Worries as Uganda Covid rate soars

montage of steep graph of Covid cases in Uganda and phone feed news story: parliamnet closes as 106 Ugandan MPs test positive

The latest graph shows a slight reduction in cases reported, following the introduction of some strict lockdown measures, while Nicci’s phone feed often brings concerning stories. Graph: Our World in Data.

portrait photo
Nicci Maxwell, medical doctor at Potter’s Village in Kisoro, Uganda

Mission partner Nicci Maxwell, working in Kisoro at Potter’s Village medical centre and with local health teams, shares news as COVID-19 cases increase in Uganda.

COVID-19 case numbers continue to rise rapidly. We know, and the government appears to acknowledge, that the recorded cases and recorded deaths are just a small fraction of what is really going on. Previous experience at Potter’s Village has told us that for every case with a formal diagnosis there are likely to be at least five cases that are undiagnosed.

The reproduction rate (R or the number of people infected by each positive case) of the virus is thought to be between 80 and 100 at the moment. That’s crazy! I remember when there was huge anxiety in the UK about an R of 3.

Lockdown limits

About two weeks ago the president announced a lockdown involving school closures, suspension of religious and other public gatherings, a limit on attendees at weddings and funerals and a ban on inter-district travel for 42 days, among other things. He left open the possibility of additional measures if people were not behaving or the numbers weren’t looking better.

Unfortunately, because of a delay to the start of the transport ban so children could get home from boarding schools, many people left Kampala, where infection rates are highest, and headed to their rural homes.

The president addressed the nation again at the end of last week. He added new restrictions, most notably a ban on most private transport and on boda bodas carrying passengers as well as extending the existing rules for a further 42 days.

These restrictions make things tricky for us at Potter’s Village. The majority of our nurses rely on a boda boda for at least part of their journey to and from work. Bodas can carry health workers to and from work so we have issued all our staff with ID cards and suggested they travel in uniform to avoid any trouble. Unfortunately, the 5pm limit on bodas has meant that our day shift now has to end at 4:30pm, making the night shift very long indeed! Our staff are currently choosing to travel rather than live on site – but that may change if restrictions get tighter.

government warning poster highlighting more rapid spread of Covid during this second wave
A stark warning from the Ugandan government

The sick can travel to hospitals and health centres with permission from their village chairperson but the cost of transport remains with the patient/relatives. I guess we will be seeing fewer patients and those we do see will probably be sicker. We already have a number of families who have missed appointments with cardiology because they couldn’t afford private transport and the necessary permissions to get to Kampala. Fewer patients means less income for our medical centre and potentially an impact on our ability to pay salaries. Most of our staff are the main breadwinner for their family.

Vaccinations – reassured and yet not reassured

The official statistics on vaccination report 869,915 doses administered so far and apparently close to 50,000 people have had two doses. Sadly only around 69,000 out of 150,000 health workers have had at least one dose according to one report I read.

I’ve had two doses of AZ now, as have around one third of our staff team before supplies ran out. Most of the rest of the team have had one dose. The AZ vaccine offers reasonable protection against most of the variants currently, except the South African one (which is reported to be among the ones circulating in Uganda). I also haven’t seen any data on the AZ vaccine versus the Nigerian and Kampala variants which we are told are also circulating. So I’m reassured and not reassured at the same time!

We are hearing reports of hospitals running out of beds and oxygen. The superintendent of our local government hospital told me last week that the current wave had “turned the hospital upside down”. The government says that the current demand for oxygen matches production capacity, though they are struggling a bit because there are no empty cylinders available for refilling at the oxygen plants. Unfortunately if numbers continue to rise, the need for oxygen is likely to be around eight times this.

There are thousands of standard hospital beds set aside for COVID-19 patients, but there are only around 210 intensive care beds in the country – up from 55 before the pandemic. Of these, over 80 per cent are in Kampala. There is no intensive care facility in Kisoro. I’ve read that a team from the USA are on their way to help out in Mbarara regional hospital, but if there’s no oxygen, they will struggle to help as many people as they’d like to.

Pretty terrifying

I did COVID-19 first wave and first lockdown in South Africa, then went through another wave and associated lockdown in England and Wales in October/November, but this is by far the scariest situation I’ve been in. The fact that the rules are at least two steps behind the disease curve and are widely thought to be annoying suggestions to be ignored whenever possible is actually pretty terrifying. The complete lack of adequate testing and care facilities is very worrying. I like data and statistics and there really isn’t any reassurance to be seen in the numbers at the moment.

I’m trying to learn Psalm 121 by heart at the moment:

“I lift up my eyes to the mountains – where does my help come from? My help comes from the Lord, the Maker of heaven and earth. He will not let your foot slip – he who watches over you will not slumber; indeed, he who watches over Israel will neither slumber nor sleep. The Lord watches over you – the Lord is your shade at your right hand; the sun will not harm you by day, nor the moon by night. The Lord will keep you from all harm – he will watch over your life; the Lord will watch over your coming and going both now and forevermore.”

It’s still very scary and uncertain and potentially dangerous but at least I know who is with us!

Please pray:

  • For safety for Nicci, the staff at Potter’s Village and other healthcare workers
  • For financial provision for Potter’s Village and their staff
  • For provision of oxygen and vaccines across the country
  • For the current lockdown to bring down the number of cases

Adapted from a blog entry posted 19 June 2021 by Nicci Maxwell.

Published 23 June 2021

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