, Gulu, Lira, Arua, Mbale, Jinja, Naguru, Mbarara, Hoima, Fort Portal, Soroti, Kabale and Moroto regional referrals as well as Mulago Hospital — had designated sections of their premises for COVID-19 treatment and care.

But, with the surge in numbers, the sections are full and the ministry has kick-started plans to set temporary structures at these centres, to expand the capacity of the hospitals.

A source privy to the new changes, which health minister Dr Jane Ruth Aceng is expected to announce soon, revealed that on top of resource limitation, the ministry has realised that it is no longer beneficial and cost-effective to test everyone.

The source observed that with the wide community spread of COVID-19, it is no longer feasible to test all contacts of a case and quarantine them. The ministry no longer quarantines contacts.

He said this is being done under the guidance of the World Health organisation (WHO) and the Centres for Disease Control (CDC).

WHO, CDC new guidelines

In August, the CDC revised its coronavirus testing guidelines, excluding people who do not show signs and symptoms from being tested for COVID-19.

But, later, it revised the guidelines to allow the tests only on the advice of a health worker.

In its revised guidelines published on September 18, WHO stated that if one has no symptoms and has not been in close contact with a known case, they do not need a test, unless recommended or required by a healthcare provider or public health official.

WHO also advised that those with mild symptoms can test, but on the recommendation of a medic. It advises them to self-isolate and seek emergency care if the symptoms become severe. 

"In the new criteria, we are advising contacts to self-quarantine. We shall only test high risk categories, to ensure that the disease is detected as early as possible and put them on treatment," the source further revealed.

Underlying conditions

He said consideration will be given to those with co-morbidities, such as old age, cancer, diabetes, hypertension and other chronic illnesses.

Studies done since the outbreak of coronavirus last year, have found that co-morbidities are a risk factor for severe and fatal outcome associated with COVID-19.

The commonest and most severe ones include diabetes, obesity, hypertension respiratory disease, malignancy, chronic kidney disease and liver disease.

For people with these underlying conditions, the source said, they will be taken to the hospital, even if they do not present with symptoms.

Last month, the Government introduced a fee of sh240,500 for COVID-19 testing for those coming  into the country and those who seek to travel abroad, on grounds that the test kits were expensive and there is need to ensure that there is no stock out.

There are three types of COVID-19 tests and they are all priced differently. These include the Polymerase Chain Reaction (PCR) test, which is currently being used in Uganda.

It has four types — Altona PCR Kit, which costs $25 (about sh92,511) per kit, GeneXpert $19.8 (about sh73,269), Abi $17.2 (about sh63,659) and Cobas 68,000/8,800, which is $18.9 (about sh69,874).

The other two types include the Rapid Diagnostic Test (RDT), which is either antigen or antibody and costs $5 (about sh18,485) and the antigen test, which costs $25 per kit.

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