Tracking Haulage in East Africa to support COVID-19 surveillance- THEA-C19

On the 13th of June, a haulage truck driver was found dead in the 32-kilometre queue of trucks at the Busia border between Uganda and Kenya. This bottleneck in regional supply chain is caused by mandatory COVID-19 testing, whose results take 14-26 hours. Waiting for test results not only represents an increased risk in COVID-19 transmission to communities but also outbreak of water borne and food borne diseases. Critically, such delays in the supply of goods and medicines for land locked countries further threaten the health and wellbeing of these populations.

To mitigate this problem, the Ministry of Health of Uganda proposes to test and allow drivers continue with journeys, however, this would require a quicker approach of tracing drivers who test positive, and profile their attributable transmission risk.

To address this limitation, we propose to develop and test digital contact tracing technology tailored to the haulage industry. This approach provides a unique opportunity to harness the input of users, characteristics of the haulage sector, support of government, technology firms and academia to maximise uptake and utility of such tools in a developing country context. Critically the tool will be open source, which allows for simultaneous testing of its utility in
other parts of the world. In Uganda, the technology will provide the Ministry of health information on location, an alert system for cases, at-risk drivers as well as expected volume of traffic at checkpoints. This strengthens public health responses to COVID-19 and improves regional flow of supply chain

The goal of contact tracing is to identify COVID-19 cases and their recent contacts then have them isolated to break the virus transmission chain. In Uganda, 68% of 1265 cases are haulage truck drivers and the control of transmission from this group has been through mandatory COVID-19 testing at the borders.
However, this requires drivers to wait for a result, causing a 7-15 day delay in the regional supply chain for the landlocked countries.

To mitigate this, the ministry of health proposes to allow drivers to continue with the journeys pending results, however, this requires a rapid approach for tracing positive cases. From the ministry's reports, it is evident that such an approach must pay critical attention to a distinct transmission profile i.e. from regional to local haulage drivers who are introducing the virus into communities.

To fill this gap, we propose to develop and test a digital contact tracing tool. The novelty here is in its enhanced privacy using a unique universal identifier (UUID), digital tracking boundary defined by the road infrastructure and simplicity based on conventional time-stamped GPS.

The mobile application will be open source, which means it can simultaneously be tested by other parts of the world thereby contributing to its robustness. In Uganda, all stakeholders support it's development and deployment, which ensures uptake. Ultimately, this technology will dramatically increase the speed and efficiency of tracing of cases (drivers) and contacts, which reduces spread into communities in the region as well as improve flow of the regional supply chain.