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Covid-19: Major Post-Treatment Gaps Worry Medics

Dr. William Worodria, who heads the Case Management Team on the National COVID-19 taskforce admitted at the beginning the people who were testing positive presented mild symptoms which is why things like rehabilitation were missed in the guidelines.

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Lack of any Ministry of Health (MOH) post-infection guidelines on managing people who have been treated for COVID-19 is baffling medical workers.

During a meeting with MOH officials, Dr. Elizabeth Kutamba, a pediatrician at Mulago hospital raised concerns of being unaware about any protocols put in place to rehabilitate children who are recovering from the virus, yet studies elsewhere have confirmed a heavy toll on survivors' organs like the lungs and the liver.

She said over 90 children have tested positive and have been enrolled into care but it is not clear what their treatment plan is while in hospital and the likely areas of follow up when they are finally discharged.

Another expert, a physiotherapist, Dr. Priscilla Kembabazi pointed out that less attention has been put on another critical area of physical rehabilitation that these people require.

Responding to these concerns, Dr. William Worodria who heads the Case Management Team on the National COVID-19 taskforce admitted that at the beginning the people who were testing positive presented mild symptoms which is why things like rehabilitation were missed in the guidelines.

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Now, as the pandemic progress and more people are presenting with serious disease, Worodria says they are alerting health workers to start flagging those that might need long term follow-up.

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On his part, Dr. Charles Olaro, the Director Clinical Services in the MOH says they have come up with a tracking mechanism which is being implemented by Makerere University to establish the quality of life of people who recover from the disease.

So far, of the 5,123 people confirmed to be positive in Uganda, 2,333 have  recovered but according to Olaro, they are not yet aware of what complications that they may present with in future.

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  However, experts are already experimenting with other exiting mechanisms used in treatment of other disease like HIV and tuberculosis (TB)  to see whether the same mechanism can be employed in COVID-19.

For instance, in an earlier interview, Dr. Bruce Kirenga who heads the Makerere University Lung Institute said they have a planned low cost intervention with predictions of having to handle cases of lung damage in the near future that may include scarring, fibrosis and inability to do certain activities due to chest pain. 

The intervention, called pulmonary rehabilitation which also helps people battling Post – TB complications, will involve using patient –tailored therapies which may include carefully selected exercises, behavioral change approaches and nutrition.

For now however, Olaro says that they are not yet clear on exact complications that people will present with.  

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