On Thursday, the Minister of Health, Dr Jane Ruth Aceng gave the nation a comprehensive update on the COVID-19 response in Uganda. Considering that the government had decentralized the management of case to districts, Dr Aceng took the time to explain the process of testing potential cases and identifying those positive with the virus. This is the process;

Those in Quarantine

First of all, one needs to know that there are already individuals in quarantine. These are mainly travellers from high-risk countries at the time the Entebbe international airport was being shut down (some of them have been under observation since January). The travellers who are 2,661 in number have been identified for either self or institutional quarantine. According to the minister, 1,015 high-risk travellers are in institutional quarantine.

Apart from travellers, individuals already in quarantine or being followed up include contacts of the 44 confirmed cases. These amount to 660 individuals mostly in self-quarantine or still being investigated.

Individuals in quarantine are already being tested.

Identifying potential patients and Collecting samples

Now that the process has been decentralized, those not under quarantine will be able to access assistance faster and without overwhelming the emergency centres in Mulago and Entebbe.

In this process, people with COVID-19 like symptoms are advised to call their respective District Health Officers (DHO). The Health Ministry also has the District Surveillance Focal persons with village health teams that are tasked with finding potential patients. These village health teams will direct alerts to the DHOs in case of a potential COVID-19 patient.

Those with suspected symptoms will be advised to stay in their homes until a team from the DHO comes in to asses them and take their samples. A nose and throat swab will be collected from the individuals by a laboratory specialist. The samples will then be sent to a hub for packaging. These hubs can be found at Regional Referral Hospitals, General Hospitals and health centre IVs.

Individuals undergoing testing are advised to remain in quarantine until lab results return.

The District rapid response team will then collect the samples and send them to the Uganda Virus Research Institute in Entebbe through the Ministry of Healths’s from the hubs. This will be achieved either through Ministry of health Vehicles or the poster bus.

Now, the Ministry of Health has developed an Emergency Medical Services plan for people who test positive for COVID-19. Under this plan, 310 ambulances have been deployed both at the Central and district level to supports the COVID-19 response, for the purposes of evacuating positive cases.

Management of COVID-19 cases

Those found to be positive for COVID-19 will be managed in designed health facilities within the district or referred to a higher institution as per the referral guidelines. Mild and moderate cases will be managed at the district level, while severe and critical cases will be referred to the Regional Referral hospitals.

In a bid to strengthen psychological support, health workers have been oriented in providing psychological first aid and debriefing as they care for people affected with COVID-19. Entebbe, Mulago and all regional referral hospitals have been given 4-6 psychological providers to give counselling to patients and health workers.

Health workers are also being trained in self-care and how to avoid being infected with COVID-19.

Discharging individuals from institutional quarantine

As mentioned earlier, exposed individuals are already in quarantine and are being monitored. The purpose of quarantine is to ensure that one does not expose family, friends and community to the virus. Those who go through the mandatory 14 days quarantine will be discharged. However, before discharge, the following procedures will be undertaken;

1) A quarantine facility, where no one develops symptoms by the 14th day will have all its inhabitants tested to rule out the presence of asymptomatic persons who may be shading the virus. If results are negative, the inhabitants will be discharged to begin another 14 days of self-isolation in their homes.

2) A quarantine facility where one person developed symptoms will necessitate beginning the count of another 14 days from the date of the evacuation of the Positive case. And the cycle continues.

3) A negative test when asymptomatic but with contact history cannot rule out pre-clinical or asymptomatic infection and a repeat test is required within 14 days.

4) Having a negative test when symptomatic does not rule out COVID-19. A test will be repeated within another 7-10 days.

At the moment, Uganda has 44 confirmed COVID-19 cases. There are no recovered individuals and no deaths at the moment. The global count for confirmed cases is closing in on the 1 Million mark as deaths near the 50,000 mark.

Source: Minister of Health, Dr Jane Ruth Aceng’s speech