Edited by Esther Nakkazi and compiled by Evelyn Lirri
On March 18th, the Health Journalists Network in Uganda (HEJNU) held a media science Café titled; The COVID-19 Pandemic: Interlinkage between HIV and COVID-19 virus.
About 40 journalists attended this Café which gave an insight to COVID-19 a disease many of the journalists were yet to learn about. The Key speakers were Dr. Monica Musenero, a senior epidemiologist and presidential adviser to the President on epidemics, the second speaker was at this Café was Prof. Kaleebu Pontiano, the director UVRI/MRC/LSHTM as well we had Hillary Bainemugisha, an editor at the New Vision Newspaper. The Science media cafes are sponsored by AVAC and implemented by HEJNU.
Café objectives (The learning objectives should be tailored for each specific café)
To give an update to journalists on the COVID-19 pandemic and its implications for health across the globe
To make an interlinkage between HIV and COVID-19 especially given that the African continent has a high rate of HIV and this could have implications for wellbeing for HIV positive people who get infected with COVID-19
To update journalists on the country’s preparedness and measures to address the disease.
Highlights, key questions/themes
Dr Monica Musenero, senior epidemiologist
The café kicked off with Dr. Musenero giving a brief background to corona virus in general, stating that they are called corona because of the way they look. Typically, she said these viruses stay within their hosts, which include bats. Bats, she says are known to have some of the largest numbers of viruses. Once in a while these viruses cross to be able to survive and acquire ability to grow in another host. But in rare circumstances, it succeeds.
For example, between 2001-2003, a new corona virus which started in China and crossed in human beings and caused severe disease was the SARS-corona virus 1. Although it killed a significant number of people, its transmission cycle was not efficient enough to spread very fast among the population. But by the end of 2019, a new corona virus emerged. Although it has resemblance to the first corona virus, this one is more efficient because it can be passed on very quickly.
According to Dr Musenero, SARS COVID-1 largely affected the lungs so it could not develop very fast. COVID-19, on the other hand, grows in the throat and affects both the upper and lower part. Because it grows in the upper part, it’s easier to transmit. When people speak, the droplets, cough and sneeze make it an efficient form of transmission.
Dr Musenero noted that despite affecting a large number of people at once, 80 per cent of people often don’t become sick. It is often the 20 per cent who may get pneumonia that will require hospitalization.
She also noted that the people who are likely to get serious forms of the disease include the elderly, those with already underlying health conditions such as diabetes, heart diseases and cancers.
“We are worried because of its ability to make many people sick at a go. No country has prepared to take care of so many people. COVID-19 has the potential to make more than 70 per cent of the population sick,” noted Dr Musenero.
She added that the best way health care system in Africa can manage the disease is by ensuring that many people do not get infected in the first place.
“If you don’t have so many people falling sick at ago, the healthcare system can handle and you will have a low death rate because you have the facilities and the health workers are not overwhelmed. But if you have like 500 people falling sick at ago, will be difficult to manage,” she said.
According to Dr Musenero, 99 percent of the virus is entering the body through eyes, nose and mouth. Hands are also some of the most efficient tools that are moving the virus. She said good hand management will play a significant role in ensuring people do not get infected.
Prof. Kaleebu Pontiano, the director UVRI/MRC/LSHTM
The interlinkage between HIV and corona
In explaining the interlinkage between corona virus and HIV, and the potential impact the virus could have on countries with high HIV burden, Prof. Kaleebu began by giving background information about viruses and how they affect and spread in the human body.
He explained that unlike bacteria, viruses are tiny microorganisms that cannot survive by themselves. Viruses often need another cell to grow and when they grow into the cells, they use the cell they have entered into to multiply and grow. For virus to enter the cell, they need a receptor. And the receptor for COVID-19 is called S-2, which is found in the lungs. This explains why the COVID-19 virus mostly affects the lungs and guts. The receptor for HIV is the CD4 lymphocyte.
According to Prof. Kaleebu, not all people who get infected with COVID-19 get severe disease. Vulnerable groups include those who have pre-existing health conditions such as HIV, diabetes and heart disease. Age also contributes to a person developing severe forms of the disease.
“If you have HIV and your immune system is not good, it’s likely it will cause severe health conditions. If you are on treatment and your immune system is good, it probably will not cause severe ill health.
These viruses infect different cells that have different co-receptors. When viruses infect cells either they kill it or disorganize it that’s why we get disease,” said Prof. Kaleebu.
In the case of COVID-19, he noted that it mainly affects the lungs, resulting in breathing problems for people who get the disease.
The lungs get inflamed, oxygen becomes low and eventually other systems fail and people go into sceptic shock.
But because the disease is also relatively new, Prof. Kaleebu explained that scientists are still studying it to understand how it affects the body.
Hillary Bainemugisha, an editor at the New Vision Newspaper
As a veteran health journalists, Hillary offered the following tips for journalists to follow while reporting about COVID-19
- Avoid derogatory language especially in describing victims of the virus
- Stop speculating about worst case scenarios because this can create fear and panic is never good in pandemics. It makes the situation worse.
- Be partners with the government and help amply their actions. Explain government actions to the community.
- The virus is going to end at some point, but that will not end is the story. We need to appraise our response, was money used properly. Voices of survivors, are there after effects, can they get pregnant, is the immunity destroyed?
- We must be ready to continue the story the story even after we have declared the virus gone.
- Find out all contacts of experts so you are on top of the story. Question and answer session for all three speakers; QN: Can COVID-19 be waded off without treatment?Yes, and that’s why we tell people to take care of their nutrition and make sure you are well fed and healthy. At the moment, we don’t have treatment that kills the virus. A lot of cases can be managed at home without treatment. 20 per cent will go on to develop serious disease, not all of them will be sick enough to be in the Intensive Care Unit (ICU). Usually in every epidemic, we are worried about expectant mothers. So far there is no evidence that they are either more susceptible or not. They are just affected like other groups of people.
QN: Can someone who has cured revert to positive?
There is still a lot we are learning about the virus in the body because it is really new.
QN: Are masks the best way we can protect ourselves?
Any barrier between the nose and the rest of the items will protect you from incoming droplets because to the virus they are as open and wide. It is only the N-95 mask that is recommended for use. If you are looking after a patient, we recommend the patient puts on the mask. But if you are sick, put on a mask, not to protect yourself, but other people around you.
QN: Do you think Uganda’s response is adequate enough?
Uganda is one of the countries on this continent which has a good response system. We are veterans in outbreaks and the ministry of health has put in place a system for response. We have learnt a lot of lessons from previous epidemics.
QN: What are the key measures we need to have in place to prevent the virus from spreading?
Social distancing is a key factor in controlling this disease. While Kampala is congested, in rural areas it is easy to self-isolate because people don’t work in offices. All you need is to give them advise about social gatherings. This disease is not like Ebola. Ebola announces itself where it is but this one may pass through a number of people before you find a person who is sick enough to show up at the health facility and before you know it, a number of people will have been infected.
QN: Can Uganda adequately test for COVID-19?
We are getting individuals who are referred to us by the Ministry of Health. When the samples are brought to UVRI we use real time PCR using a German Kit that has primers for corona virus. The test we are using is not new, we have been using it for a long time. We are able to get results between four to six hours. But there are more labs which can do this test because as I have already explained, this type of test is not new. We can do 520 tests per day.
QN: Can herbal medicine work in fighting COVID-19?
Herbal medicine could have benefits, but there is no scientific proof.
QN: Can the COVID-19 virus mutate?
Yes, the virus mutates and it is the reason we are having these infections in humans because every time a virus multiplies, there are some mutations that happen. The strains are different and by that way you get a strain that can infect another species. That’s what has happened in China: you have one virus but one strain is more aggressive than the other. That’s why sequencing is important. If we get any COVID-19 cases, we are going to sequence them to see how closely related they are to the other COVID-19 viruses.
QN: With UVRI being the only testing centre, won’t it affect and hinder how we manage the virus?
For now, it’s only UVRI that’s doing COVID-19 tests but if there is need, other labs will be used. The technology is not complicated. We hope reagents will not run out. We are going to make more orders.
QN: Will people with HIV be most affected if they get COVID-19?
If people are on treatment and they are taking their ARVs, their immune system is good enough so they will not be affected badly.
QN: Chloroquine is one of the drugs that is being looked at as a potential treatment for COVID-19, how significant is it?
Chloroquine is an interesting drug. Even when HIV started, we used it in the lab so studies are now going on to see if it can be effective. A drug used for Ebola (Remdesivir) is also being potentially tested.
QN: Are the samples picked from the patients infectious? How safe are the lab technicians who pick them?
Yes the samples are highly infectious, that’s why we provide PPE equipment to those who handle the samples, including the drivers who must transport them.
QN: Can we get false negatives when people are tested for COVID-19?
Yes, that is possible but we also have active actions to ensure this does not happen. We have test controls. We have positive and negative controls. We have three controls that we put in every experiment which means if you get negative then it is a negative test result.
QN: Do we have enough funding in the event of a large outbreak of the disease?
We have already requested for additional funding from the emergency Fund and we hope it will be released soon. We should not fail in case we have an outbreak just because may be CDC or WHO has not given us funding.
QN: When does a person present with symptoms?
Symptoms come between 2 to 14 days
QN: Why don’t babies typically get COVID-19 yet we know they have very low immunity?
Maybe because their receptors are not well developed but I don’t have a good answer I need to do more research.
- Stories linked to COVID-19 café https://www.independent.co.ug/coronavirus-three-drugs-tried-cure-far-from-being-identified-experts/https://www.independent.co.ug/face-masks-cant-protect-you-from-coronavirus-musenero/Two stories aired on Simba FM/Two stories aired on Super FM/Capital FM/CBS radio/
Dr. Monic Musenero, Senior Presidential advisor on epidemics illustrating to health journalists under their umbrella organisation Health Journalist Network in Uganda (Hejnu)on how to wash hands to prevent the spread of Coronavirus. @HEJNUganda @Nakkazi @Elirri @MinofHealthUG pic.twitter.com/o4iTunRrrS
— Vivian Agaba (@VivianAgaba14) March 18, 2020