Uganda: COVID-19 death

Warnings ignored

Although the number of confirmed COVID-19 infection cases continues to rise daily, complacency has replaced the initial fear of the disease because no severe cases or death has occurred. That contributed to pressure on Museveni to re-open in spite of advice from experts like Dr. Monica Musenero, a senior epidemiologist who is an advisor on epidemics to the President.

On July 14, Musenero had told journalists that those pushing for re-opening of arcades might regret it.

“Let’s not take it as a joke or political gimmick,” she told journalists, “a dead tenant is not useful to the landlord or arcade owner.”

Dr. Musenero is highly respected in scientific circles because she has been at the frontline of fighting Ebola and other epidemics in Uganda for long and won awards for her role as technical advisor when the world’s worst Ebola pandemic struck West Africa in 2014.

Before re-openings, President Museveni had also just warned that Uganda has entered a “dangerous phase” in the spread of COVID-19, following the confirmation of new positive cases within the community in the Buikwe, Kyotera, and Amuru.

Museveni said the guiding logic of whether to –re-open any sector should not be wealth, business, jobs, or convenience. He said the guiding logic should be saving life.

“Do we live even when businesses suffer and jobs are lost or do we continue doing business, making money and die? I, unhesitatingly, choose life. That is the logic. Moreover, with discipline, we can even have both: life and wealth. This is provided we do what is recommended.”

Museveni’s focus had been on arcades which are considered a high risk for spreading the coronavirus disease, COVID-19 but are equally powerful trading hubs. They attract large numbers of buyers and sellers who spend very long hours, close together, in closed tiny rooms with questionable ventilation. Museveni appears to have succumbed to business and political pressure to re-open them.

The pressure on Museveni to re-open arcades followed weeks of work by a Joint Verification Committee comprising Kampala Capital City Authority (KCCA) officials, leaders of traders, politicians, and scientists.

The Minister of Trade, Amelia Kyambadde, who chairs an Inter-Ministerial Committee on the issues, led the pressure to re-open arcades.

The Minister for Kampala, Betty Amongi, was under pressure to justify the continued closure of the arcades when many stand-alone shops and shopping malls were opened.

“We are not stifling the economy but protecting lives,” she told journalists at the meeting on July 14 when a pilot re-opening of arcades was conducted.

But the Secretary General of the Kampala City Traders Association (KACITA) was unimpressed.

“Government should handle the issue of the economy with urgency,” he said, “As the business community, we are badly off and the priority should be to open the arcades.”

Tension was growing over continued lockdown of sectors such as business, schools, buildings of worship and sports, and political rallies. In line with predictions in a report from the Institute for Economics & Peace (IEP) that the coronavirus pandemic could lead to greater political instability and unrest around the world, the traders on July 14 attempted to forcefully re-open the arcades.

Police deployed heavily to block the forced re-opening and the leaders of KACITA were dragged to for question for allegedly inciting the protesters. In an election year, these are battles Museveni would rather not fight. Already, critics were accusing Museveni of extending COVID-19 lockdowns for political rather than health reasons.

As pressure to re-open mounted, the government issued guidelines which the arcade traders vowed to implement and enforce.  Although the traders said the guidelines “practical and implementable”, the reality is they have failed elsewhere.

The guidelines include ensuring hygiene, having dedicated cleaners and COVID-19 standard Operating Procedure (SOP) enforcers, temperature checks, wearing face masks, and keeping a distance of two meters between sellers and buyers.

Re-opening guidelines will not work

When President Museveni announced the arcade re-opening, he said each must have temperature guns, seller and buyer to wear masks, ensure social distance, and hand-wash. He also introduced new Standard Operating Procedures (SOPs) for the arcades including no trading in corridors, steps, or pavements, sellers keeping contact details of buyers, no air-conditioning, and ensuring enough toilets.

According to experts, however, the most critical aspect to aid contact tracing in case of an outbreak; of arcade, salon, and boda boda operators keeping contact details of customers, will not work.

“Many boda boda riders cannot write their names,” said Ashraf Kiyaga, the secretary general of theBoda Boda Union Taskforce.

The experts also said when reopening arcades, President should have emphasised having enforcers of the SOPs and that controlling entry and exit of customers to limit overcrowding is critical.

The other SOP that the President missed is constantly sanitising critical contact areas such as service counter tops, and ensuring proper air circulation through proper ventilation even without air-conditioning. The other is limiting use of cash.

Most of these are in the Ministry of Health guidelines for prevention of covid-19 in public places (banks, offices, shopping malls, restaurants, markets) issued in March when the first COVID-19 cases were reported in Uganda.

According to the experts, some of these critical areas are not being addressed because they are not “practicable in the Kampala situation.

Experts have been warning that arcades, bars, theaters, and churches; the indoor places where people crowd together for long periods of time pose a higher risk for coronavirus spread.

Museveni had earlier warned that arcades would not be re-opened quickly because they 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,” he said.

It is not clear, how arcades plan to fix the overcrowding and ventilation challenges.