THE REPUBLIC OF MINISTRY OF HEALTH

PRESS STATEMENT

UPDATE ON COVID-19 RESPONSE IN UGANDA

22 December 2020

Dr. Joyce Moriku Kaducu Minister of State for Health in charge of Primary Health Care 22nd December 2020 - The Ministry of Health would like to update the general public on the status of the COVID-19Pandemic in Uganda.

OVERVIEW OF COVID-19 - THE NEW VARIANT STRAIN

The Ministry of Health is closely followingthe global trends of a new variant strain (501. V2) of SARSCoV-2that has been reported in the United Kingdom, other parts of Europe and now South Africa and Nigeria. It has been shown to spread much faster but so far no evidence of high severity than the first strain.

So far, we know that the new variant strain is spreading faster than what we experienced in the 1st wave.

It is important to note that this new variant strain has NOT been reported in Uganda.

The Ministry of Health working with regional partners, Africa CDC through Uganda Virus Research Institute (UVRI)will start genome surveillance for the new strain to determine its prevalence in the country. However, we know that the transmission of the virusxand the control measures remain the same as the virus in the 1st wave. i.e. Consistent mask use, social distancing and good hand hygiene.

COVID-19 IN UGANDA

As you are all aware, Uganda is in phase 4 of the pandemic. This means that there is intense and widespread community transmission of COVID-19in nearly all districts and with occasional and emerging hotspots. Currently, remains the hotspot followed by the other emerging hotspots which are: Kabarole, Kasese, Lwengo, Kabale, , Masaka and Lyantonde.

To date, we are reporting a weekly average of 3,600 cases emerging from 85 districts.

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...t' , , ~, This has significantly increased compared to 22nd November 2020, when I last updated the public where we were reporting 1,900 cases weekly.

As of 20th December 2020, the country has registered a total of 31,384 confirmed cases of COVID-19, 10,549 recoveries and a total of 238 deaths.

INCREASING COVID-19 CASES AND DEATHS

In the past one month, we have recorded a total of 13,716 cases and 38 deaths. This is a high number and we are now witnessing patients quickly progress from moderate to severe forms of the disease.

The strain on the health systems can only be reduced if the population adheres to the SOPs and this will lead to a reduction in the infections.

EXPANSION OF ICU AND HDU BED CAPACITY

The increasing number of patients presenting with severe and critical disease across the country, has raised new challenges and strain on the health system, specifically:

1. Increased demand for beds, that is, High Dependency Unit (HDU) and Intensive care Unit (ICU) 2. Increased requirement for round-the-clock patient care and monitoring with more staff required than would normally be needed. 3. Exponential increase in oxygen utilization by over 10-fold.

Government continues to expand ICU and HDU bed capacity as part of its surge plan to meet the ever increasing demand. While the current need is greatest in the capital Kampala, it is projected that over the coming months the regional referral hospitals will have similar demand patterns.

3 · t. '.-~ . The HDU and lCU expansion plan, therefore, involves expansion in the COVlD-19 Treatment units in Greater Kampala Metropolitan Area (GKPMA)namely NRH, Grade B, China-Uganda Friendship Hospital, Naguru and all 14 regional referral hospital across the country. This comprehensive nationwide plan is addressing the key patient care 'pillars namely staffing, supplies (including medical, non-medical, PPE and oxygen) and finally structure and equipment.

This will include 19 new lCU beds and 298 new HDU beds in Mulago NRH,bringing the total in Mulago to 545 beds. Each regional referral hospital will have 10 lCU and 20 HDU beds, bringing the total to 30 in each region, and 420 total across all regions.

At the end of this enhancement, it is envisaged that there will be 965 functional beds across the country dedicated to managing severe and critical COVlD-19 cases.

OXYGEN PLANTS There have been several reports that the country has no oxygen or some patients have died as a result of lack of oxygen in the public facilities. Allow me inform you that at the onset of the COVlD-19 Pandemic in Uganda, the Ministry of Health undertook a needs- assessment, revised specifications and procured 7 oxygen plants, 450 oxygen cylinders, 5 filling stations and other accessories.

Four (4) of the seven plants have been installed at Mulago National Referral Hospital while the two (2) have been installed at Entebbe Grade B and Mbarara Regional Referral Hospital. One (1) has been allocated to Kayunga Regional Referral Hospital.

These are high tech, high volume, high flow and high purity oxygen plants procured to ensure continuous supply of oxygen to patients, which is critical in the management of COVlD-19.

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'.-~ " As I mentioned earlier, we are now experiencing more patients progress from moderate to severe conditions.

It is pertinent to note that Mulago National Referral Hospital uses pure piped oxygen (99 -1000/0).

GUIDANCE ON HANDLING OF INDIVIDUALS WHO HAVE DIED DUE TO COVID-19

The Ministry has noted the undue dramatization of burials of persons who have since passed from COVID-19. The fundamental principle of burying bodies of people who have died due to infectious diseases of public health concern such as COVID-19is maintaining a delicate balance between safety concerns and the dignity and cultural/ religious rights of the deceased and their loved ones.

The Ministry has developed guidelines to ensure proper treatment and packaging of the bodies to ensure that they do not unduly expose the public to the risk of contracting infection. We therefore strongly recommend the following: • All bodies shall be appropriately wrapped and put in a sealed coffin or body bag in line with Ministry of Health Guidelines for handling COVID-19 bodies prior to release to the family members • Family members MUST NOT at any point open the coffins or body bags • People carrying the coffin should don masks and gloves BUT DO NOT NEED TO put on coveralls and other Personal Protective Equipment (PPE)as we have consistently seen • Spraying of the ground and the air along the path of the body does not contribute to safety and is highly discouraged and SHOULD STOP

5 t . .. ~-- • Other standard procedures for gatherings including hand hygiene, physical distancing of at least 2 meters and use of masks must be observed at ALL TIMES GUIDANCE ON USE OF FACE SHIELDS INSTEAD OF FACE MASKS The Ministry has noted with concern that an increasing number of people are using face shields in place of face masks as a preventive measure against COVID-19. Face shields are a good physical barrier that provide additional protection by shielding the eyes from droplets. While they reduce the number of droplets reaching the nose and mouth, face shields leave a lot of uncovered space around these areas, enabling some droplets and aerosols (airborne particles that are finer than droplets) to reach them. Face shields therefore give limited protection to the nose and mouth. Masks, however, protect individuals by preventing droplets from landing onto their lips and nose, the major areas through which the COVID-19virus enters the body. Masks also prevent infected persons from dispersing virus laden droplets as they talk, cough or sneeze and in so doing they protect those near them. The Ministry therefore strongly discourages the public from using face shields as an alternative to face masks. In case they are used, this MUST be alongside masks as an additional protection.

COVID-19 VACCINE

Uganda submitted a COVAXApplicationon 7th December 2020 under the Global Alliance for Vaccine Initiative (GAVI)COVAXfacility where we shall be able to access approximately 18 million doses of the vaccine to cover 9 million people. The first batch of the vaccine is expected between May and June 2021 and subsequent deliveries during the year and will cover 20% of the population.

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t '.-~ . The first batch of the vaccines which are approved by World Health Organization (WHO)will be prioritized for; frontline health workers, the elderly (vulnerable population) and individuals with co- morbidities. A deployment plan of the vaccine to cover the remaining Ugandan population including the private sector is being finalized and communication will be made accordingly. HEALTH WORKER INFECTIONS

Allowme applaud the frontline health workers for their dedication, commitment, hard work and resilience to save lives of people who have been infected by COVID-19.

To date, we have registered 1,689 confirmed cases amongst health workers and 15 have succumbed to the disease. May their souls rest in eternal peace.

I call upon all health workers to adhere to infection, prevention and control measures both in the health facility and when you go home. This will greatly reduce the rise in infections that we are currently experiencing among health workers.

RISK COMMUNICATION

The Ministry of Health has intensified risk communication and is now implementing the 'COVID-19 IS REAL AND IT KILLS' campaign. This is intended to raise the public's risk perception on the dangers of COVID-19, the economic and personal impact that this deadly virus has on both the individual and family.

Now, we are aware of a new variant of this deadly virus that has started ravaging different parts of the world. Therefore, we need to strongly adhere to the COVID-19public health preventive measures: consistent mask use, social distancing and good hand hygiene.

7 t " '.. ~.--:; In light of the above, allow me appreciate the media fraternity for their continued collaboration and strong partnership in raising awareness among the population on the effects of COVID-19.

RESTRICTIONS ON LOCKDOWN While the Ministry has lifted restrictions on lockdown, it is important to note that bars, night clubs and concerts which are focal areas of COVID-19 spread based on global evidence and COVID-19 transmission dynamics REMAIN CLOSED.

This is due to the current phase of the epidemic which Uganda is experiencing with rising cases and deaths.

FESTIVE SEASON CELEBRATIONS As we approach the festive season, on behalf of the Ministry of Health, I want you to caution you all against travelling to the visit your parents and other elderly relatives in the village. As mentioned earlier, Kampala is a hotspot for COVID-19and we are likely to take infection to the vulnerable group. i.e. the elderly. It is our responsibility to protect them from this deadly virus and keep the safe. If we must travel, let us adhere to the Standard Operating Procedures at all times. Remember, life is better than death.

PROVISION OF STANDBY EMERGENCY MEDICAL SERVICES FESTIVE SEASON 2020

The Christmas and New Year festive season is characterized by increased pedestrian and motor vehicle traffic with resultant increase in road traffic accidents. These lead to many casualties requiring lifesaving first aid at the scene of the accident followed by rapid safe transportation to the health facilities for critical care.

8 Festivities also result in an Increase In patients with other emergencies from domestic violence; food poisoning; alcohol intoxication; the routine medical, mental, surgical, paediatric (child) and maternal emergencies.

In an effort to ensure rapid response to these emergency cases, the Ministry of Health has therefore deployed a fleet of 50 Ambulances Vehicles for the Kampala Metropolitan area, along the major highways and at selected sites in the health regions from the 23rd December 2020 to 30th January 2021. They will cover both the Christmas season and the Election period. Working with our key stakeholders, a crew of over 60 professional Ambulance Officerswill man the vehicles and offer emergency care in the locations highlighted below:

1. Kampala- Jinja Highway: Ambulances will be stationed at the Uganda Red Cross Society Offices in Jinja

2. Kampala- Hoima Highway: Ambulances will be stationed at the Uganda Red Cross Society Offices in Hoima

3. Mbale - Tirinyi Highway: Ambulances will be stationed at the Uganda Red Cross Society Offices in Mbale

4. Kampala-Luwero Highway: Ambulances will be stationed at the Uganda Red Cross Society Offices in Luwero

5. Nakasongola - Gulu Highway: Ambulances will be stationed at the Uganda Red Cross Society Offices in Gulu

6. Mubende - Kyegegwa Highway: Ambulances will be stationed at the Uganda Red Cross Society Offices in Mubende

7. Kampala - Masaka Highway: Ambulances will be stationed at the Uganda Red Cross Society Offices in Masaka 9 . \.

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8. Masaka - Mbarara, Ntugamo and Kabale Highways: Ambulances will be stationed at the Uganda Red Cross Society Offices in Mbarara

9. Kampala Metropolitan area: Ambulances will be stationed at high risk points listed below for quicker access ..The duty stations are geographically mapped basing on police stations in the Kampala metropolitan area and are dependent on posts anticipated to be of high risk as below;

1. Kira Police Station (area one); covering areas of Metroplex, Kira Division, Najeera, , , Buwaate, Northern By-pass and Namboole areas. 11. Police Station (area two); covering areas of , , Kazo, Kalerwe, and .

111. Police Station (station three); covering areas of , , Kirruddu, Entebbe Expressway and Busabala. IV. Division station (station four); covered areas of Mutunde, Natete, , , Lubaga, Mengo and Entebbe Expressway. v. Police Station (station five); covered areas of Entebbe municipality stretching to VI. Police Station (area six); covered areas of Northern By-pass, Hoima Road and Mityana Road.

V11. Jinja Road Police Station (area seven); covered areas of , Mutungo, and .

V111. Kampala central Police Station (area eight); covered areas of , Kamokya, Mulago, and Naguru. lX. Mukono Police Station (area nine); covered areas of Seeta, Mukono, Bweyogerere, Mbalala, Mabira and Lugazi. x. Fire Brigade headquarters (area ten); covered areas of Kampala Central Business District and standby for backups.

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10. An additional 30 Ambulance Vehicles to be deployed in all regions for the festive season. The Hospital Directors working with District Health Officers will determine the deployment sites.

These ambulances will be deployed on a 24 hour basis and can be reached directly through the followingInstitutions/Officers • Ministry of Health Toll Free Line: 0800 100 066 • KCCAToll Free Line: 0800 990 000 • Dr. Waniaye John Baptist-Mol-l: 0772 503598 • Dr. Josephine Okwera-URCS: 0780430189 • Irene Nakasiita -URCS: 0755 000695 • Directors of Regional Referral Hospitals • District Health Officers

The public is advised to call those contacts or institutions listed above in case of any medical emergency and also report any case of Ambulance misuse by health workers and drivers.

In this same vein, the general public is hereby requested to grant right of way ALL Ambulances (public or private) that are in response mode (lights on, sirens on or both), by turning to the sides and allow Ambulances drive in the middle between lanes.

APPEAL • In light of the expanding transmission including several emerging hotspots, the Ministry of Health strongly appeals to the Electoral Commission and Uganda Police Force to institute and maintain stringent measures to limit and curtail super spreading scenarios associated with large uncontrolled crowds with inconsistent use of masks and inappropriate social distancing

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I thank you.

I wish you all peaceful, safe and healthy Christmas and New Year celebrations. Stay safe, Stay alive. 1K~ Dr. Joyce Moriku Kaducu Minister of State for Health in charge of Primary Health Care 22nd December, 2020

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