Addressing the nation on Monday night, Museveni said Uganda is in phase three of the Covid-19 pandemic as evidenced by the clustered cases in Amuru, Kyotera, and Buikwe, while the other border districts remain at high risk. Below we bring you excerpts from his speech
Adjustment of the curfew time
The aim of the curfew was primarily to act as an enforcement tool to prevent high risk nocturnal activities/establishments like Bars, Nightclubs, etc., from conducting business and to deter crime under the cover of darkness.
The start of the curfew at 7pm (just before darkness) and end at 6.30am (just at the beginning of daylight) was deliberate to deter crime. Pushing forward the curfew time from 7pm to 8pm, triggers delayed closure of other sectors like shops, supermarkets, public transport and gives opportunity of engaging in crime which strains law enforcement.
Uganda is in phase three of the Covid-19 pandemic as evidenced by the clustered cases in Amuru, Kyotera, and Buikwe, while the other border districts remain at high risk. Activities that promote convergence with non-feasible mitigations, can lead to occurrence of more clustered cases and eventually general community transmission. From the epidemiological point of view, the curfew acts as a measure to restrict activities that depend on convergence of people from taking place, hence reducing the risk of spreading COVID-19. The idea is to discourage gatherings in homes, hotels, restaurants, etc. Going home early and staying home the whole night is part of the prevention. It means less mixing. The curfew time is, therefore, strategic to reduce risk of spread and preempt crime.
2. Increasing numbers from the current 3 people in private vehicles
The current recommendation is for a private vehicle to have not more than 3 occupants, inclusive of the driver. This can be increased to four people in a vehicle. The requirement for masks for all vehicle occupants should be maintained, preferably with natural ventilation.
3. Boda Bodas
The Boda Boda business is one that relies of transportation of goods and people. The Boda Boda riders and passengers are in close proximity during travel. Yet, physical distancing is an important prevention strategy for COVID 19.
Secondly, Uganda has transitioned from imported cases to phase 3 of the epidemic, with the epicenters in the districts of Amuru, Kyotera and Buikwe. Further, the boda bodas don’t use traditional/gazetted routes like main roads or feeder roads. Boda Bodas, if allowed to transport people at this stage of the epidemic, may lead to further spread with complexity in tracking cases and contacts, given the large number of people they transport and penetrating the society and reaching where the vehicles do not reach.
People, walking to their homes is safer than the bodabodas spreading with passengers in the community.
The mitigation measures like putting a barrier between the passenger and rider to prevent contact may pose additional risk of hurting the rider/passenger in case of a fall. The materials used for the barrier could also increase risk of COVID-19 transmission since some materials maintain viability of the virus longer.
The innovation of introducing the barrier is applauded. However, there is need to review the risks and provide further guidance through SOPs. The innovations will be reviewed by the MOH in consultation with the ministry for transport and the Boda Bodas Association. In the interim, they should continue with only the transportation of goods.
4. Places of Worship
Places of worship are characterized by the following risk profiles;
• Clustering with many people of unknown risk from multiple points of origin — these will open multiple congregations across several religious denominations countrywide and potential to fuel infections across the country.
• Difficulty to enforce preventive measures like physical distancing.
(c) Closed indoor settings where transmission is more efficient than the airy outdoor settings.
The various places of worship by nature attract persons irrespective of their nature, lifestyle and risk profile. Mitigation by use of masks, hand and cough hygiene may also be difficult to enforce complex especially in special religious ceremonies such as Holy Communion.
Finally, contact tracing could be complex in the event of exposure of multiple people to COVID-19 since there are no records or listing of congregants.
The restriction on religious gatherings should be maintained and reevaluated in the last phase of lifting of restrictions. The NTF and MOH should engage and involve religious leaders in the COVID-19 response across various levels, given their critical role in shaping societal perspectives and behaviors.
The closely knit multistoried densely populated buildings with multiple entrances, no service areas for parking commonly known as arcades are areas where there is close clustering of people with unknown risk profiles. The arcades are interconnected and the ventilation is poor, which increases the risk of transmission of COVID-19. The ability to enforce physical distancing is minimal as witnessed by what is happening in Kikubo in Kampala.
We have already experienced clusters of COVID-19 in work places e.g. a factory in Buikwe area. The multiple entrances compounded with the convergence of people makes it difficult to track people in case of contact tracing.
The NTF should direct the MOH, Ministry of Trade, and KCCA to engage with the arcade owners to identify potential arcades to pilot prevention procedures.
KCCA, MOH, and Ministry of Trade should also review and enhance prevention compliance within the open shopping centers particularly Kikuubo and other downtown centers.
7. Hawkers, food and other vendors
A hawker is defined as he/she who travels about selling goods, typically advertising them by shouting: “abatembeyi”. These persons interact with persons in their homes, offices and cars when at traffic light stops. The interactions are between people of unknown risk profiles and if one was positive, the transmission chain would potentially be explosive. It’s difficult to track these persons as they are highly mobile. It would be wise not to encourage hawking during this third phase of the pandemic. Additionally, they should be targeted with communication to ensure compliance to prevention measures.
8. Repatriation of bodies for burial in Uganda
COVID-19 is transmitted through respiratory droplets and by contact with contaminated surfaces. Current evidence suggests that dead bodies do not pose increased risk of transmission if handled with the appropriate precautions including ─ use of personal protective equipment including gloves, gowns, aprons and masks, preventing fluid leakage and minimizing manipulation of the bodies. Bodies should, therefore, be repatriated if they fulfill the following conditions:
• Medical Certificate of Cause of Death;
• Post-mortem report or Comprehensive Medical Report from the attending doctor/health facility;
• Embalming certificate (Embalming may not be done for COVID-19 bodies);
• Copy of passport/identification document of the deceased (The original passport /travel document/identification document to be presented to immigration authorities);
• Import license/import authorization from the Director General of Health Services;
• Appropriate packaging – wrapped in a waterproof body bag then placed in a zinc lined coffin and an outer metal or wooden box.
Most of the activities in salons e.g. hairdressing, massages, etc., involve close contact between the dressers and their clients. Salons also often have many customers from multiple risk profiles and settings. Contact tracing of exposed individuals, if this occurred, could also be complex without detailed contact information of the customers.
The restrictions on salons should be maintained given the experiences elsewhere — salons have been documented to spread infections in other countries e.g. Ebola in West Africa, COVID-19 in the US, among others. NTF should direct the ministries of Health and Trade to engage with the salon owners to explore options for safety and training.
10. Travel in and out of Uganda for medical reasons
Travel into Uganda for treatment: Several people from neighboring countries such as South Soudan, may wish to enter Uganda for purposes of accessing medical care. Entry into Uganda has been restricted, except for cargo related handlers such as truck drivers and air cargo crew. This decision was made to reduce the risk of importation of COVID-19 cases, due to the rapidly growing COVID-19 pandemic in all neighboring countries.