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 5 488 825 confirmed (84 314) and 349 095 deaths (5 581) Source: WHO SitRep 128, as of 1000hrs CEST 27 May 2020
• Africa 54 States reporting 124 482 confirmed 3 696 deaths and 51 095 recoveries Source: Africa CDC Report, as of 0900hrs EAT 28 May 2020
• Nationally a cumulative of 132 confirmed cases (76), 25 recoveries and 4 deaths (0) Source: Zimbabwe MoHCC Update issued 27 May 2020
• In Bulawayo fifteen cases (3), nine recoveries and 1 death (0) Source: City of Bulawayo: Health Services Department 28 May 2020

The Ministry of Health and Child Care on Wednesday, 27th May 2020 reported 3 new COVID-19 cases for Bulawayo. The details of the new cases were yet to be shared. .

For the first 12 cases, a total of 668 contacts were followed up, of which 610 (91%) have completed the 21 day follow up period. The city depends on the NUST ACTG/NTBRL for RT-PCR tests. The Gene Xpert platform is being capacitated. At least 1 234 specimens have been sent to the laboratory for RT-PCR testing and 1 166 (95%) processed and only 68 results were pending. .

The Lancet laboratory which now collects specimens and sends to their Harare counterpart for RT-PCR testing has not reported any new cases in the city. .

The City had 9 new recoveries that is, they have had at least 2 RT-PCR respiratory specimens testing negative. Two cases are asymptomatic and the City is in the process of identifying an isolation facility for these cases.

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 Polytechnic College (422) and the United College of Education (452). Of new returnees the city is following up 162 cases that will undergo RT-PCR testing. .

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.

BCC 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 the 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

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, Lobengula and Magwegwe.

EPIDEMIOLOGY & SURVEILLANCE

In Indicator Based Surveillance the District Health Information System (DHIS2) shows that there is an increase in the number of 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 355 scares. They have submitted specimens from 1234 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 28st May 2020, the city had submitted 1 234 and 1166 have been processed and 68 are pending. Furthermore at least 162 new deportees are being swabbed for PCR.

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 teams in Bulawayo. Follow up of the other travellers is in progress. The area with the highest number of travellers under surveillance remained Suburbs. 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 CBD are still being monitored to encourage social distancing amongst customers, checking if sanitizers or hand washing facilities are available at entry points as well as educate on the risks of contracting Covid-19.

This week the City has reactivated the Rapid Response Team to at least 5 RRTs.

CASE MANAGEMENT

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

The city has 15 confirmed cases of Covid-19 by 28th May 2020.

Three cases are new and details will follow.

Of the 12 previous cases, 11 were due to active local transmission and nine of the cases have now recovered, i.e. they have had at least 2 RT-PCR respiratory specimens testing negative.

The city has 5 active cases at present.

Other than the index case, diagnosed posthumously the other fourteen 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 were 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 was recently 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).

This will be cascaded.

RENOVATIONS AT THORNGROVE HOSPITAL

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.

• • Partitioning of three cubicles in the male ward
• • Extension of main isolation ward COVID19 by creation of - disinfection rooms, change rooms, dish wash rooms, linen rooms and labour ward
• • Ambulance wash bay
• • Disinfection septic tank
• • Wheel and foot baths 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
• • Children’s isolation ward has been refurbished as follows: External walls painting, roof painting, repairs of broken window panes, removal and replacement of gutters.
• • Two boreholes drilled with one fitted to a Jojo Tank
• • All internal service roads within the facility have been resurfaced with tar
• • A new entrance and gate created
• • Walkway leading to staff rest rooms

The City is still working at the Sites and some of the outstanding works include the electrifications to light internal roads and walkways, extension of the laundry among other aspects.

Works are ongoing at the hospital and will be concluded soon.

The City has received information that going forward, Elangeni training institution isolation centre has been deactivated to cater only for positive but not ill cases

RISK COMMUNICATION AND COMMUNITY ENGAGEMENT

The Risk Communication and Community Engagement team is 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.

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 PA system are used to disseminate information with assistance from ambulance services.

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

Areas Covered by RCCE teams were as follows.

The focus to date has been on the following hot spots

CBD, (CBD Warnborough 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.

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

Social Media:

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

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-19 continue to be conducted on daily basis in all health facilities.

CHALLENGES / RESOURCE GAPS IN RESPONDING

1) Limited ability to continue testing, with delay in receiving results

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.

4) Elangeni isolation/ quarantine being deactivated for positive but not ill cases.

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

4) `Urgent identification of a new isolation centre for asymptomatic cases

LOGISTICS AND SUPPLY CHAIN MANAGEMENT