Experts explain why 16 districts have survived COVID-19 pandemic

Good behaviour, luck and early enforcement of COVID-19 standard operating procedures (SOPs) have been attributed to districts that have not registered any COVID-19 cases so far.

According to the health ministry's latest update on the COVID-19 pandemic in the country, 16 districts have not registered any single COVID-19 case since Uganda registered its first case on March 21.

More than 116 districts have registered COVID-19 cases as of Sunday, October 25, according to the health ministry.

Uganda currently has 11,621 cases, 103 deaths and 7400 recoveries as of October 26. The districts without COVID-19 cases include Buyende, Kalungu, Kamwenge, Kapelebyong, Kassanda, Kazo, Kiruhura, Kitagwenda and Namutumba. Others are Otuke, Pakwach, Ruburizi, Rukiga, Rukungiri, Rwampara and Kibaale.

Whereas some of the above districts are either located along busy highways or are near major border points of entry which could have fuelled the spread of the deadly virus, the COVID-19 teams that were set up to heighten surveillance said this did not complicate their work.

They instead concentrated on enforcing the SOPs within their communities which have enabled them to remain on top of their COVID-19 response strategy.

Other factors that played out for them include the good behaviour exhibited by the residents as well as luck.

FRONTLINES SPEAK OUT

"Whereas our surveillance teams continue to remain vigilant, we have not only involved the health department in the district but also security teams and the community at large. We continue to carry out sensitisation drives on our various radio platforms," Dr Daniel Isabirye, the Buyende district health officer (DHO), said.

Isabirye said when one of the doctors working at the district contracted COVID-19 from Kampala, he was quarantined before he transmitted the virus to other people.

He said the district's geographical location given that is mainly surrounded by water bodies has also worked in their favour as movements were minimised.

"We have really been lucky but our only worry now are the political campaigns and burials where people hardly observe the SOPs," Isabirye said.

Benjamin Wanichan, the Pakwach surveillance focal person, said they intercepted and isolated five drivers from DR Congo who tested positive on March 24.

 "We immediately organised for their transportation to Arua Hospital for management. When we later got communication that the drivers had interacted with 27 people on their way, we isolated the contacts and drew their samples. Luckily all turned out negative," Wanichan said.

He said the district had collected 193 samples since March and all have turned out negative

That notwithstanding, they continue to carry out sensitisation campaigns both on radio and mobile sensitisation vans to ensure that the people do not relax. Describing Pakwach as the gateway to West Nile, Wanichan said they also recently intercepted five drivers who were coming from Mutukula and heading to South Sudan.

Whereas not much could be done after the Government opened up public transport in July, Dr William Mucunguzi, the Kamwenge DHO, said they resorted to carrying out specific interventions such as risk assessment testing in hotspots, including refugee camps and hospitals.

On the other hand, Gad Nshemereirwe, the Rukungiri district COVID-19 surveillance focal person, said people in Rukungiri naturally fear getting caught on the wrong side of things and that is why implementing the SOPs has been easy. "People in our community fear so much and will quickly identify and report any strange faces," he said.  

Besides that, Nshemereirwe also said the deployment of both Police and UPDF soldiers along the DR Congo border and other neighbouring districts such as Kanungu, Ntungamo and Mitooma helped them manage cases that would have been imported into the district. He said a politician who tested positive got infected from Mirama Hills. Luckily, his contacts tested negative.

He also clarified that the COVID-19 patient who was buried in Rukungiri over the weekend had tested positive while in Kampala.

Health ministry experts speak out

Dr Charles Olaro, the director clinical services at the health ministry (pictured), said behaviour could have been one of the reasons why some districts have not registered COVID-19 cases.

He also said the locals could have adhered to the SOPs or have just been lucky not to register any cases so far. Considering that Uganda's cases have largely been asymptomatic, Olaro also said the districts could have registered cases that did not progress to mild or severe cases and that the alert systems could have probably not picked or reported such cases.

The health ministry's approach regarding COVID-19 also changed when the country registered community widespread infections and that is why Olaro explained that the current approach involves targeting congregated places such as prisons and schools, unlike the previous community tracing approach. "As a country, we have done fairly well.

We, however, need to remain vigilant both at health facilities and community level," Olaro said.