More than eight months since Rwanda confirmed her first Covid-19 case, the country has recorded 5,620 total positive cases. Of these, 5,163 have already recovered while 46 people succumbed to the virus according to current statistics. To get the general picture of the current state of Covid-19 in Rwanda, measures in place to contain it and how the country is ensuring that it is not left out in developments happening around the world in regards to the Covid-19 vaccine, The New Times’ Lavie Mutanganshuro had an interview with Dr Tharcisse Mpunga, the Minister of State in charge of Primary Healthcare at the Ministry of Health. Excerpts: What are the current Covid-19 hotspots in Rwanda? Currently, in Rwanda, Covid-19 is prevalent in congested areas such as refugee camps and prisons. The virus is also prevalent among cross border traders. All these clusters are well known and they are followed up daily by health authorities. In the community, we rarely notice Covid-19 infections. For instance, in the recent drive/walk-through testing that we did in Kigali a few weeks ago and collected over 1,800 sample tests in streets and markets, no one tested positive. Speaking of Covid-19 infections in prisons, statistically, what is the current state of Covid-19 in the area and what is being done to normalize the situation there? So far, there are three prisons that have reported Covid-19 cases. They are Nyarugenge, Muhanga and Rwamagana prisons. Overall, these correctional facilities have reported over 180 Covid-19 confirmed cases and 12 fatalities. Concerning measures in place to contain Covid-19 in these facilities, in addition to measures like regular washing of hands and mandatory wearing of facemasks, we have established a treatment centre in each of the three prisons. We have also deployed our medical team in the areas and they are carrying out contact-tracing and testing as many people as possible to ensure that we leave no loophole for the virus to spread wider. Dr Tharcisse Mpunga, the Minister of State in charge of Primary Healthcare. / Photo: File Other measures include separating older people from other inmates because they are more vulnerable as far as Covid-19 is concerned. All people who supply goods to correctional facilities also undergo Covid-19 testing. Additionally, no new inmates are received at prisons where Covid-19 has been already confirmed, and employees at these specific facilities are not allowed to move to other locations. For other prisons country-wide, fresh inmates must be put under a 14-day quarantine before joining others, and those who are discharged must be tested before joining the community. Before we leave this subject, are we aware of how Covid-19 arrived in these prisons? It is almost impossible to discover how Covid-19 arrived in prisons because these facilities are not as enclosed as one may think. Some inmates go to hospitals outside prisons, fresh inmates arrive in prisons from different detention centres across the country, there are people from outside who supply goods to these prisons, and these facilities also have employees who reside outside prisons. All these may lead to contraction of Covid-19 and hence spread the virus to many other inmates due to how they are congested. You’ve pointed out something regarding congested places as where Covid-19 is most prevalent. Schools are among congested places. What is being done to ensure that the recent reopening of schools will not be a trigger of the second wave of Covid-19 infections as has been the case in some places like New York? It is true that some places have registered a surge in Covid-19 infections after the reopening of schools, and that’s why our schools delayed reopening, and are now resuming in phases so that we first see how things go. As we speak, we are conducting over 3,000 Covid-19 tests in schools country-wide, and we are soon announcing what came out of that exercise. This will help us to know the current situation in schools vis-à-vis Covid-19, and hence decide accordingly. In August, Rwanda piloted home-based treatment of Covid-19 patients. More than two months down the road, how has been the experience? The experience has been very impressive. For instance, overall, 1,326 Covid-19 patients have been admitted for home-based treatment. Of these, 1,224 people have already recovered. These statistics among others reflect the reduction in government’s expenses that would previously go on establishing and maintaining treatment centres, feeding patients, paying people who take care of these patients and many other things involved in the process of treating Covid-19 patients. The initiative of treating some Covid-19 patients from their homes has also helped patients as well, because they are now near their families, and this is good for their psychological health. Recently, we heard of many Covid-19 treatment centres being closed down across the country. Considering that Covid-19 is unpredictable and no one so far knows when it will disappear, was it a good idea to close these facilities? Between June and August when we used to have many Covid-19 patients we had 30 treatment centres countrywide, but now we only have five. The decision to close some treatment centers came after the country started recording many Covid-19 recoveries, detecting few infections and treating some patients with home-based care method, all of which had caused many treatment centers to remain idle. Nonetheless, infrastructures that used to accommodate Covid-19 patients are still there and so are health workers who used to take of these patients. Therefore, if there comes a second wave, we can’t fail to respond quickly and effectively. In the daily Covid-19 update by the Ministry of Health, there can be seen consistent fluctuation in the number of sample tests collected. One can also notice a reduction in daily tests nowadays compared to the past two to three months. What determines the number of sample tests conducted daily? One thing that is a fact is that Covid-19 tests are expensive, and most of the time the government pays that cost. As I said earlier, among the random testing we carry out in the community, we usually find no positive case or very few infections, which shows that the virus is not prevalent in the community. For this reason, we can’t test the entire country of more than 12 million people, but instead, we test high-risk groups. The more high-risk groups we have, the more test we collect and vice versa. But of course, we also make sure we keep on evaluating the rate of Covid-19 prevalence in the community through random testing. There are many Covid-19 vaccines in their last trial phases before approval. What does this imply and what steps is Rwanda taking to acquire a Covid-19 vaccine once it becomes available? There are several Covid-19 vaccines that have shown potential, and though they are still in trials and not yet approved for human use, it shows that we’re near to getting one. This is a commendable thing in the fight against Covid-19 that has severely affected everything globally. As a country, we are currently part of the Covax framework, a global initiative that aims to speedily and affordably secure doses of the Covid-19 vaccine for member countries, once the vaccine is available. We are therefore mobilizing $15 million that we’ll spend on acquiring doses of the vaccine once it is available. The first beneficiaries of these doses will be high-risk groups such as health workers, old people and those with underlying health conditions. This first phase will be of vaccinating 30 percent of the entire population and as time goes by, we’ll vaccinate more and more priority groups such as police officers, students and others. What should Rwandans learn from second waves hitting several countries across the world? The lesson we should draw from that is that there is no such country that would say that they completely won the fight against this pandemic because it is unpredictable and keeps changing. Therefore, we should remain vigilant and abide by all Covid-19 preventive measures. In some countries, Covid-19 has sort of eroded the effort to combat other diseases. How is the situation in Rwanda? Generally, this pandemic affected a lot of things both in Rwanda and elsewhere, including the health sector. Nonetheless, Covid-19 found our country having a strong health system and therefore kept on providing other healthcare services in all hospitals across the country. As you are aware, there are specific treatment centers where Covid-19 patients are treated, and this prevented scenarios whereby different health facilities would be overcrowded by Covid-19 patients and unable to provide other healthcare services.
