A REPORT BY HIS WORSHIP SOLOMON MGUNI THE

MAYOR OF BULAWAYO

ON COVID -19

IN THE CITY OF BULAWAYO

WEDNESDAY, 8 APRIL 2020

i Introduction

The City and the rest of the country entered the second week of the national lockdown. It is unfortunate that as we make the second weekly report on the City’s activities on COVID -19, we have received the results of the first positive case and also a first death from the deadly disease in the City of Bulawayo.

I wish to express my heartfelt condolences to the family of the deceased for this unfortunate death. The City of Bulawayo received the results from the National Microbiology Laboratory on Wednesday, 7 April 2020 advising that a 79 year old male, who had been admitted at a local hospital had tested positive for COVID-19. It is unfortunate that the results were received after his passing away on Saturday, 4 April 2020.

ii. COVID – 19 Case

The Client was admitted at a local hospital on Thursday, 2nd of April 2020 and was moved to an isolation cubicle in Intensive Care Unit the following morning (Friday, 3 April 2020). He was given oxygen, and other medication and not put on a ventilator. A test for COVID-19 (among other tests) was done and it is unfortunate that he passed away on Saturday, 4th April 2020. To guard against COVID-19 and as per the protocol when dealing with infectious diseases, the disinfection protocols were instituted while results were awaited.

The Client had exhibited the following signs and symptoms (at least 2 days)

• Cough
• Breathing difficulty
• Sore throat
• Temperature 36°C (at time of Rapid Response Team visit)

The client’s history presented as follows;

The client had stayed at a Lodge in Hwange on the 14th -16th March 2020 and on the 23rd March 2020 developed a sore throat, fever and cough. He underwent treatment using antibiotics prescribed by his General Practitioner (GP). The worsening shortness of breath led to attendance at the hospital accident and emergency unit on the 2nd of April. He was admitted to first floor overnight then transferred to isolation cubicle of the intensive care unit on the morning of the 3rd of April 2020. A physician was asked to see the patient and suspecting COVID-19, he called the local Rapid Response Team to attend and take samples through a throat swab. The Local RR Team instituted isolation in intensive care unit (ICU) cubicle bed. The patient unfortunately passed on the 4th April 2020. The disinfection team was called and came in to spray, and barrier methods of the body and waste management done. The body disposal will be cremation.

The City notes that the challenges of travel between cities because of the lockdown, delayed the process of obtaining the results timeously. The courier services were not available on Friday,3rd April 2020 and the samples were only sent to the National Microbiology Reference Laboratory at the Sally Mugabe Central Hospital in Harare on Monday, 6th April and the results were obtained on the 7th April 2020 where the results were found positive.

Following receipt of the results from the Laboratory, the Rapid Response Team (together with the disinfection team) went back to the Hospital at 21:00 hours on the 7th April 2020 to;

• Locate the next of kin.
• Obtain more information on the travel history (modes of travel, passenger manifest, etc).
• Identify and list all contacts, including the attending General Practitioner.
• Collect swabs from contacts – (at least 13 samples were collected by then, more to be collected during the course of today (8th April 2020).
• Find and isolate contacts (The hospital has a self-isolation facility for staff).
• We will be monitoring all contacts for 14 to 21 days i.e. till 18th to 25th April 2020.

Bulawayo Situational report

Before the lockdown, the implementation of protective factors to reduce the general risk of transmission had begun. These included activities such as contact tracing, active case finding, intensified shop inspections, health education on key messages that include self- isolation, social distancing, and hygiene practices; with special emphasis on the importance of staying at home to break the chain of transmission.

Public health surveillance activities continue in the City of Bulawayo to assist in the early detection, monitoring, prediction and prevention of human illness. This is being achieved through the ongoing integration of both Indicator Based Surveillance (IBS) and Event Based Surveillance (EBS) activities that assist to interpret data and facilitate both prevention as well as control of diseases.

Events followed up by the Rapid Response Teams

Table1 Events Followed up by the rapid Response Teams

The Rapid Response Team followed up a total of 94 people complaining of COVID-19 related signs and symptoms. For the 31 (33%) people who fit the case definition, specimens were sent to National Microbiology Reference (NMRL) for Polymerase Chain Reaction (PCR) testing. No specimens were sent in February 2020. Results for 21 (100%) specimen sent during the month of March 2020 were negative. These include results for two presumed cases that were admitted at Thorngrove Hospital. So far of the 10 specimens collected in April 2020, 8 are negative, 1 is positive and 1 is pending. Generally the turn-around time for results from NMRL has been approximately 48 hours. Testing for Covid-19 is still not done in Bulawayo as of 7th April 2020

The city has also been conducting traveller’s surveillance from February to March 2020. Because of the lockdown, the number of travellers (1125) remains the same as reported the previous week. We noted that there was an increase in the influx of travellers reported by the ports of Entry (PoE) from February 2020 (498) to March 2020 (627).

The map below shows a spatial distribution of travellers that arrived into the city from COVID-19 affected areas. The area with the highest number of travellers under surveillance is Suburbs (shown below). All (100%) travellers that came into the country during the month of February 2020 have been followed up at least once and are all asymptomatic. The list of travellers that came into the country during the month of March 2020 was received at the end of epidemiological week 13. Updated lists of travellers from PoE have since been received and follow ups are ongoing. From the spatial map there has been increased awareness through our Health Education for the communities to adhere to the lockdown in order to break the chain of transmission.

Distribution of travellers by Place (Destination)

The citywide clinics have been trained to triage patients, elicit epidemiological and clinical history as well as expedite movements into and out of the clinic. Efforts to improve infection control processes are also in place as well as national guidelines for use of personal protective equipment.

As a City we note with concern that the traffic of people has increased despite the lockdown, resulting in some shops and public buildings failing to manage the numbers. There are illegal activities such as public drinking being observed. The ZRP was engaged to assist teams in enforcement with regards to the implementation of the above measures.

Disinfection

The City of Bulawayo has started the disinfection process of the City with Hydrogen Peroxide as part of our efforts to eliminate the spread of the virus. The first phase targeted the Central Business District with the main emphasis being on areas where there is high human traffic such as supermarkets, bus termini and the market area.

The programme in the Central Business District will take four days. It started on Tuesday 7th April 2020 and will end on Friday 10th April 2020. Areas sprayed so far include areas bounded by 13th Avenue, 6th Avenue, Lobengula Street and Fife Street. Market areas will be sprayed on Friday 10th April 2020 to allow traders to collect their wares from vending stalls.

The programme is citywide and residents will be advised when the teams go to the residential areas.

Donations and Equipment Received to date

Stocks received from the Ministry of Health and Child Care through NatPhar to date.

STOCKS WERE RECEIVED :21 MARCH 2020

• Fossil Group – Donation of Hydrogen Peroxide for fumigation

Donations reported previously (Week ending 3 April 2020)

• Qoki Zindlovukazi (UK based Zimbabweans) who donated groceries.
• PSI Zimbabwe ( FFP2 face masks, liquid soap)
• OPHID Tust (sanitisers, surgical masks and latex gloves)
• Rainbow Hotel Bulawayo (bed sheets), pillow slips and bath towels)
• Thuthuka Matabeleland Trust (groceries)
• Bulawayo Babies (face masks)
• Chloride Zimbabwe (who will be putting up a solar back up system at the isolation ward)

iv. Water Supply Situation

The City continues to be affected by water supply challenges. As at Wednesday, 8 April 2020 the City’s water supply dams are at 32. 32% with two dams still decommissioned and Lower Ncema earmarked for decommissioning in May 2020. The 2019 – 2020 rainy season has come to an end, with minimal inflows being realised into the City’s Supply dams. Total inflows for the season amounted to 12,220,000 m3 which is equivalent to just one month’s supply.

The challenges in raw water supply, have made the Council make a difficult decision of increasing the water shedding hours from 96 hours weekly to 108 hours weekly with effect from today. This is because the drawing of raw water from the dams is increasingly becoming a challenge, and our raw water reserves and clear water reservoirs are deteriorating to critical levels.

To attend to these challenges, we await the declaration by Government of Bulawayo as a water shortage area so that we get the urgent support in water augmentation projects to increase water supply in the City.

It is important that at this point in time, the residents of the City recognise the dire state that Bulawayo is in. After the decommissioning of the Lower Ncema in May 2020, only 60 - 65 Mℓ/day of raw water will be available for the City from three supply (3) dams and Nyamandlovu aquifer. However, there is potential to cover the gap through the implementation of the following sustainable projects, which have been submitted to Government.

• Further development and extension of the Nyamandlovu Aquifer towards Sawmills in Tsholotsho. It is envisaged to supply an estimated combined (Rochester & Epping Forest) ground water potential yield of 20Mℓ/day. Presently the Nyamandlovu Aquifer scheme currently supplies on average 3-4 Mℓ/day out of potential of 20 Mℓ/day.
• Mtshabezi Dam has the potential to supply maximum raw water of up to 25 Mℓ/day. Currently the dam can supply 15 – 17 Mℓ/day. A potential of 8 – 10 Mℓ/day is available, if the bulk-pipelines from Mtshabezi to Ncema Water treatment works are upgraded and improve conveyance capacity by (32 – 40) %.

From the applications made to the Government of Zimbabwe for a declaration as a Water shortage area the following projects with an estimated cost of Z$ 910 Million (USD $22.75 million) are proposed.

Water Supply Augmentation Projections

It should be noted that these projects are medium to long term and are not likely to be completed before the decommissioning of the Lower Ncema Dam in May. In the long term, the completion of the Gwayi – Shangani Dam should ease the City’s water challenges and there after the completion of the Matabeleland Zambezi Water project.

Since the decommissioning of these two dams Umzingwane and Upper Ncema), the City has been unable to meet its daily demand which averages 155 Mℓ/day. The maximum available raw water supply is currently at 94 Mℓ/day. As a result of the gap between demand and supply of 59 Mℓ/day, the City has been on water shedding since February 2019, which has been progressively implemented from the 48-hour, 72-hour, 96-hour and currently the 108 hour shedding programme.

This limited raw water abstraction, coupled with high consumption has significantly affected the Raw water reservoir, resulting in it failing to recover beyond the 3m level. 5.5m is the expected safe raw water level, but the reservoir currently stands at 1.04m (13% full). This leaves the city without a buffer and exposed in case of any eventuality. For the past five months, the 96-hour shedding has been adequate to cover the deficit until recently when the dams hit 32%, predominantly due to reduced head from Insiza dam and inconsistent delivery from Mtshabezi due to erratic power supply reducing raw water abstraction for treatment. The raw water reservoir buffer has now been completely depleted meaning that should we have pumping failure due to equipment breakdown or power supply outage the system will collapse. It is therefore necessary to reduce consumption in line with available raw water and rebuild the raw water reservoir levels to create the much needed buffer.

To augment water supplies, the City has been working with various partners to rehabilitate the 282 local community boreholes for non-portable use during period of water shedding. Twenty five boreholes were rehabilitated in 2019 using materials donated by Edgars Pvt Ltd. A contract is being prepared to rehabilitate more boreholes in anticipation of the water supply shortages which continue to worsen given the dire state of the City’s supply dams.

Conclusion

The City of Bulawayo would like to urge the resident to adhere to the national lockdown. It should be noted that the lockdown prescribes staying at home and indoors and reducing interaction with others in order to break the chain of COVID-19 spread. In case one needs to leave the household, you are encouraged to practice social distancing and good hygiene practices to prevent the spread and contracting of COVID-19.

COUNCILLOR SOLOMON MGUNI

MAYOR