Availability of Equipment, Testing, and Capacity
Due to the transmissibility and infectivity of the SARS-CoV-2 pathogen, there is a crucial need for high screening and testing capacity. COVID-19 case management can require significant health resources in patients with severe or critical illness, which can be challenging in Rwanda where there is limited ICU capacity.10 To preemptively address the issue of capacity, the government of Rwanda has allocated funds to the development of COVID-19 health units, purchased equipment for testing, and installed thermal imaging cameras to screen all arrivals at air and land borders.9,11 Personal protective equipment (PPE) and testing kits have been purchased or donated by different stakeholders. Tests obtained at hospitals are analyzed by the National Reference Lab. In addition to these preventative and containment measures, confirmed cases are admitted and their contacts are followed for isolation or tested if they had any symptoms during the last 14 days.
Demonstrating the flexibility of the Rwandan health system, critical infrastructure utilized in combating COVID-19 was based on existing built structures. In February 2020, the Kanyinya health center initially constructed in 2013 was transformed into a COVID-19 treatment center with 75 floor beds and 8 ICU beds that can manage patients in isolated units. Following this model, a second COVID-19 treatment center with 126 floor beds and 8 ICU beds was opened two weeks later by repurposing a hotel. Additionally, each of the country’s 80 public hospitals were requested to set aside two beds for PUI isolation and COVID-19 treatment. In early May, to further protect health care staff and minimize transmission risks, treatment centers began using robots for patient monitoring and care documentation.12 Treatment teams have been assembled to ensure holistic medical and psychological welfare of patients. Each unit includes a medical director, doctors, nurses, clinical psychologist, biomedical staff, nutritionists, infection prevention control (IPC), administrators, logistic managers, and data managers.