A pile-up of active cases might complicate Kenya’s fight against Covid-19 if the country continues reporting fewer recoveries at a time average daily new cases continue to grow, suggests a Nation Newsplex analysis of the country’s coronavirus data.
Only 232 people were reported to have recovered from the virus in Week 16 (June 26 to July 2) of the country’s journey through the pandemic. This was the lowest number in four weeks and close to a half the 437 people that were reported to have gotten well in week 13, when recoveries peaked before the numbers started to fall.
“The recovery rate should not worry you very much. I wish you concentrated on the case fatality rate because that will be telling you the quality of care that you provide to the people,” Mr Patrick Amoth, Health director-general, told journalists on Friday.
The number of people confirmed to have fully recovered dropped from an average of 62 per day to 33 in four weeks, even as the country’s average number of people reported to have contracted the virus shot up to 222 from 125 over the same period. Coincidentally, it is the same week in which the highest number of infections in a day was reported, 307 (on July 1), that the Ministry of Health also announced (on July 2) that 20 people recovered, the lowest number in a month.
The divergence between the infection and recovery curves has introduced a trend which, if not disrupted, will deliver a huge active Covid-19 caseload with the potential of firing up the infection rate and overwhelming the healthcare system.
That the country ranks 10th in Africa in number of cases (7,577) but climbs up five places to position five in number of active cases (5,182) gives the impression that alongside the swelling number of infections, the country is faced with a stubborn virus that seems to hang around for a little longer than is the case in many other African countries. A very low death rate too would partially explain a high number of active cases. For example, about a quarter of the 15,070 cases so far reported in Algeria are active, thanks to not only a recovery rate of 70 per cent, one of the highest in Africa, but also a high death rate of six per cent. However, a 100 per cent recovery rate and a zero per cent death rate are the most desirable results in fighting the pandemic.
Kenya has a death rate of two per cent, mirroring the continent’s share of infections that have resulted in death.
Many of the active cases in the country might be people who contracted the virus in the past few days and therefore may not have had enough time to recover. People with a mild attack of Covid-19 recover in about two weeks, while it takes about three to six weeks for those with severe or critical version of the disease to expel the virus from their body, according to the World Health Organization.
However, the fact that there are a number of countries that have reported high numbers of infection but managed to maintain relatively low figures of active cases might necessitate a re-examination of the country's Covid-19 treatment and management approach.
About seven in 10 (68 per cent) of Kenya’s reported cases are active. The number is higher than the continent’s 50 per cent. The share is only second to Egypt’s 69 per cent, among countries that have reported over 5,000 cases. The country has a recovery rate of 30 per cent, the 15th lowest rate in the continent and only higher than Egypt’s 27 per cent, among nations with 5,000 cases or more. The recovery rates in Africa and the world are 48 per cent and 56 per cent, respectively, according to data in the John Hopkins University Covid-19 portal.
A high and growing number of active cases has proven to be the surest way to getting the hospitals overwhelmed through increased admission and management of critical cases. However, the country has one thing going for it. “Available data in our country shows that 78 per cent of infected persons admitted to our hospitals are either asymptomatic or mildly symptomatic, and, therefore, can be managed at home, provided proper laid down procedures are followed” said Chief Administrative Secretary for Health, Dr Rashid Aman on June 10, when the Ministry of Health launched the home-based isolation and care guidelines. On the same day the ministry announced the highest number of recoveries in a day to date - 175.
The Jitenge System stepped in to relieve health facilities of the mounting pressure brought about by the rapid growth of community transmission of the virus. It will see hospitals handle only serious conditions while households host and take care of asymptomatic patients and those with mild symptoms under strict conditions spelt out by the ministry.
However, even though the sharing of the disease burden between health facilities and communities would guarantee hospitals a lifeline, spreading out a high number of active cases into household might not yield the desired results if the guidelines are breached. Since the country started fighting the pandemic in March, the government has repeatedly warned that indiscipline and a laissez-faire attitude are the biggest impediments to containment.
No need for alarm
According to the general trend displayed by countries that have gone past the most devastating stages of the disease’s progression curve, the journey to the peak involves a general growth of new case, death and recovery numbers reported every day. Kenya’s dwindling number of recoveries is peculiar, but the Health ministry says there is no need for alarm. “The recovery rate should not worry you very much. I wish you concentrated on the case fatality rate because that will be telling you the quality of care that you provide to the people,” Mr Patrick Amoth, Health director-general, told journalists on Friday.
The country recorded 39 and 88 recoveries on Friday and yesterday, respectively. This gives an indication of a higher recovery rate this week and in days to come if the trend lasts.
Eastern Africa has both the highest and some of the lowest recovery rates in the continent. Djibouti and Mauritius lead with 97 per cent each, while South Sudan sits close to the bottom with 16 per cent. Djibouti also has a conspicuously low death rate of one per cent. Neighbour Uganda, with 1,032 cases, has a recovery rate of 84 per cent and is yet to report a Covid-19 death.
In the continent, Ghana has been seen as a good example of resilience. With 19,388 cases, the fourth-highest, the country has a high recovery rate of 74 per cent and a low death rate of one per cent.
Kenya has the highest number of Covid-19 cases and deaths in Eastern Africa, a region where two countries, Tanzania and Burundi, have been inconsistent in making their Covid-19 statistics public. The country’s average number of deaths reported in a day has stayed between two and five in a month, consistently furnishing a tally that now stands at 159. This represents about two in five of the deaths in the region.