COVID-19 pandemic in Rwanda: An overview of prevention strategies

James Ngamije, Callixte Yadufashije

1Department of Community Development, University of Tourism and Business, UTB, Rwanda

2Department of Biomedical Laboratory Sciences, INES Ruhengeri-Institute of Applied Sciences, Rwanda

As of May 6, Rwanda has reported 268 cases of COVID-19 with zero death, 130 recovered cases and 138 active cases since the first case on 11 March 2020. The World Health Organization(WHO) mentioned some of the challenge for many countries in dealing with COVID-19 including struggling with a lack of capacity, resources, and lack of resolve[1]. Preparedness and response to COVID-19 have differed among East African countries.Rwanda has drawn on its experience with Ebola virus Disease(EVD) in collaboration with the WHO[2] in the use of ThermoScan checks for every person entering the country and availability of hand washing stations.

This emphasizes the need to have well equipped diagnostic laboratories, trained health professionals and public health measures to respond to COVID-19 pandemic in Rwanda. In response this novel virus the country has stepped up preparedness for the novel coronavirus by setting up a test lab at Rwanda Military Hospital,making country the second in the region to establish such a facility after Kenya[2] in addition to contact tracing and community mobilization to contain the virus and reduce risk of contamination and mortality rate.

According to Dr. Jose Nyamusore, Division Manager of Epidemic Surveillance and response at Rwanda Biomedical Center, National Referral Lab in Kigali appeared to be equipped with technical and human resources required to diagnose COVID-19. The laboratory can provide results of suspected cases of COVID-19, health professionals working in this lab has been trained by experts from Germany. Nyamusore noted that the government of Rwanda used to test existing coronavirus and now has the capacity to test this novel virus[3].

However, like other countries with the number of COVID-19 cases increasing, Rwanda is struggling to increase the number of the required tested people to grasp with the full extent of the outbreak[3].While in two weeks since the first con firmed case, “the laboratory has only been able to test an estimated three hundred people, Daniel Ngamije, Minister of Health Ministry, reported that through process tracing, the first seventeen con firmed patients interacted with more than 680 people demonstrating the magnitude of the possible spread in a country with a high population density” [3].

Before the first confirmed case, the government pursued the same strategy to combat the spread of COVID-19. Trained health professionals with equipments such as fever scanners were allocated to airports and all border posts considered as high-risk exposures,and the government established handwashing stations in the bus park of Kigali, the capital of Rwanda. However, as the COVID-19 cases in Rwanda have increased, the government has adopted newer and stricter measures that has been in force beginning at 23:59 on 21 March 2020 for two weeks but extended to updated prevention measures effective on 6 May 2020 to mitigate the exposure as follows: Unnecessary movements and visits outside the home are not permitted, excepts for essential services such as health care,food shopping, or banking, and for the personal performing such services. Electronic payments and online banking services should be used whenever possible rather than visiting banks or ATMs. all employees (public and private) shall work from home, except for those providing essential services. Borders are closed, except for goods and cargo, as well as returning Rwandan citizens and legal residents, who will be subject to mandatory, 14 days’ quarantine at designated locations. Travel between different cities and districts of the country is not permitted, except for medical reasons or essential services. Transport of food and essential goods have been permitted to function. Shops and markets were closed, except those selling food, medicine (pharmacies), hygiene and cleaning products, fuel,and other essential items. Motocyles are not permitted to carry passengers, but may offer delivery services. Other public transport within cities will only operate for essential movements, as above,and with at least one meter distance between passenger. All bars are closed. Restaurants and cafes may only provide take-away services.Local governments institutions and security organs are tasked with ensuring compliance with these institutions (Office of Prime Minister, Republic of Rwanda, 2020).

The government’s sudden enforcement of the lockdown and stay home seem rapidly prepared and immediately disadvantaged already vulnerable populations. There has been a mass exodus of workers from Kigali to other provinces of Rwanda with no means of transport and concerns raised about starvation among people who work in the informal economy, motorcyclists and those involved in small business as majority do not have savings and are unskilled labor paid on daily basis. In response to this problem, the government provided financial support and a measure of food security to ease this pressure in the city of Kigali, while in other districts, local government in collaboration with community at cell level supported families affected by COVID-19 prevention measures with food. However,effective planning and communication could help prevent this problem. However, efforts to reverse the situation are underway as hundreds of thousands of testing kits have become available. Testing needs has been expanded with more than thousand people tested in 24 hours to provide epidemiological evidence and new cases are mainly track drivers from the neighboring countries.

One threat to the COVID-19 response in Rwanda is the spread of misinformation driven by fear, stigma, and blame despite the government effort to educate population about prevention of stigma. The stigmatization of people with or suspected of having COVID-19, could impede reporting of illness. Implementing public measures is difficult in rural areas and those living with overcrowded living conditions and inadequate hygiene and sanitation.

May 1, the government of Rwanda announced updated COVID-19 prevention measures. These updated prevention measures have been effective since May 42020 which include: movements are prohibited from 8:00 pm to 5:00 am, Public and private businesses may resume work with essential staff only. Other employees should continue to work from home, Hotels and restaurants will operate but close by 7:00 pm, public and private transport will resume within the same province and Individual sporting activities in open spaces are permitted. But primary schools, secondary schools and universities remained closed till September. The closure of schools will affect employees, and schools themselves. Some of schools stared suspending employees’ contracts due to loss of income as most schools’ income comes from students’ tuition, but this started after announcement of new measures on COVID 19 prevention especially in private schools. In this update COVID-19 prevention measures, the immediate challenge is to keep infections at manageable levels and ensure the ability to test all people, trace contacts, isolate patients,implement COVID care plans, and disseminate timely information.Thus, to save our economy while maintaining our health, this require the participation and responsibility not only to the government but also everyone, including people with suspected cases of COVID-19,citizens in general and government at all levels investing in building local capacities. The majority of Rwandan wanted lockdown and stay home to be over and business resumed. In this period of two weeks, they need to know how to control this outbreak and everyone should be involved.

Conflict of interest statement

The authors declare that there is no con flict of interest.

Authors’ contributions

Both authors have equal contributions.