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How do optimal policies to control the spread of SARS-CoV-2 vary across countries? In an influential recent paper, Eichenbaum, Rebelo, and Trabandt (2020) incorporate economic behavior into a standard epidemiological model calibrated to the United States, finding that spontaneous social distancing will fall short of the social optimum without policy intervention. In this paper, we apply and extend their model to explore how optimal policy varies across contexts depending on demography, comorbidities, and health system strength — which affect the infection fatality rate — as well as poverty — which affects agents’ willingness to forego current consumption to reduce disease risk. Calibrating the model to Uganda, we calculate an optimal path for a containment policy equivalent to a 4% consumption tax over one year (compared to a 40% tax in the U.S.), which reduces predicted mortality by...

On 21st March 2020, Uganda reported its first COVID-19 case. The government responded by instituting a lockdown and other measures. We assess the effects of the COVID-19 containment measures on health services to better inform the next preventive measures. We use a case study approach that involved document reviews and secondary analysis of data on attendance of key health services and mortality for the years 2019 and 2020. The services included outpatient department (OPD), antenatal care (ANC), malaria, immunization, TB, and hypertension. Interrupted time series analysis was applied to test the significance of difference between pre-and postintervention. We find that from March to April 2020, attendance to health services reduced and then rose in June or July. Notable reduction was in general OPD (17%), malaria-OPD (7%), ANC (8%), immunization (10%), hypertension (17%), and...

To the Editors of The Pan African Medical JournalThe unprecedented novel Coronavirus disease, COVID-19, which emerged in December 2019 has been labeled “disease X” by the World Health Organization (WHO) based on its rate and extent of spread as well as harsh ramifications. In response, different nations have adopted different management approaches hinging on various considerations, among them the WHO recommendations. Uganda has incorporated lockdowns, a measure that has affected schools, hospitals, businesses, places of worship, markets, public transport, and a rise in abuse of human rights in the form of police brutality, and domestic violence [1]. However, contextual factors such as socioeconomic realities and poverty pose a different set of problems for the mitigation and suppression of efforts for COVID-19, especially for vulnerable populations. Eventually, the effects of...

Background The COVID-19 pandemic has disrupted health care access in many countries. The aim of this study was to explore factors that influenced access and utilisation of sexual and reproductive health services among Ugandan youths during the COVID-19 pandemic lockdown. Methods This was across-sectional study carried out from April 2020 to May 2020 in Uganda. A questionnaire was administered online to participants aged 18 to 30 years. Subjects were recruited using a snowballing approach. STATA version 14.2 was used for statistical analysis.Results Of 724 participants, 203 (28%) reported that they did not have access to information and/or education concerning sexual and reproductive health (SRH). More than a quarter of the participants (26.9%, n=195) reported that testing and treatment services of sexually transmitted infections were not available during the lockdown. 27.2% could not...

To explore the impact of COVID-19 public health restrictions on the lives of older adults living in Uganda. Qualitative semi-structured interview study. Participants’ homes. Older adults living in Uganda (aged 60+). Older adults in Uganda were interviewed over the phone and asked about their lives before and since COVID-19, and how public health restrictions have affected their lives. Semi-structured interviews were audio-recorded, transcribed and translated into English. Transcripts were thematically analyzed and themes generated in discussion. In total, 30 older adults participated in the study. Five themes were identified: (1) economic impacts; (2) lack of access to basic necessities; (3) impact on healthcare utilization; (4) social impacts and (5) violent reinforcement of public health restrictions. COVID-19 public health restrictions had severe impacts on their lives, with many...

How do optimal policies to control the spread of SARS-CoV-2 vary across countries? In an influential recent paper, Eichenbaum, Rebelo, and Trabandt (2020) incorporate economic behavior into a standard epidemiological model calibrated to the United States

Evidence that face masks provide effective protection against respiratory infections in the community is scarce. However, face masks are widely used by health workers as part of droplet precautions when caring for patients with respiratory infections. It would therefore be reasonable to suggest that consistent widespread use of face masks in the community could prevent further spread of the Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). In this study we examine public face mask wearing in Uganda where a proportion wears masks to protect against acquiring, and the other to prevent from transmitting SARS-CoV-2. The objective of this study was to determine what percentage of the population would have to wear face masks to reduce susceptibility to and infectivity of COVID-19 in Uganda, keeping the basic reproduction number below unity and/or flattening the curve. We used...