State seeks second opinion on coronavirus test

Kenya is still at grave risk even as the country anxiously awaits preliminary test results from a patient suspected to be infected with the highly contagious novel coronavirus (2019-nCoV).

Although the Ministry of Health on Thursday tried to reassure the public that the situation was under control, it elicited little confidence as health experts said the government was not doing enough to protect its citizens.

Health Cabinet Secretary Sicily Kariuki said that the results were yet to be processed. Meanwhile, the patient (who is said to be in a stable condition) admitted with flu-like symptoms will remain in isolation.

As of Thursday, the country was still waiting to know the results even as Ms Kariuki insisted that the country had the capacity to carry out the tests.

“The fact that we sent a set of samples does not mean we lack the capacity. We sent the samples to South Africa for a second opinion,” Ms Kariuki said.

CONTROL STRATEGIES

Health experts have, however, faulted Ms Kariuki’s statement, saying that there is no capacity locally or on the continent to carry out the test for the coronavirus.

Lancet Group of Laboratories chief consultant pathologist Ahmed Kalebi said that although China shared the genetic sequence of the novel coronavirus with the world, African countries would still need to rely on laboratories outside the continent to test any suspected case.

“The test required is PCR molecular test to detect active infection and serology antibody test to check for previous recent exposure. Both require specific kits which we do not have,” Dr Kalebi added.

However, he said that although the results of the samples will not directly affect the patient, it will inform the government on the next steps to follow.

Controlling the spread of the virus requires both public health and medical measures.

However, the limited clinical information coming out of China means that experts only know about the mid-to-worst-case outcomes, Dr Kalebi said.

AFRICA'S CHALLENGES

The World Health Organisation (WHO) has asked countries with exported cases to share patient data, collected in a standardised way, so that more can be learned about coronavirus.

As research institutions and companies sprint to develop vaccines and new tools to prevent the spread of the virus, the WHO on Thursday held its fourth Emergency Committee meeting to determine whether the ongoing outbreak of coronavirus constitutes a public health emergency of international concern.

Under the WHO's current regulations to manage such situations, the emphasis is on containing an outbreak at its source.

They also require countries to be transparent with information about the outbreak and be prepared to isolate those infected.

Testing is not the only challenge Africa faces. The current virus that has infected thousands of people globally has no cure nor a vaccine. And now, scientists say the virus can be passed on even before the onset of symptoms.

“We are now learning that some people can transmit the virus even if they are not showing symptoms. This, therefore, renders screening useless,” said Dr Kalebi.

HEALTH MEASURES

Hand hygiene and personal protective barriers — gowns, gloves, masks, and goggles — reduce droplet transmission.

The incubation period, however, is unknown but rough estimates put it at between one and 14 days.

The WHO came under fire after it last week declined to declare a global health emergency.

In its official definition, Public Health Emergency of International Concern is defined in the IHR (2005) as “an extraordinary event which is determined by a situation that is serious, unusual or unexpected”.

A panel of experts, called the IHR Emergency Committee, is convened to discuss the situation. IHR stands for International Health Regulations — 196 countries including all WHO member states agreed to its most recent revision in 2005.

Ultimately, after assessing evidence, including human-to-human transmission rates, the final decision rests with the WHO Director-General, currently Tedros Adhanom Ghebreyesus.

A declaration would lead to a boost in public health measures, funding, and resources to prevent and reduce international spread.

The measures could include recommendations on trade and travel, including airport screening of passengers — although the WHO generally aims to avoid disruptive trade restrictions.

EBOLA EPIDEMIC

Only five emergencies have been declared since then: the H1 virus that caused an influenza pandemic (2009), West Africa's Ebola outbreak (2014-2016), polio (2014), the Zika virus (2016), and the ongoing Ebola outbreak in the Democratic Republic of Congo (2019).

It took a year after the outbreak of Ebola in the DRC for the WHO to declare it a PHEIC.

Other countries have also started evacuating citizens from China on chartered flights, and some major airlines have halted all flights to and from mainland China. However, Ms Kariuki said that evacuation “is currently not on the table”.

In the past five years, the world has faced outbreaks of Ebola, Zika, another coronavirus called MERS (Middle East Respiratory Syndrome), and now the virus simply known as "2019-nCoV" has infected thousands of people and killed more than 100.

But, unlike in many previous outbreaks, where vaccines to protect people have taken years to develop, research for a vaccine to help stem this outbreak got under way within hours of the virus being identified.

Chinese authorities on Thursday said that there were 7,711 people who have become infected and at least 170 have died from the disease since it was first identified on December 31. Globally, infections have spread to at least 15 other countries.