Covid-19: Worry as counties stop contact tracing

Coronavirus mass testing in Ruaraka

What you need to know:

  • By Wednesday, only six counties – Nairobi, Turkana, Isiolo, Meru, Mandera and Taita Taveta – had submitted their reports, meaning the remaining had done little or nothing to trace patients’ contacts.
  • Nairobi County has the highest number of contacts to be traced with 1,637, and is followed by Kiambu at 646 and Kajiado with 364. 
  • Mandera is the only county that has done about 95 per cent of contact tracing, having found all 27 contacts listed.

The war on Covid-19 in counties seems to be on its deathbed, with 41 of them failing to submit reports on contact tracing to the Ministry of Health, the Nation has learnt.

By Wednesday, only six counties – Nairobi, Turkana, Isiolo, Meru, Mandera and Taita Taveta – had submitted their reports, meaning the remaining had done little or nothing to trace patients’ contacts.

Data from the ministry shows contact tracing is on its deathbed in most counties. Some counties have not traced a single person who interacted with Covid-19 patients in a month.

From the data, out of over 34,200 confirmed Covid-19 cases, 5,722 cases lack contact lists.

Nairobi County has the highest number of contacts to be traced - 1,637 - and is followed by Kiambu at 646, Kajiado at 364, Machakos at 315, Nakuru at 287 and Busia at 231.

Top performers

Mandera County is leading in contact tracing as per the Ministry of Health data. It is the only county that has done about 95 per cent of the work, having found all 27 contacts listed.

It is followed by Elgeyo Marakwet and West Pokot, which have traced their six cases each.

Isiolo County, with about five cases, has also done well in the area, having traced 56 patients.

Health acting Director-General Patrick Amoth said that because of the increase in Covid-19 cases and widespread community transmission, contact tracing of all the contacts is not possible and only those with symptoms will be picked.

“Projections to determine how many people would have the virus in a population being traced is now very important. Positivity begins to be a second issue while we concentrate on asymptomatic cases. This is very important,” Dr Amoth said.

“It is now upon people to take care of themselves because we will not be able to trace all of them. It is not easy.”

Significance

A study conducted and published by Lancet Global Health indicates that contact tracing strategies are very important as they “keep the effective reproduction number below one”.

The recent research found that delays in testing of index patients and delayed contact tracing have been detrimental in the fight against the virus.

This is because the reproduction of any single case becomes too high if no contact tracing is undertaken as soon as possible as it hinders efforts to test, isolate and manage patients.

The reproduction number is the expected total of cases directly caused by a case in a population where all people are vulnerable to infection.

Health Chief Administrative Secretary Rashid Aman confirmed that contact tracing has been a challenge in the country, especially in hot spots such as Nairobi.

“The more positive cases we have means there is an exponential number of contacts to be traced and this poses challenges. This became an even bigger challenge when contact tracing became a responsibility of the counties,” he said.

He added, however, that despite all the setbacks in testing and contact tracing, he is confident the country is slowly flattening the curve.

Little testing

But as Kenya claims it’s flattening the curve, statistics show the samples tested in a day have been very low.

From over 8,000 a day, Kenya has reduced to 3,500 samples a day and no longer conducts mass testing, without which it is not easy to determine the spread of the disease in communities.

Due to an inadequate capacity, the ministry has opted to test symptomatic and high-risk groups including essential workers such as those in the health sector and truck drivers.

Meanwhile, the Kenya Medical Research Institute (Kemri) has published a paper stating that Covid-19 infections peaked in July.

"We estimate that the SARS-CoV-2 pandemic peaked before the end of July in the major urban counties, with 34 – 41 per cent of residents infected, and will peak elsewhere in the country within 2-3 months,” says Kemri.

“Despite this penetration, reported severe cases and deaths are low. The Covid-19 disease burden in Kenya may be far less than initially feared. A similar scenario across sub-Saharan Africa would have implications for balancing the consequences of restrictions with those of Covid-19.”