Has the time come to say bye to Covid-19?

On January 30, 2020, the World Health Organisation (WHO) declared Covid-19 a global public health emergency of international concern.

But 11 days ago, the WHO indicated that Covid is no longer a global health emergency after nearly 1,200 days of untold human suffering and permanent disruption of the way of life.
But in the same vein, the health agency warned countries not to lower their guard, with a caveat that the virus is still with us.

“The worst thing any country could do now is to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that Covid-19 is nothing to worry about,” said the WHO Director-General Tedros Adhanom Ghebreyesus.

“The virus is here to stay,” he added.

Does this mean that the virus has moved from being a global emergency to country-specific since countries are still recording cases and even fatalities due to the virus?

The May 5 decision was arrived at given that for almost a year, countries have been recording a downward trend in the numbers of deaths, severely ill patients and even the cases, with population immunity increasing from vaccination and infection.

This has since eased the pressure on health systems, with many countries not recording cases for months.
According to the data by the WHO, global Covid-19 deaths have reduced from a high of 41,000 weekly for the last three months to about 3,500 late last month. 

The disease had killed over 6.9 million people and infected 765 million others globally as of last week since the first case was reported in the Chinese city of Wuhan in November 2019.

In Kenya, the virus is still responsible for some hospital admissions, though not severe.  However, the risk still exists, given that many have stopped observing the preventive measures.

Even the way the announcement was made, it was clear that had it been for Dr Tedros doing, he would not have made the announcement. However, he was following a directive from the committee.

“The International Health Regulations Emergency Committee met ... and recommended to me that I declare an end to the public health emergency of international concern. I have accepted that advice,” he said.

With the emergency phase behind us, countries are relaxing the containment measures, with Kenya opening up for travellers without the Covid-related health restrictions. 

“All travellers arriving into the country through any point of entry shall no longer be required to show proof of either the Covid-19 vaccination or a pre-departure Covid-19 test,” said Health Cabinet Secretary Susan Nakhumicha.

This decision aligns with the guidance from the WHO and America’s Centres for Disease Control and Prevention (CDC) on de-escalation of containment measures. The revised travel requirements took effect on May 3.

However, the Health boss said there is a caveat: “Even with the lifting of the public health emergency phase, Kenyans should continue taking personal safety, hygiene and sanitation seriously by observing the measures at all cost.”

Her message is likely to be embraced by the numerous people battling long-term effects of Covid-19, or long Covid as it is popularly called, and are in dire need of long-term care. For them, the emergency is not yet over — and may never be.

Experts’ warnings 

The Healthy Nation spoke to a number of experts who cautioned that despite the announcement, the country needs to tread with care.  

Prof Omu Anzala, a virologist and immunologist, warned that the virus is still here with us and that people should not let down their guard.

“In as much as the emergency phase is over, the disease is still here. Many will get the virus and it is not going any soon,” Prof Anzala said.

He advised countries to continue vaccinating the elderly.

“We should continue with vaccination of the elderly since they are the people with low immunity and any attack, be it mild, may take them down fast,” noted Prof Anzala.

For Dr Githinji Gitahi, the CEO of Amref, the end of the pandemic emergency is the beginning of a bigger challenge. 

“Finally, the battle is over. The war against this and other health emergencies is just beginning,” Dr Gitahi said, asking Kenyans not to put their guard down.

On May 25, 2021, Prof Shem Otoi, the programmes coordinator at the Lake Region Economic Block Covid-19 advisory committee and an infectious modelling expert, tweeted that it would take three-and-a-half years from December 2019 to contain Covid-19 comprehensively.

In the mathematical model dubbed, Otoi-Narima, he established seasonality and periodicity of Covid-19 surges. 

“It is true we are out of the emergency phase. But that does not mean that the virus is gone. We still need to take the necessary precautions. When next to people with suspected symptoms, adhere to the measures. Avoid shaking hands. Make this a habit and exercise caution at all times,” Prof Otoi said.

Farhan Yusuf, a global health professional, says the pandemic should serve as the motivation to boost healthcare systems in the world: “It is time to start thinking and acting about preventing a situation like [Covid-19] from ever happening again. I hope we can build better and stronger health systems.”

In the 1,160 days that Covid-19 has been in Kenya, it has taught Kenyans how to adapt and to change their care-seeking norms to keep themselves and others safe.

Covid-19 has arguably been the most disastrous human experience since World Wars I and II.

But in what ways did the pandemic alter human behaviour, delivery of healthcare services and life?

The pandemic has had both upsides and downsides, majorly in human health, with massive shifts in behaviour, attitudes, the economy, travel, recreation, work, medicine and virtually every area of human life. 

Enter the sanitiser

Before Covid-19, the vast majority of Kenyans had never seen, much less used, hand sanitiser. This changed as soon as the pandemic arrived on our shores. Personal hygiene became a matter of survival. From regular handwashing to sanitising and using a disinfectant on surfaces, and avoiding handshakes, multiple ways to keep germs at bay were recommended by the Health ministry as social distancing became the primary precautionary measure.

Two years later, handwashing has stuck. The hand sanitiser is still a prominent feature in most homes and public places. 

At the reception in most offices, a bottle reminds one of the need to cleanse themselves of germs.

“I have never quite been able to shake hands since the pandemic. I find it unhealthy and almost inappropriate,” admits Abubakar Ahmed, a student at Mount Kenya University. “I try to avoid cramped spaces. They make me uncomfortable.”

Social distancing 

These personal hygiene practices have led to healthier lifestyles among Kenyans. In particular, fewer cases of communicable diseases were recorded in the months of the pandemic.

In Australia, for instance, health authorities reported 50 percent fewer incidents of communicable diseases between January and June 2020. The acute reduction was attributed to the hygiene practices observed by the population.

To date, some public spaces like banks still enforce social distancing measures. Customers are required to stand at least 1.5 metres from each other while queuing for services.

Mental health crises

Whereas the full extent of the impact of Covid-19 on human behaviour will take years to be known, the socioeconomic and psychological upheavals of the pandemic triggered immediate changes in how people behave. Life in isolation during lockdown came with stresses and uncertainties that took a toll on people’s mental health conditions, with a 25 per cent increase in cases of depression according to the World Health Organisation (WHO).

In many countries on the continent and indeed globally the situation necessitated the development of crisis services for mental health. 

Says the CDC: “Younger adults, minority groups, essential workers and caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use and elevated suicidal ideation.”

On the flipside, the negative psychological effects of the crisis created more mental health awareness as the condition was destigmatised. 

At the same time, there was an increase in the uptake of mental health services, including sessions with psychologists.

“I had never consulted a psychologist before. In March 2022, I contacted one, with whom I have been in touch ever since. I have been more open about freely discussing the state of my mental health with people close to me,” revealed Bridgitte Atieno, a freelance writer.

Resetting of social lives

On personal relationships, restrictions on movement meant that people were socially displaced, and could no longer interact with family and friends in person. This affected how people communicated. 

In some segments of the population, communication through text messages and video calls with family and co-workers increased as they sought to break the boredom of isolation. 

In other sections of the population, there was a drive to work out more and to eat healthier. In some, communication and healthy habits slumped as loneliness quickly set in.

“Months after the lockdown was lifted, I found it harder to go out and meet people. I started hanging out with friends only in the first half of 2022. Even so, I was still anxious about the possibility of catching the virus. I am still not entirely comfortable about being in social spaces,” said Julius Korir, an architect based in Nakuru.

“I have developed social anxiety that I did not have before. I prefer to spend my time indoors like in the pandemic days. With WhatsApp, I am able to stay in touch with friends,” he added.

For others, research shows, new spending habits were acquired, as they went on a shopping spree, buying both essentials and non-essentials, often as a coping mechanism for the uncertainty. Others curtailed spending. Experts say these pandemic-fuelled habits may have altered human behaviour.

Change of lifestyles

The contagion also came with wide-ranging lifestyle changes and choices. Three months into the pandemic in June 2020, about 85 percent of consumers reported having changed their food habits, among them the approach to cooking, eating, shopping and thinking about food. 

Households and individuals had started to watch what they ingested. Many more were now washing their food before eating or cooking it, results of a survey by the International Food Information Council (IFIC) showed.

“A higher percentage of people [surveyed] said they were eating healthier than they usually do as a result of the pandemic,” said researchers at IFIC, an institution that conducts studies on food science, health, safety and nutrition.
When the pandemic struck, people who led an active life added more hours to their workout regimen. 

But for millions of others, working from home meant leading a sedentary life. At the time, gym facilities, considered high-contact areas, had been closed down in keeping with the requirements of social distancing.

But as the pandemic continued to pummel humanity, with no end in sight for the crisis, some Kenyans – like other people globally – started to work out at home, conscious of the need to stay fit and healthy. 

From simple indoor exercises on a mat to cardio, weightlifting and yoga, the use of online fitness programmes reported a spike at the time. Others who could previously not afford the time to work out added it to their daily or weekly routine to fill the hours.

Meanwhile, to escape the ennui of staying at home and being concerned about their gained kilos, hundreds of Kenyans hit the road every morning and evening. For many, jogging provided an opportunity to get a breath of fresh air and to escape the dullness of being cooped up indoors for months. 

Many people may have gone back to their pre-pandemic lifestyle. Others like Dorris Mugane, an event organiser, though, have maintained this active lifestyle post-pandemic, working out at home or even joining a gym.

“I had never imagined myself working out in a gym. I started slowly at home in June 2020. I bought a subscription in my neighbourhood in mid-2021. Since then, working out has become a central part of my life. I feel healthier and happier overall,” said Ms Mugane.

Increased drug abuse 

With more time spent at home and the anxiety caused by uncertainty, some people increased their alcohol intake. Even some non-drinkers before the pandemic started drinking to cope with anxiety and to fill the surplus time they suddenly had. With bars and restaurants closed, there was a steep increase in binge drinking in Kenya as children too were also exposed to alcohol.

Online alcohol sales increased nearly fivefold, according to findings of a survey by the National Authority for the Campaign Against Alcohol and Drug Abuse.

In the US, for instance, scientists have warned that the one-year increase in intake of alcohol during the pandemic will lead to 8,000 additional deaths owing to liver disease, 18,700 from cases of liver failure and 1,000 from liver cancer by 2040.

The rise of telemedicine 

Globally and in Kenya, researchers have found a significant decrease in non-emergency hospital visits since the pandemic, with visits to the accident and emergency departments on a sharp decline. 

In Italy, for instance, paediatric doctors working in emergency departments noted a reduced flow of patients, especially those without urgent complaints, visiting. 

The majority of Kenyans requiring outpatient services and routine care stayed away as hospitals dealt with an upsurge in Covid-related admissions. For many patients, visiting a hospital increased the risk of contracting Covid-19.
But even as normal hospital visits declined, uptake of services such as telemedicine peaked, as patients consulted doctors online and on call. 

Telemedicine allows a patient and a doctor to engage virtually for primary care, special care and even management of chronic conditions such as hypertension.

Redefinition of the workplace 

If Covid-19 changed lifestyles, it is how people work and make a living that was turned on its head. With requirements for social distancing to prevent new infections and reinfections, jobs requiring physical proximity were hugely disrupted.

In most economies globally, as in Kenya, people were asked to work from home. For many months, professionals met and planned online and delivered their work remotely. For teleconferencing platforms, such as Zoom, Google Meet, Microsoft Teams and Skype, the pandemic months were a period of abundance as millions globally logged on to get in touch with colleagues.

When Covid-19 numbers went down and the government relaxed protective measures, most local employers carried on with telecommuting for months.

And even after measures were further scaled down, people continued to work partly from home and partly from the office.

This has become the norm and now experts believe the model, where professionals work from home in a hybrid system that combines telecommuting and in-person appearance will define the future of work. It will also determine whether companies attract top talent or not.

“By creating a more flexible and inclusive work environment, companies can attract and retain top talent, boost productivity, improve retention, and align with Environmental, Social and Governance (ESG) values,” says Dr Gleb Tsipursky, an expert in hybrid work systems.

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