Covid-19 and the grave risk in intercounty travels

Thousands of Kenyans are expected to travel upcountry with President Uhuru Kenyatta’s lifting of a cessation of movement order that was placed to help curb Covid-19.

Unfortunately, many will transport the coronavirus disease home and possibly transmit it to their relatives and neighbours, given that the majority of Kenyans (90 per cent) who have contracted it are asymptomatic, according to Dr Patrick Amoth, the acting Director-General for Health Services.

Also, 73 per cent of Kenyans live upcountry and the majority of them are old so if the virus spreads there, the effects will be devastating, public health expert Bernard Muia said in an interview with the Nation.

Even before the President opened up the counties, health officials had complained about Kenyans’  recklessness, which is believed to have fueled the spread of Covid-19.

President Kenyatta expressed fear that the public may be carried away by the ‘freedom’ and forget that the disease has not been contained.

SHARP CURVE

With the new found ‘freedom’, experts say that the number of positive Covid-19 cases is expected to swell and the infection to sharpen.

Dr Gitahi Githinji, Chief Executive Officer of Amref Health Africa, said the infection curve will continue to rise, and will be “accelerated a little more.”

The expert said that with the opening up of counties, the health system should be readied to handle more critical cases.

“There should be enough intensive care units, oxygen and infrastructure in case the numbers in need of these critical services surge,” he said. “ICU care cases may increase so we need to be ready.”

In an earlier interview, Dr Githinji explained that a sharp curve (narrow high) implies a huge number of infections occurring at the same time.

According to the experts, if Kenyans do not adhere to the public health guidelines and protocols on Covid-19, the number of infections will become overwhelming.

This means health workers will also be strained, said Dr Chibanzi Mwachonda, acting Secretary-General of the Kenya Medical Practitioners and Dentists Union (KMPDU).

“We do not have an adequate number of healthcare workers. If we do not adhere to the guidelines, we will overwhelm them as well as the facilities. We will have lost the battle to the pandemic,” he said.

SHORT CURVE

With the previous containment measures in place, the curve was expected to be wide and short, meaning the number of infections would be lower but extended over a longer period of time.

According to Dr Githinji, a wide and short infection curve means the number of people getting infected is able to get services. He said the measures give governments time to prepare to test, treat and manage cases.

Dr Mwangi Thumbi, an epidemiologist, explained that if the restrictions had not been imposed early enough, the cases would have surpassed previous projections by the Ministry of Health (MOH).

He explained that it took some 100 days to reach the first 5,000 cases because of the containment measures.

In March, Dr Amoth predicted, as a worst case scenario, that there would have been 10,000 cases by the end of April. Kenya passed the 10,000 mark in July.

The numbers are expected to rise exponentially especially in the rural areas if Kenyans do not take responsibility and with the easing of movement restrictions, he said at a recent press briefing.

“We have not yet peaked. It could be in August- September, or sooner if we do not follow measures,” he warned.

RECOMMENDATIONS

The experts proposed home-based care refining  isolation needs to accommodate asymptomatic patients.

According to Dr Mwachonda, the healthcare system has been underfunded in terms of infrastructure and human resource.

With the partial lifting up of the economy, Dr Mwachonda reiterated President Kenyatta’s call for Kenyans to take responsibility and avoid travelling upcountry unless it is absolutely necessary.

“Counties are not well prepared. Only 15 have attained the 300 isolation-bed capacity. The pandemic has brought an opportunity to know where the gaps really are,” he said.

The expert said health workers issues including additional allowances, Covid-19 perks, hiring of more staff and development of  infrastructure should be addressed urgently.

Mr Seth Panyako, the Kenya National Union of Nurses(Knun) Secretary General expressed optimism, saying, “This is the testing time for the healthcare system. I am optimistic we shall handle the pandemic. The only thing we need to do is advise Kenyans to take care of themselves.”

Dr Muia said infrastructural developments being initiated to tackle the coronavirus pandemic should be for posterity and that there is need to change the communication strategy for rural folks who understand little about the virus.

“If Kenyans can observe the public health guidelines, we do not expect to see dramatic numbers,” he said and proposed testing before trips to the countryside to ensure the elderly, most of whom have underlying conditions, are protected.