Uganda, Zambia hit by lethal Covid-19 spikes; political rallies to blame?

Uganda had been praised for its initial coronavirus response. Now, a more lethal wave of Covid-19 is sweeping the country, in part driven by political decisions.

Questions remain over the swearing in ceremony of President Yoweri Museveni, which may have acted as a super-spreader event. Zambia, with elections in August, has some tough decisions to make.

Uganda received plaudits from many healthy exports across the globe for efficient management of the first coronavirus wave. However, the country has been hit by a deadly second wave, prompting Museveni to declare a total lockdown of 42 days. No one is allowed to move except essential workers and those attending to emergencies.

In an article published by the ‘American Journal of Public Health’ in 2020, Ahmed Sarki, Alex Ezeh and Saverio Stranges applauded Uganda as a “model for pandemic management in Africa.”

Why the plaudits? Uganda had scored highly in pandemic risk communication, testing and community task forces instituted in all districts for surveillance. Although some Asian countries such as South Korea, Vietnam, and Taiwan are considered as exemplary around the world in their public health response to the pandemic, the authors argued that Uganda’s response, both in African and global contexts, should be commended.

“It teaches us that the economic standing (high or low income) of a country does not necessarily determine preparedness for pandemics,” they said. “This is true not only for countries in Africa such as Nigeria, South Africa, and Egypt (the top three economies and the three countries with the most COVID-19 cases) but also for high-income countries such as the United States and the United Kingdom.”

Lethal second wave

But the country has been hit by a deadly wave and now tops the list of African countries that have seen a high spike in new cases in comparison to the numbers of cases registered at the start of the pandemic. Uganda has registered 28,173 cases which is 39% of all the positive cases since the start of the pandemic, according to an analysis from the John Hopkins University coronavirus database on Monday 21 June 21.

The rapid surge in the intensity of the pandemic appears unprecedented.

Across the border, in the past month, Kenya has reported 6% of its almost 180,000 total cases while Rwanda has recorded 13% of its more than 30,000 cumulative cases. On the other hand, Tanzania and Burundi never took the pandemic seriously, and as a result, they have not been testing or reporting cases. However, after President Samia Suluhu took over from coronavirus sceptic John Pombe Magufuli in March, Tanzania is now seeking a $500m loan from the IMF, with the promise of releasing coronavirus data.

In Southern Africa, Zambia is one of the countries experiencing a huge spike in coronavirus cases. In the past one month, it recorded 27% of its almost 130,000 total cases.

Within the same period, neighbouring South Africa – that has been hit hard by the pandemic – recorded 10% of its 1.8m cumulative cases.

In Zambia, politicians are focusing on the August presidential election rather than rallying masses to follow the Covid-19 standard operating procedures.

West African countries

Ghana, that has registered only 1.4% of its total cases in the past month, and Senegal, which recorded 3% of its cumulative cases in the same period, seems to be winning the battle against the pandemic. Senegal and Ghana were better prepared due to experience from handling earlier pandemics and swift government response. But unlike Uganda, the West African states are still on the success trajectory.

Uganda’s laxity propelled by politics

Between January 2021 and early May, Uganda was registering less than 100 cases per day. Business had returned to normal after the January general elections, politicians were starting to hold meetings of large gatherings and schools had resumed regular classes.

On 12 May, 4,000 people – including 11 heads of state – attended Museveni’s swearing in for his sixth term. This was in spite of positive cases rising steeply at the start of May and in contradiction of the government’s pandemic regulations that capped gatherings at 200 people. Since the start of June, Uganda has been registering more than 1000 cases per day according to the WHO coronavirus tracker.

At the end of May, the president had brushed off recommendations for a total lockdown. However, he later settled for a ‘mini-lockdown’: closure of schools, stopping inter-district travel and strict adherence to pandemic operating procedures such as wearing masks in public. When cases continued increasing, Museveni ordered a 42-day total lockdown on Friday 18 June, banning movement of cars and motorcycles with the exception of essential workers and emergency situations.

“The rapid surge in the intensity of the pandemic appears unprecedented, but still manageable using similar measures we have used since last year at the beginning of the pandemic,” Museveni said. “The proportion of people testing positive from samples has remained as high as 17%. Yet for us to control the disease effectively, this number has to be less than 5%.”

Uganda is also experiencing a steep rise in Covid-19 fatalities. For instance, as of 22 June (when data was analysed), the country had recorded 221 deaths in one week which is 32.5% of total Covid-19 deaths registered since the start of the pandemic. Museveni said his government is “cognizant that both the number of Covid-19 cases and deaths may be higher than this (figures reported).”

There has been a shortage of oxygen and ICU beds for coronavirus patients across the country. Last week, 30 fatalities were reported at Mulago National Referral Hospital due to lack of oxygen. Ugandans have also been crying foul over the hike in cost of coronavirus treatment in private hospitals. A patient admitted to a private hospital pays between $600 and $1600 per day.

Vaccination

Like many countries in Africa, Uganda’s hope of escaping from this current wave is vaccination. “The only solution to this current wave is following standard operating procedures and vaccination. We need to vaccinate a sizable amount of the population to build hard immunity,” says Muhwezi Muhereza, secretary general of Uganda Medical Association. Museveni has said Uganda will fully reopen after vaccinating 4.4m people.

It is a steep path. The government says it has run out of the vaccines. It received 964,000 doses received from Covax, a programme supporting low-income countries to access coronavirus vaccines.

According to government statistics, a total of 869,915 people–which accounts for 90.2% of the 964,000 doses received – have been vaccinated. Out of those vaccinated, 57,797 (6.6%) have received two doses. This is a paltry 1.3% of 4.4m people that the government says should be vaccinated before the country can fully reopen.