The Ministry of Health has procured 5,000 pairs of protective gear for healthcare workers in readiness should the deadly coronavirus, which had claimed 362 lives in China as of Monday, “arrives” in the country.
Health Director-General Patrick Amoth said the gear includes masks and gloves for those at the airport as well as additional goggles, special protective overalls and boots for health workers who would be dealing with confirmed cases.
Dr Amoth told the Nation by phone that the ministry has also readied a 16-bed isolation centre at Kenyatta National Hospital and Coast General Hospital in Mombasa.
It is at these sites that three people who had been quarantined after a coronavirus scare will be isolated for further investigation — one at KNH and the other two in Mombasa — even though they initially tested negative.
The ministry has not spoken about the fourth patient, who is suspected to have been discharged.
Health Cabinet Secretary Sicily Kariuki also formed a national task force to advise the government on what to do as well as train front-line workers — those at the ports — on identifying travellers at risk and reporting and isolating them until healthcare workers arrive.
Dr Isaac Ngere, a medical epidemiologist and a member of the national task force on coronaviruses, says that Kenyans can take solace in the fact that the disease seems to be less severe outside China.
However, he warns that with travel, danger is not that far and calls for “very tight surveillance”.
Dr Ngere, whose research is mainly about coronaviruses, told the Nation: “If steady health systems like China’s are shaken by this, and you can see how fast the US and UK have responded, countries like Kenya that are establishing their systems would really struggle.”
There is no cure for the virus and doctors would ideally offer “supportive treatment” relying on the person’s immunity to fight the disease.
Save for the oxygen, the Ministry of Health expressed confidence in having enough bolus — the water injected in a patient’s veins — and antibiotics in case of bacterial diseases that may accompany the disease.
WEAK HEALTH SYSTEM
While he declared the coronavirus a public health threat of international concern, World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus said:
“Our greatest concern is the potential for the virus to spread to countries with weaker health systems and which are ill-prepared to deal with it.”
Ms Kariuki has repeatedly said that the healthcare system in Kenya will handle the virus if and when it lands, but holes are being poked into how the government responded to the suspected cases even though the response was swift.
Prof Omu Anzala, a professor of viruses at the University of Nairobi, said that while there are tests and people who can carry out laboratory confirmations in Kenya, there were no reagents needed for these types of viruses — primers and probes.
It is likely that the absence of these tools is what made the ministry to ship the samples to South Africa.
Apart from the timeliness, Prof Anzala said, a resilient health system needs to have the capacity to manufacture the two needed commodities when and if needed.
“This is not about cost or time, but the confidence that you can take care of your people.”
The don’s concern echoes a 2017 World Bank report — "From Panic and Neglect to Investing in Health Security" — that stated that Kenya is not prepared to handle a pandemic.
Apart from funding set aside for these new diseases that are crawling from all unlikely sources, the report also noted the weakness in the laboratory systems.
The nature of these viruses also scares the hell out of scientists.
Wuhan Coronavirus, which is provisionally called 2019-n-CoV, is one such disease that has even moved to people, who are also infecting other people.
It belongs to a family of viruses called coronaviruses that have strains that cause deadly diseases in mammals and birds.
The virus has had quite an itinerary that has shocked the scientific community on its speed and lethality — it was detected in early December 2019 in Wuhan, China.
The first death was reported by the WHO on January 9, 2020 and by Monday it had spread to 25 countries and killed more than 300 people.
But this is not the first time China has experienced a disease whose mode of transmission is airborne.
In 2003, severe acute respiratory syndrome (SARs) infected 5,327 people in mainland China and killed 349 people.
China used that tragedy to strengthen and invest in its health system, so much so that they could build a 1,000-bed capacity hospital in just 10 days in preparation for this disease.
WHO praised China for, among many other things, a swift response and openly sharing all the information about the outbreak, including the molecular make of the virus — how it looks, and how it changes when it interacts with the environment — in an open portal, perhaps seeking help for the development of a vaccine or test kits.
Laboratories and diagnostic technology are a critical part of this preparedness.
Kenya has had its lessons, too, and, while not perfect, it would not be caught flat-footed.
Dr Eric Osoro, a medical doctor and an epidemiologist attached to the Washington State University global health programme in Kenya, said he feared that should the virus come to Kenya, it would be difficult to contain because it is new, not because there are no systems.
“There is still a lot not known about it. It spreads fast and people have little or no immunity against it,” Dr Osoro said in a telephone interview.
Dr Osoro is referring to the body’s reaction when exposed to a disease for the first time.
The immune system recognises the foreign molecules (antigens) and this triggers the body to produce antibodies and special white blood cells that put the foreign molecules in the line of fire for destruction.
Dr Joyce Nyairo, a cultural analyst and academic, scoffed at a claim by Kenya Airways that it was able to isolate passengers showing symptoms of the disease, asking why they would even allow them to fly with others.
“Where is the isolation room in the plane? Is it in the toilet? Was the air prevented from coming to the other passengers?” she asked.
At the airport, a spot check revealed that some customs officials had not even worn face masks, and would only get curious about those that presented the telltale signs of infection — a cough, shortness of breath and fever.
There is no way in Kenya or even China to test those that are asymptomatic — those that have the disease but are not sickly and are able to spread the virus. Such a case has been reported in Germany.
For this reason, Dr Osoro stressed the importance of educating the public on what to do when they see a person with a cough, shortness of breath and fever.
The US realised this potential and ordered a mandatory 14-day isolation for anyone entering the country from China, whether they are healthy or not.
This is because the incubation period of the virus — the time it takes to start making you fall ill — is two weeks.
Other countries banned flights to mainland China while stopping incoming flights from the country.
More than 10,000 flights into China had been stopped from the time the outbreak started to January 31, according to Cirium, an organisation that conducts research and provides data on travel.
Back home, it took a public outcry for Kenya Airways to suspend its Boeing 787 flights to Guangzhou.
An average of 24,000 passengers transit through JKIA daily. This is not comforting given how the virus behaves, and the fact that it is spread through the air.
Prof Kariuki Njenga, a professor of virology, says scientists are always playing catch-up with coronaviruses.
He says coronaviruses “marry” other components and micro-organisms to create novel versions of themselves. “From that marriage, another monster may emerge,” he said.
At first, scientists found solace in the disease’s low reproductive number — how many people it can infect from the first patient. It was between two and 2.5, lower than SARS, which was as high as five.
But, in less than a month, 2019-n-CoV has already claimed more lives than Sars killed in eight months.