A REPORT BY HIS WORSHIP SOLOMON MGUNI

The MAYOR OF BULAWAYO

ON COVID -19

IN THE CITY OF BULAWAYO

i. Situational Report on COVID-19

SITUATION UPDATE / HIGHLIGHTS

• Global cumulative total of 3 018 953 confirmed (66 276) and 207 973 deaths (5 376) Source: WHO SitRep 100, as of 1000hrs CEST 29 April 2020
• Africa 54 States reporting 95 201 confirmed 2 997 deaths and 38 075 recoveries Source: Africa CDC Report, as of 0900hrs EAT 21 May 2020
• Nationally a cumulative of 48 confirmed cases (2), 18 recoveries and 4 deaths (0) Source: Zimbabwe MoHCC Update issued 20 May 2020
• In Bulawayo twelve cases (0), four recoveries and 1 death (0) Source: City of Bulawayo: Health Services Department 21 May 2020

A total of 668 contacts were followed up, of which 604 (90%) have completed the 21 day follow up period.

The city depends on the NUST ACTG/National TB Reference Laboratory for RT-PCR tests and has gone for 23 days without a new COVID-19 case.

At least 1 222 specimens have been sent to the laboratory for RT-PCR testing, 1 166 (95%) processed and only 56 results are pending to date.

The Lancet laboratory now collects specimens and sends to their Harare counterpart for RT-PCR testing.

They have not reported any new cases in the city.

The City diagnosed 12 cases of COVID-19 after Real Time Polymerase Chain Reaction (RT-PCR) identified the SARS-CoV-2 virus.

Eleven of the cases were due to active local transmission.

Four of the cases have now recovered, i.e. they have had at least 2 RT-PCR respiratory specimens testing negative.

Six other cases have at least one negative RT-PCR and await the second repeat test result.

Other than the index case, diagnosed posthumously the eleven diagnosed (active and former cases) are stable without symptoms.

Efforts to prudently implement effective outbreak containment measures are ongoing.

The city has received a total of 2764 travellers from outside the country of which 2726 (98.6%) have been cleared and 38 are still being followed up.

Of the 2 764 travellers 874 (31.6%) were deportees who passed through Bulawayo and were isolated at the Bulawayo Polytechnic College (422) and the United College of Education (452).

BULAWAYO CITY COUNCIL COORDINATION ACTIVITIES

The Bulawayo City Council (BCC) has different thematic teams participating in the Epidemic response: Call Centre; Case Management; Coordination; Risk Communication & Community Engagement (RCCE), Disease Surveillance; Disinfection, Environmental Sanitation, Waste Management & Body Management; Logistics Supply Chain Management; Rapid Response Teams (RRTs); Suspected / Probable Patient location facilitation.

Bulawayo City Council Health Services Department Epidemic Preparedness and Response Teams get daily updates through physical meetings (beginning 28th of January 2020) and complemented by electronic media platforms.

The overall city response was escalated to be level of the Provincial Minister of State.

A call out roster for staff, enhanced by a WhatsApp chat group is in place.

The BCC call centre (backed by resources persons) can be contacted for information / services on numbers:

• 08084700 (Econet Numbers Only)
• 08004700 (TelOne Numbers Only)
• 263-2922 71290 (All Networks)
• 263-774 668 432 (WhatsApp Only)

Two numbers are available for direct calls to the rapid response teams (cell phones courtesy of the Bulawayo Entertainment Industry) i.e.

• 263 - 784 150 042
• 263 - 784 149 828

The national lockdown is in effect indefinitely.

Some sectors are now allowed to resume work on condition that their employees have temperature tests upon entering work premises; hand sanitizers upon entry to sanitize their hands; each employee to wear a face mask in appropriate form; and employees to practise social distancing in the work place.

DISINFECTION

This past week disinfection was in Luveve, Lobengula and Magwegwe.

Bulawayo City Council uses Hydrogen Peroxide to disinfect open spaces characterised by high human traffic.

Areas with high human traffic that were disinfected in the past include the Central business district where spraying took place from 7 to 10 April 2020, the Railway station which was sprayed on 11 April, 2020 and Residential areas including Nketa 7 shopping centre, Nketa 9 shopping centre, Emganwini (Food 4 Less), Emganwini (Tashas), Sekusile shops, Sekusile Flea market, Bullet Shopping Centre, Nkulumane Complex, Makokoba Shops, Renkini, Entumbane Complex and Entumbane Long Distance Bus terminus, Cowdray Park areas and Luveve (Chigumira/Matsika) shopping centre.

The disinfection was applied using water cannons sourced from the Zimbabwe Republic Police.

The spray was either aerial or a direct fine spray on shop pavements. Spraying started at 15:00 hrs after the close of shops so as to ensure that targeted areas were found clear of human traffic.

Communities where spraying was done were sensitised in advance. No challenges were encountered during the spraying process. Hydrogen Peroxide disinfects through the effect of its reduction to water with the release of oxygen. The chemical is therefore environmentally friendly.

Sanitization of the environment complements washing of hands, social distancing, cough etiquette etc.

EPIDEMIOLOGY & SURVEILLANCE

In Indicator Based Surveillance the District Health Information System (DHIS2) shows that there is an increase in the number on Acute Respiratory Illnesses (ARI) cases month on month up to March as well as in 2020 comparing to 2019, particularly the moderate and severe types. The number of cases in April was much lower than any other month, possibly due to the lockdown.

In Event Based Surveillance the Rapid Response Teams (RRTs) active since February 2020 have been following up rumours of possible suspected cases of COVID-19 and presently have followed up more than of 355 scares. They have submitted specimens from 1222 people that fit the case definition to laboratories for Real Time Polymerase Chain Reaction (RT-PCR) tests to detect the virus.

Staff members from the National University of Science and Technology (NUST) Applied Genetic Testing Centre (AGTC) working with those at the National Tuberculosis Reference Laboratory (NTBRL) located at Mpilo Central Hospital in Bulawayo started testing using RT-PCR on the 11th April 2020.

By 0800hrs, on 21st May 2020, the city has submitted 1 222 and 1166 have been processed and 56 are pending.

The screening of all rumours and follow ups of suspected cases received via the call centre was done.

The number of travellers that came into Bulawayo to their homes was 2 764. Of these at least 2 726 (98.6%) travellers had since been followed up by the teams in Bulawayo.

Follow up of the other travellers is in progress.

Suburbs remained the area with the highest number of travellers under surveillance.

The updated lists of travellers that come into the country during the month of May was from official Ports of Entry (PoE) keeps being received and follow ups are ongoing.

Of the 2 764 travellers 874 (31.6%) were deportees who passed through Bulawayo Polytechnic College (422) and the United College of Education (452).

In Health Surveillance the implementation of protective factors to reduce the general risk of transmission is ongoing.

These include activities such as 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.

Shops in the Central Business District (CBD) are still being monitored to encourage social distancing amongst customers, and checking if sanitizers or hand washing facilities are available at entry points as well as educate on the risks of contracting Covid-19.

CASE MANAGEMENT

A WHO case definition which includes all age groups is being used.

The city remains with 12 confirmed cases of Covid-19 by 21st May 2020.

Eleven of the cases were due to active local transmission.

Four of the cases have now recovered, i.e. they have had at least 2 RT-PCR respiratory specimens testing negative.

Six other cases have at least one negative RT-PCR and await the second repeat test result.

Other than the index case, diagnosed posthumously the eleven diagnosed (active and former cases) are stable without symptoms.

It remains emphasised that these low figures should not lull health care workers and the community into complacency because a surge in the number of cases remains possible.

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.

Training of trainers on infection prevention and control is ongoing at Impala lodge (20 – 21 May 2020) and this is conducted by the Ministry of Health and Child Care (MoHCC) and supported by Africa Centre for Disease Control (CDC), with expertise of the Africa Field Epidemiology Network (AFENET).

Thorngrove Hospital is still undergoing renovations and these include the ambulance wash bay, a disinfection septic tank, a wheel bath at the main entrance gate, extension of the drug store, all internal service roads within the facility have been resurfaced with tar, a new entrance and gate created, a walkway leading to staff rest rooms. The children’s isolation ward has been refurbished as follows: external walls painting, roof painting, repairs of broken window panes, and removal of gutters, yet to be replaced.

Two boreholes have been drilled at the Hospital with one borehole fitted to a Jojo Tank.

Mater Dei hospital has an isolation and treatment centre as well as a laboratory that is yet to commence RT-PCR testing.

Elangeni training institution isolation centre is active for positive but not ill cases.

RISK COMMUNICATION and COMMUNITY ENGAGEMENT

Still following the master schedule the RCCE team continued giving context specific information related to Covid-19 as well as to respond to any queries.

Introduction

Risk Communication and Community Engagement as an important component

Risk communication is the exchange of real-time information, advice and opinions between experts and people facing threats to their health, economic or social wellbeing.

The ultimate purpose of risk communication is to enable people at risk to take informed decisions to protect themselves and their loved ones.

In response to the pandemic, the city has engaged communities, local partners and various stakeholders to protect individuals and families from Covid-19.

Various strategies have been used to disseminate information to the community.

COVID-19Activities

COVID-19 Campaign during Lockdown:

The City embarked on a COVID-19 campaign covering all the three (3) administrative districts in the city. A hailer and Public Address system are used to disseminate information with assistance from ambulance services.

These activities were conducted by City Health Department, Ambulance Services, Public Relations Section, National AIDS Council (NAC), Population Services Zimbabwe (PSZ), Ministry of Gender and Women’s Affairs and Nehemiah project.

This week, Moriti Oa Sechaba trained volunteers on health and hygiene and launched their Water, Sanitation and Hygiene (WASH) programme on the 21st May at Cowdray Park Housing Office.

The organisation will run a six month programme in Cowdray Park and will distribute 1000 health kits to beneficiaries.

Areas Covered by RCCE teams were as follows.

The focus for the week was on hot spots which were visited on daily basis

CBD, (CBD Wanborough Mansions), Robert Sinyoka, St Peters, Mazwi, Hyde Park, Cowdray Park, Luveve, Pumula East, Pumula South, Pumula North, Pumula Old, Lobengula, Northend, Magwegwe North, Magwegwe West, Old Magwegwe, Nketa 7, Nketa 9, Nkulumane Sekusile, Nkulumane Complex, Makokoba, Mzilikazi, Barbourfields, Nguboyenja, Mahatshula North and Mahatshula South.

Old People’s home and Children’s home reached.

Thembiso Children’s Home and Percy Ibboston Home,

Food distribution Points

Lobengula Brethren in Christ Church

Sexual Rights Centre; areas Mzilikazi, Nguboyenja, Makokoba, Barbourfields, Pumula Old, Pumula South, Pumula East, Pumula North, Magwegwe Old and New Magwegwe, Mabutweni and Mpopoma. Temperature checks done and one client was pyrexial with a Temperature of 38oC, however after screening by one of the nurses and it was established that it was not COVID-19 related.

Achievements

• Key Messages delivered to the community
• The use of OK Mart wholesale’s intercom to relay health messages to the customers and encouraging the manager to continue messaging in the absence of the risk communication team
• Significant gains on behaviour change in some areas continue to be observed due to persistent information dissemination to the residents
• The uniformed forces (Policemen and the Zimbabwe National Army) collaboration ensured compliance on social distancing
• Continuous support of hot spots yielded good results as there was compliance on social distancing
• Integration COVID-19 with Africa Vaccination Week 2020 and EPI outreach services
• Reached out to deportees quarantined at Bulawayo Polytechnic and United College of Education
• Vulnerable populations reached at the Children’s Home and Old People’s Home
• Fumigation messages relayed to the residents at Cowdray Park
• Flighting of the COVID-19 video at the Bradfield Shopping Centre from Friday, 8 May 2020 which was a donation from Digitech Advertising.

Challenges

• Public loitering remains a challenge
• Lock down not observed especially in low density suburbs thereby putting the community at risk of contracting COVID-19infection.
• Re-emergence of unauthorised vending in the Central Business District.

Comments and Way Forward

• To continue engaging the police and the business community in enforcing maintenance of social distancing
• Information Dissemination in the CBD and hot spots to be done on daily basis
• To continue engaging Councillors and residents associations to assist with information dissemination on prevention of COVID-19.
• Need to enhance enforcement of illegal vendors.

Social Media:

Various messages on COVID-19 continue to be shared on social media.

Flighting of the COVID-19 video at the Bradfield Shopping Centre from Friday, 8 May 2020 which was a donation from Digitech Advertising

Radio Programs

Pre-recorded messages continue to be flighted on; Skyz Metro, Star FM and Khulumani FM (Sponsored by; City of Bulawayo, PSZ and Plan International).

Print IEC material distributed

Posters and Flyers distributed.

Health Education Sessions in Health Facilities

Health Education sessions on Covid-19continue to be conducted on daily basis in all health facilities.

Mobile Applications: The City of Bulawayo continues to use the Sis Joyce application in providing information to the community on COVID-19.

CHALLENGES / RESOURCE GAPS IN RESPONDING

1) Limited ability to continue testing, with the lab out of stock for lab consumables and a non-functional biosafety cabinet.

2) Inadequate human resources should the cases increase in numbers and for testing.

3) Need for more oxygen canisters, flow metres, delivers tubes and masks/nasal prongs.

RECOMMENDATIONS & PRIORITY FOLLOW UP ACTIONS

1) Capacitate more laboratories to test for COVID-19 using PCR, or GeneXpert

2) Expedite secondment of 15 nurses and laboratory staff to BCC

3) Expediting infrastructure renovations for piped oxygen etc.

LOGISTICS AND SUPPLY CHAIN MANAGEMENT

ii. Progress On Decentralised Bulk Fresh Farm Produces

Introduction

>Council in response to Covid-19 has decentralised the delivery of bulk fresh farm produce from the Central Business District to suburban shopping centres. The move is aimed at decongesting the city of the traffic generated by vendors getting into the city to access fresh farm products. Bringing the bulk deliveries closer to consumers will also reduce the cost of doing business as well as unproductive time spent on travelling.

Engagements with Wholesale Distributors of Fresh Farm Produce

• Council has engaged the wholesalers who are currently delivering their produce in existing city markets to take the initiative.
• The wholesalers have organised themselves into an association called Bulawayo Association of Farmers Markets (BAFM).
• Council identified initial 6 bulk delivery sites namely Emganwini/ Mupedzanhamo Flea market, Sekusile Terminus, Pumula Old Market, New Magwegwe Market, Magwegwe North Market and Cowdray Park Market.
• The Bulawayo Farmers Association Markets has taken five sites except Magwegwe North.
• The logistics have been worked out for the BAFM deliveries to start and they started on the week ending 15th May 2020.
• Other wholesalers who are not interested to join the BAFM, but with financial resources would be considered on vacant undeveloped sites for partnerships with council.
• There are additional sites identified at Tshabalala Market, Luveve, Entumbane, Burombo, Magwegwe North which were not taken are still open for other interested parties.

Stakeholder Engagements (Vendors)

• Council is in continuous engagement with Informal Trading Associations with respect to the redesigning of bulk food markets and vending markets.
• There are number areas of agreement with respect to redesigning of vending bays and decongesting of bulk deliveries.
• However, there are some areas of disagreement with respect to abolition of 5th Avenue vending sites.

Redesign of Vending Markets

• Council has redesigned vending markets to comply with COVID-19 requirements which include sanitary infrastructure and social distancing.
• The move has seen the number of vending sites and bays being reduced in the CBD because of space and sanitary provision requirements.
• All vending sites along 5th avenue have been abolished.
• Affected vending bays to be relocated closer to suburban shopping centres of residence of the vendors and others would be accommodated at Highlanders site.
• Vendors displaced by the redesigning of bays will also be relocated closer to places of residence of vendors
• A stakeholders meeting was held on Friday 15 May 2020 at the Small City Hall at 10am.

Allocation of Vending Bays

This is an ongoing exercise and is prioritised as follows:

• 1st priority on allocation of vending bays is given to the licensed vendors trading in any given trading site which has been redesigned.
• 2nd preference is given to displaced licensed vendors either by abolition or redesigning of the vending site.
• 3rd preference is given to the registered vendors who have not yet renewed their licences.
• 4th preference is given to applications for regularization vendors who have been trading on new redesigned sites without registration or licences
• New applications are then considered last.

Conclusion

The City of Bulawayo last week introduced the 144 hour water shedding programme following the decommissioning of the Lower Ncema Dam on Friday, 15 May 2020. The dam became the 3rd Dam to be decommissioned in Bulawayo as a result of consecutive droughts that have been faced. The decommissioning of the Lower Ncema Dam, leaves the city with 60 ML – 65ML / day of raw water against a city demand averaging 110 ml/ day. It is saddening that the City has come to a point of supplying residents with only 24 hours a week. It is anticipated that the various water augmentation initiatives will be attended to quickly and ease the burden being faced by the residents.

COUNCILLOR SOLOMON MGUNI

MAYOR