Assessing the Impact of Haulage drivers in Uganda's COVID-19 Delta Wave

Adrian Muwonge, Paul R Bessell, Barend Mark de Clare Bronsvoort, Ibrahim Mugerwa, Erisa Mwaka, Emmanuel Ssebaggala, Wee Aidan Bryan, Aggelos Kiayias, Christine Mbabazi Mpyangu, Moses Lutakome Joloba
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Abstract

Abstract Background: Haulage truck drivers can quickly connect distant communities, with risks of potential disease introduction. However, interventions to limit such risk must balance public health protection, economic continuity, and individual rights. Here distinguishing between their role in disease introduction and its onward spread is crucial for achieving this balance. Methods: To investigate the role of haulage during the Delta wave of COVID-19 in Uganda. We fit a susceptible-infectious-recovered (SIR) model to the 625,422 records in the national surveillance dataset to assess the notion of a “core-risk group” by examining the incidence and impact of haulage-targeted interventions in border districts associated with heavy haulage traffic compared to the districts in the central region of Uganda. Results: Although haulage drivers accounted for only 0.036% of the cases, the border districts associated with them registered 12.02% more cases than inland districts, suggesting a role in disease introduction. This risk was particularly higher in Tororo, compared to Amuru and Kyotera, which border Kenya, South Sudan, and Tanzania, respectively. Some interventions even increased the risk in Tororo by as much as 6%. However, in general, the haulage targeted interventions reduced the case load in border districts but registered limited impact on inland districts. This suggests a limited role in secondary within country spread. We note that combining such interventions with vaccination achieved greater reduction in case load. Conclusions: Our findings suggest that truck drivers were a core risk group, though this risk was transient and in some cases exacerbated by some interventions. Pandemic preparedness strategies should characterize risks posed by core groups to ensure interventions balance public safety with individual rights in key sectors like supply chains.
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评估乌干达 COVID-19 三角洲浪潮中运输司机的影响
摘要 背景:运输卡车司机可以快速连接遥远的社区,带来潜在的疾病传播风险。然而,限制这种风险的干预措施必须在公共卫生保护、经济连续性和个人权利之间取得平衡。在此,区分他们在疾病传入和疾病继续传播中的作用对于实现这种平衡至关重要。方法:调查运输在乌干达 COVID-19 三角洲疫潮中的作用。我们对国家监测数据集中的 625,422 条记录进行了易感-感染-恢复(SIR)模型拟合,通过考察与大量运输相关的边境地区与乌干达中部地区相比的发病率和针对运输的干预措施的影响,评估了 "核心风险群体 "的概念。结果:虽然运输司机仅占病例的 0.036%,但与他们相关的边境地区的病例比内陆地区多 12.02%,这表明他们在疾病传播中发挥了作用。与分别与肯尼亚、南苏丹和坦桑尼亚接壤的阿穆鲁和基奥泰拉相比,托罗罗的风险尤其高。一些干预措施甚至使托罗罗的风险增加了 6%。不过,总体而言,有针对性的运输干预措施减少了边境地区的病例数,但对内陆地区的影响有限。这表明,这些干预措施在国内二次传播中的作用有限。我们注意到,将此类干预措施与疫苗接种相结合可更大程度地减少病例数。结论:我们的研究结果表明,卡车司机是一个核心风险群体,尽管这种风险是短暂的,在某些情况下还会因某些干预措施而加剧。大流行病防备战略应确定核心群体的风险特征,以确保干预措施在供应链等关键部门的公共安全与个人权利之间取得平衡。
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