Mandatory Institutional Quarantine in the Response to COVID-19 in Uganda: Field Notes from Frontline Health Workers

Introduction/Background: On 21st March 2020, the Ministry of Health of Uganda confirmed the first case of COVID-19 and established measures like institutional quarantine for high-risk travelers to interrupt transmission. Methods: From 21st March to 30th September 2020, alumni of Makerere University School of Public Health including Clinicians, Infection Prevention and Control Specialists, Epidemiologists and Psychosocial Experts supporting Ministry of Health conducted a prospective follow up of travelers under quarantine at 13 hotels and two Government Learning Institutions. Their roles; daily observation of the travelers, coordination to other response arms like laboratory, case management. We analysed demographics of the travelers, documented best practices and challenges experienced during implementation. Results: We followed up 1882 travelers, and 1225/1882 (65.1%) were female, 62 (3.3%) children below 12 years, 96 (5.1%) tested positive for COVID-19 of whom 73 (76%) were male. Of the 96 cases, 29 (30.2%) showed COVID-19 related symptoms. No death was registered amongst the 96 high-risk travelers that tested positive during institutional quarantine. Best practices: Monitoring travelers for onset of symptoms, timely onsite sample collection and writing reports. Challenges: Logistical impediments. Conclusion: The Ministry of Health should use experiences to revise guidelines with special focus on challenges that impeded effective implementation of institutional quarantine. Keywords: Institutional quarantine; Frontline Health Workers; COVID-19; Travelers; Uganda