UPDATE ON THE COVID19 SITUATION IN THE COUNTRY AHEAD OF THE FESTIVE SEASON

The Ministry of Health would like to update the public on the evolving COVID-19 situation in the country and progress on Vaccination ahead of the festive season.

Overview of COVID-19 in the country

To date, the country has registered 130,888 cumulative confirmed cases of COVID-19, of which 98,127 have recovered, and 3,274 have succumbed to the disease.

Currently, there are 85 patients admitted in various public health facilities, 14 of these are in Mbarara Prison. Most (42) of these patients were admitted in the last 7 days.

For the period between October and December 11^th, 2021, the country had completely controlled the disease. The country’s positivity rate consistently remained under 5% which is the desirable positivity rate and indicates control of the pandemic. However, in the last two weeks, we began to observe an increase in the number of confirmed cases

In the last 14 days of December 2021, we have registered 2,423 confirmed cases, giving an average of 173 cases per day. We have registered a 100% increase in cases and positivity in the last 7 days compared to the previous week.

We notice that most of these cases are in Wakiso 46% (1,107/2,423), followed by Kampala (926/2,423), Kyotera 6% (144/2,423), Tororo 2% (49/2423), and Amuru 1% (37/2,423), among other districts. This increase in cases is being observed mostly in border districts.

We have observed that 70% (775/1,107) of the cases registered in Wakiso are mostly incoming travelers through Entebbe International Airport. These travelers are coming from the following countries; Kenya, United Arab Emirates, South Africa, South Sudan, Tanzania, Democratic Republic of Congo Nigeria and United Kingdom. The confirmed cases registered in other districts are also travelers and truck drivers.

The Omicron variant

Although Uganda has officially registered only 73 cases of the Omicron variant, the picture in the communities could be different given that Omicron is largely responsible for the surging numbers in many countries around the world. The Uganda Virus Research Institute (UVRI) will continue to conduct genomic sequencing of samples obtained from in-coming travelers at the ports of entry and among cases detected within the country, so as to establish the true picture of this variant in Uganda.

Based on evidence from elsewhere, we know the following about this variant:

1. It is highly transmittable, and therefore rapidly multiplies in the community within a short period
2. Unvaccinated people are at the highest risk for severe and critical illness and they tend to be more effective.

In light of the above, the Ministry of Health recommends that;

1. all unvaccinated persons should ensure they get vaccinated.
   1. Senior persons above 50 years and those with co-morbidities get a booster dose of the vaccines
   1. The SOPs be strongly adhered to at all times.

The high transmissibility of the Omicron and ongoing festivity warrants that we comply to the SOPs so as to avoid mortalities and shield the fragile health sector.

Although disease caused by the Omicron variant has generally been reported to be mild (87% cases), the high attack rate of Omicron means that severe (8%) and critical (5%) might accrue at a rate that our respective (HDU and ICU) bed capacity might not sustain for long. In light of this, it becomes the responsibility of everyone to protect the window for the planned full Re-Opening of the Economy in January 2022.

To ensure optimal response and control of the omicron variant and other Variants of Concern, the Ministry of Health is doing the following.

1. Acceleration of the COVID-19 vaccination activity;

Variants emerge when the vaccine coverage is low. Accelerating vaccination denies variants susceptible/ individuals with weak immunity to propagate transmission.

• Contact tracing and enhanced surveillance including.
• Sustaining the mandatory testing at Entebbe International Airport, and intense information sharing to the incoming travelers, to ensure they observe SOPs and isolate when confirmed positive.

ii. Implementing the Cabinet directive for mandatory testing, and follow-up of positive cases for all incoming travelers at the 53 Land border points of entry. Currently, the focus is on the five major points of entry (PoEs); Malaba, Elegu, Busia, Mutukula, and Mpondwe. The testing is being implemented by the private sector at Government set rates ($25) as the Ministry of Health builds capacity to take over the testing.

Costing for the complete set-up of port health at the 53 Land border points has been done and a request was placed with the Ministry of Finance. c) Genomic sequencing

There are currently four laboratories capable of conducting Genomic sequencing: three laboratories are located in the Uganda Virus Research Institute, and one at Makerere University. This capacity enables the country to detect the different variants of concern circulating in the population.

COVID-19 Vaccination

COVID-19 vaccination remains one of the key strategic interventions to control the pandemic, especially with the emergence of new variants. So far, 10,633,472 doses of the COVID-19 vaccine have been administered to the target population of 22 million people. Of this, 9,162,284 persons (43%) have received the first dose of the COVID-19 vaccines, of these 1,944,194 are vaccinated using the J&J vaccine, while 1,471,188 (15%) have received the second dose and are considered fully vaccinated. This, therefore, means 3,415, 382 (15%) are fully vaccinated.

Vaccines Pipeline in the country

To date, the Government has received a total of 32,696,440 doses of vaccines of which 20,039066 doses have been utilized countrywide and some are still in the districts. The distribution of the remaining 12,657,374 doses is ongoing.

We expect an additional 11,010,810 million doses of various vaccines by end of March 2022. This indicates the country has enough vaccines for all eligible persons.

Accelerated Mass COVID-19 Vaccination Campaign (AMVC)

In order to increase uptake, the Ministry of Health will continue to undertake regional accelerated Mass Covid-19 Vaccination Campaigns (AMVC). To date, the vaccination campaigns have been conducted in the sub-regions of Teso, Lango, Acholi, Ankole, West Nile, Tooro, Rwenzori, and part of Buganda.

The ongoing regional vaccination campaigns have enabled the vaccination of 4,506,480 million people over the last one and a half months in the eight regions.

COVID-19 Vaccine Boosters

After evaluating the evidence of reducing/waning immunity 6-8 weeks after full vaccination elsewhere in the world, the Ministry of Health recommends booster doses, for persons aged 50 years and above, and persons with comorbidities to further enhance their immunity. One can get a booster dose at least 6 months after completing the primary COVID-19 vaccination series. The objective of a booster dose is to restore vaccine effectiveness from that deemed no longer sufficient.

The rationale for booster doses may differ by vaccine product, epidemiological setting, risk group, and vaccine coverage rates. The World Health Organization recommends that the optimal timing for any country to start booster doses is when its vaccination coverage of the eligible population is at least >50%. Uganda’s vaccination coverage is still below the WHO recommended threshold. Accordingly, full-scale boosting program may start at the end of January 2022 when all regions have reached 50% vaccination coverage.

Mix and Matching of COVID-19 Vaccines

After a review of evidence and in line with the World Health Organization interim recommendations for mixing and matching vaccines from different manufacturers for both the second and booster shots, the Ministry of Health NOW authorizes mixing and matching of vaccines for use in Uganda.

So far, three types of vaccines are considered in the mix and match

1. Viral Vector vaccines which contains instructions for making coronavirus antigens e.g. AstraZeneca and Johnson and Johnson
2. mRNA vaccines which use a code from SARS COV 2 to prompt an immune response in recipients e.g. Pfizer and Moderna
3. Inactivated vaccines where the SARS COV 2 virus is inactivated or killed using chemicals, heat or radiation e.g. Sinopharm and Sinovac

Benefits of mixing and matching includes

1. mixing offers advantages in enhanced immune response and, therefore, anticipated enhanced protection.
2. Mixing COVID-19 vaccines is emerging as a good way to get people the protection they need when faced with unpredictable supplies.

Therefore, the Ministry would like to inform the population that the same vaccine will remain our standard practice, but in the circumstances of extreme unavailability, both in stock and pipeline mixing and matching may be undertaken. The Ministry of Health Will Issue detailed guidance to District Health Teams to implement this instruction.

Reverse Logistics and Vaccine distribution

COVID 19 vaccines by their very nature have a short shelf life, thus massive mobilization of the people for vaccination remains very critical to save the vaccines from expiry. Districts leaders are reminded that rejecting vaccines delivered to them or requesting the National Medical Stores for redistribution or reverse logistics of vaccines supplied to them defeats the very purpose for delivering the vaccines to them for protecting vulnerable people from severe disease, hospitalization, and death. Accordingly, the District task forces are requested to review their actions and commit to providing vaccines to the populations.

Adherence to SOPs in Celebration setting

The Ministry of Health has observed that there is an increase in the number of celebration events taking place this season, which among others; include wedding parties, birthday parties, and family reunions. These kinds of events are likely to act as super-spreaders once organizers and individuals don’t take responsibility to adhere to the SOPs. We strongly advise that the organizers of such events should ensure strict adherence to the Standard Operating Procedures including; handwashing with soap and water, social distancing, and proper use of facemasks at all times.

Public Transport Operators are reminded to ensure they board buses/taxis, operating at half capacity to allow for social distancing. Please, remember to report any Public Service Vehicle whose operations fall short of following the COVID-19 preventive measures.

Risk Communication interventions

The Ministry of Health has increased risk communication messages through all channels of communications with a keen emphasis on vaccination and observing the SOPs at this time of apparent uncertainty of the direction of the pandemic.

The Ministry will further ensure that there is regular information to the public, and will also provide timely clarifications on misinformation.

Advisory on Emergency Medical Services (EMS) during Festive Season

The “Christmas and New year” festival season is characterized by increased pedestrian and motor vehicle traffic with a resultant increase in road traffic accidents. This leads to many casualties who require lifesaving first aid at the scene of the accident followed by safe professional transportation to health facilities for continued acute and critical care. The Festive season also results in an increase of patients with other emergencies from domestic violence, food poisoning, alcohol intoxication, routine medical care, maternal and child emergencies.

Due to the above factors and the fast-spreading Omicron variant of the COVID-19, the Ministry of Health through its Emergency Ambulance Services will be on standby to respond.

With effect from today 23 ^rd December 2021 to 5th January 2021, EAS will deploy over 300 ambulances staffed with 600 emergency care professionals across the country for the response.

This will be coordinated using established Regional Emergency Teams under the leadership of the Regional Referral Hospital Directors, City Medical Officers, and District Health Officers.

Ambulances will be deployed on the highways at selected Hospitals, Police Stations, URCS offices, and selected district sites to respond to road traffic injuries.

The detailed contact numbers for ambulance regional coordinators will be published. For central coordination, the Call number is 0313313600 Naguru Ambulance Station and MOH toll-free line 0800100066.

I also appeal to the general public to grant way for all ambulance vehicles that are in emergency response mode (lights on, sirens on).

The Ministry of Health will work with the Uganda Police force, UPDF, URCS to respond to any emergency that occurs.

CONCLUSION

In conclusion, I would like to appeal to the general public to embrace the COVID-19 vaccination exercise. With the evolving epidemiological picture, I appeal to the elderly who have been fully vaccinated to go for booster doses. Those who have not taken any jab should do so with urgency. The COVID-19 vaccine is safe, effective, and free. It will protect you and your loved ones from the devastating effects of COVID-19.

As we head out for the festive season, I call upon the Technical Multi-sectoral

Taskforce to ensure that they enforce adherence to the Standard Operating Procedures (SOPs) since it is the most assured way to protect our loved ones from being infected with COVID-19.

Lastly, I take this opportunity to thank the Almighty God who has protected us, and brought us this far even with the challenge of the COVID-19 pandemic as a major health concern.

I wish you all a Merry Christmas and Happy New Year!!!

For God and My Country.

Dr. Jane Ruth Aceng Ocero

Minister for Health

23 ^rd December 2021