Dear fellow Americans:
I hope that each of you is well and staying safe. During this challenging time, I want to ensure you have the information that you need to stay up-to-date and make informed decisions.
Uganda has handled COVID-19 very well to date, but we are now entering a new phase of the outbreak. As many of you are aware, the Government of Uganda’s initial target for COVID-19 was to prevent, prevent, prevent, by closing the airport, testing people at borders, and quarantining travelers starting in March. These quick and decisive actions succeeded in largely preventing importation of COVID-19 into Uganda for far longer than most countries. After that, the goal was to delay, delay, delay. As more cases entered and a small number of unlinked cases were found, intensive efforts were put forth to trace nearly 100% of contacts of cases and stall the spread of the outbreak, buying valuable time to prepare the healthcare system for the inevitable influx of large number of patients.
Since June, the Government of Uganda has started to ease lockdown measures. We are now moving into an approach of manage, manage, manage (or, “flatten the curve”). We know now that there are many asymptomatic cases for each symptomatic one, and many symptomatic cases for each person who dies with COVID-19 disease. We have seen a handful of deaths in a very short time without seeing the increase in diagnosis of asymptomatic or symptomatic cases at the same time. What that means is that for each death you see on the news, there may be hundreds of infected persons linked to them who were never detected. If those infected persons are not wearing a mask and socially distancing, which most people unfortunately are not, then they are out in public right now and may be infecting other people. COVID-19 is in Kampala – possibly a lot of it.
Please let me repeat. Kampala has a lot more cases of COVID-19 than are currently known. They won’t show up on the daily press releases because there are not enough test kits to do widespread community testing (although there are intense efforts underway to bridge that gap). In this phase of the outbreak, we find out about clusters of patients when one gets sick enough to show up at a clinic, and that clinic knows to report that they have a possible case. For each sick patient who shows up at a clinic, there are many more who may not get very sick, but who can still spread the virus to others. In the phase we are now in, we will continue to have a lot of cases out there that we just don’t know about. And it is not only Kampala. We’ve had “hotspots” of community transmission for several weeks now in other areas of the country, and will expect to see more.
This is not unexpected. We knew that community transmission (identification of cases unlinked to other known cases) would eventually begin, and Uganda would start the upward climb in cases that nearly every other country has seen. We are now there. If you were not paying attention before because it seemed there was no COVID-19 in your area, PAY ATTENTION NOW. People who are infected may show NO SYMPTOMS – meaning that you could be a carrier and you wouldn’t even know it – and still transmit the virus to other people. That vendor you interacted with yesterday? The one who had his mask around his neck instead of over his face while he chatted with you? He could have given you COVID-19, and you could infect everyone you talk to before you even realize it happened. As we go into the fifth month since the initial cases were introduced into Uganda, it is safest to simply assume that everyone you meet is infected. This is not a call to panic, but an encouragement to return to the behaviors that will keep us safe. In this phase of increasing community transmission, it is up to each of us to protect ourselves, follow the guidelines, and do our part.
Wear a mask whenever you go out of your house. If you are infected, cloth masks protect other people from you. Cloth masks do not protect you from other infected people. Because of this, masks only work if everyone is wearing them, and wearing them correctly over the nose and mouth, whether or not they have symptoms. Even outside, if you are standing close to a person who is talking directly at you, that can be enough to transmit the infection. Keep your distance and walk away from anyone who doesn’t want to put on a mask before they talk to you. Wear your mask always, but to protect yourself you must make sure that everyone around you wears their mask also. In this outbreak, each person must do their part to keep everyone safe.
Keep your hands clean. Carry a little bottle of soapy water if you don’t want to buy sanitizer–it’s cheap and the soap kills the virus very well. Don’t touch your mask a lot, and don’t touch your face until you’ve washed your hands. Make sure everyone who lives in the same house as you also knows these important guidelines so they don’t bring the virus home to you and others in your household.
If you develop even a slight cough or a fever, if you realize you can’t seem to smell or taste things anymore, or otherwise feel like you might have symptoms of what folks call “flu,” STAY HOME. When symptoms first start, you won’t be able to tell if what you have is COVID-19 or some other more normal cold or ‘flu’, so play it safe and stay home. If you are feeling even a little sick, stay away from your family members as much as possible. Put a mask on even at home to protect others in your house. Wash your hands a LOT and clean the surfaces in your house a lot. If you feel any shortness of breath, or if your symptoms get worse, call the Ministry of Health on the toll free lines at 0800-100-066 or 0800-203-033 so they can direct you to the best location to receive care.
Stay safe out there. COVID-19 is spreading right here, right now – don’t let it be you. If we all stay home to the degree possible, stay distant, and make sure masks are being worn by everyone around us and our hands are clean, we WILL reduce the impact this outbreak will have on our families, our communities, and Uganda.
Thank you all,
U.S. Embassy Kampala, Uganda