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

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.