KAMPALA – Uganda, Kenya and Rwanda have suspended passenger flights from India amid that country’s surge in COVID-19 cases and  fears that a number of African countries are on the brink of their own surges.

“All flights from India and all passengers originating from India are suspended from 1 May,” the Uganda Ministry of Health said in a statement. “All passenger flights are suspended until further notice. No travellers from India shall be allowed into Uganda regardless of the route of travel.”

Meanwhile, Kenya has suspended flights from India for 14 days, according to the Kenya Ministry of Health. Kenya Airways and Rwandair have also suspended flights from and to India.  

However, East African residents will be allowed to return home. India is a top medical tourism destination for residents in East Africa. 

The three countries are demanding that travellers who have been to India or travelled through India in the last 14 days, be in possession of a negative PCR COVID-19 test certificate that is digitally verifiable and has been conducted within 120 hours of travel. They will also undergo a PCR test upon arrival.

Uganda will allow cargo flights from India where the crew do not disembark and technical stops where travelers do not disembark. It is also allowing aircraft in a state of emergency, operations related to humanitarian aid, medical evacuation, diplomatic flights approved by the appropriate Authority.

Uganda has also advised travellers from the USA, United Kingdom, United Arab Emirates, Turkey, South Africa, and Tanzania to consider postponing non-essential travel to Uganda.

Travellers from these countries, including Ugandans, will be subjected to a PCR test upon arrival at the points of entry into the country said Dr Jane Ruth Aceng, Uganda’s Minister of Health, during a weekly briefing.  

“We should make a difference between people and the virus. The virus is the enemy, not the people. If someone has an authentic negative PCR test, they do not cause a problem,” said Dr John Nkengasong, director for Africa Centres for Disease Control and Prevention (CDC).  

Truck Drivers’ Testing is Tightened

The East African Community (EAC) is tightening up on the COVID-19 testing requirements  of interstate truck drivers, identified as vectors of the virus, amid numerous problems including forged tests 

At a recent EAC meeting, Uganda, Kenya, Tanzania, Burundi and South Sudan agreed to submit the names of accredited national laboratories for COVID-19 testing so that these could be linked to the upgraded Regional Electronic Cargo and Driver Tracking System (RECDTS), which recognises digital COVID-19 certificates for truck drivers.

The deadline for uploading all accredited COVID-19 testing laboratories in the RECDTS is 15 May. This will ensure that interstate truck drivers and other travellers test for COVID-19 in only through accredited laboratories and that all partner states take up and implement the RECDTS system.

Digital certificates are uploaded on the drivers’ smartphones through an app and are valid for 14 days. The App, which was launched in September 2020, was developed with donor funding. It provides a surveillance system to monitor long-distance truckers’ health and enables contact tracing. It also allows partner states to electronically share truck drivers’ COVID-19 test results.

The new system is aimed at resolving some of the challenges that were being experienced in the execution of health protocols including multiple testing of truck drivers at the border crossing as there lacked a framework of mutual recognition, document fraud and conflicting test results.

The interstate truck drivers also are the single largest group of people who have been identified to be carrying the variants of concern – the  B.1.351 variant from South Africa and the B.1.1.7 from the UK. From 399 samples sequenced by the Uganda Virus Research Institute (UVRI) these two variants were detected in 30 truck drivers.The Indian variant has been identified in one patient who was admitted to Mulago Hospital.

By Wednesday, the EAC Secretariat expects to have shared a detailed concept note on the development of a common regional health pass to be linked to the upgraded surveillance.

Uganda and Kenya Cases Increase

By Monday, the Ministry of Health in Kenya had reported that 369 people had tested positive for the disease, from a sample of 4,469 tested in the last 24 hours – a positivity rate of 8.3% compared to the world average of 2.2%. 

A total of 1,298 patients are in various health facilities countrywide, while 6,652 patients are in isolation at their homes and 19 had died in the 24 hours before Monday. Total confirmed positive cases are now 160,422 and cumulative tests so far conducted are 1,679,779.

Some 190 patients are in the ICU, 29 of whom are on ventilatory support and 118 on supplemental oxygen – 43 patients are on observation. 

Aceng said that Uganda was “experiencing a gradual increase in the COVID-19 cases and it is the beginning of a resurgence”. 

“This surge is already showing in districts that have remained on high alert and have been carrying out active surveillance,” said Aceng, adding that “this second wave will be worse than the first one”.

Uganda has already organised a resurgence plan which is projected to cost over $290 million and is organised around three thresholds: control, alert, and action. The alert threshold is reached when there is a 10% increase in cases while the action threshold begins when there is a 20% increase in the cases observed from the baseline in any geographical location.

“The main objective of the resurgence plan is to mitigate transmission and minimise the public health and social economic impact,” said Aceng. The resurgence plan will include enhanced surveillance, active case search, contact tracing, procurement of test kits, Personal Protective Equipment, critical care support, strengthening community engagement and risk communications, and supporting the vaccination teams but it does not include procurement of vaccines.

By 30 April, Uganda’s cumulative COVID-19 cases stood at 41,866 with 342 deaths. There are currently 444 active cases.

WHO Warns of African Resurgence

The World Health Organisation (WHO) predicts a high risk of COVID-19 resurgence in several African countries due to poor adherence to public health measures, mass gatherings, low testing and vaccination rates.

“We cannot be lulled into a false sense of security. The devastating surge of cases and deaths in India, and increases in other regions of the world, are clear signs that the pandemic is not yet over in African countries,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. 

“ A new upsurge of COVID-19 infections is a real risk in many countries even if the region’s case count in recent weeks appears to be stable,” she added. “Combatting COVID-19 fatigue appears to be the key battle in our collective response to the pandemic.”

According to the WHO analysis of 46 African countries, Kenya, Egypt, Ethiopia face a very high risk of resurgence, while a further 20 countries face a high risk and 22, moderate risk, and only one country faces low risk. 

The risk was calculated using seven indicators with data from the past four weeks, including COVID-19 cases per million people; the percentage of change in new cases; the percentage of change in new deaths; the reproductive number (the rate at which an infection spreads); the pandemic trend; the average weekly number of tests per 10 000 people; and the percentage of the population that has received at least one vaccine dose.

With more than 4.5 million confirmed cases and over 120 000 deaths to date, the continent has not experienced a surge in cases since January and the epidemic curve has plateaued for six weeks. 

But the relatively low number of cases has encouraged complacency and reduced adherence to behavioural measures to prevent the spread of the virus.

In addition, recent political rallies in Benin, Cote d’Ivoire, Guinea and Kenya caused a spike in new cases. Upcoming elections in Cape Verde, Ethiopia, Gambia, Sao Tome and Principe and Zambia could also trigger cases due to mass gatherings, said Moeti.

Of the 46 countries analysed, 31 performed fewer than 10 tests per 10,000 people per week in the past four weeks.

“Most new cases are still not being detected among known contacts. Investigation of clusters of cases and contact tracing are worryingly low in most countries in the region,” Moeti said. “We must scale up testing including through rapid diagnostic tests to enhance response to the pandemic.”

Image Credits: EAC.