Haphazard Covid-19 response worries medical experts

Medical experts are concerned that haphazard enforcement of Covid-19 preventive measures could cause a sharp rise in new cases.

The medics are calling for caution as the government hastens the process of reopening schools.

On October 12, learners began flocking back to schools after Education Cabinet Secretary George Magoha announced October 12 as the reopening date.

However, Covid-19 cases are rising, with 442 cases recorded on October 10,538 on October 11, 388 on October 12, 318 on October 13, 604 on October 14 and 602 on October 15. By October 19, the case load had jumped to 685.

So far, 832 people have died from 44,881 reported cases of the disease in the country, with 31,857 recoveries recorded.

Concerns are rising among parents that the reopening of schools could set the stage for a resurgence of infections countrywide.

Speaking on a local television show on the resurgence, infectious diseases specialist Dr Lois Ombajo noted that the country flattened the curve in July and August but this is changing.

Dr Ombajo also said the numbers of new patients in need of hospital admission indicates a worrying trend.

"The numbers of people sick enough to require hospitalisation are going up. This trend has been noted even in counties that have previously recorded low numbers," She said in Nairobi on Sunday.

Special groups

Dr Ombajo, a University of Nairobi lecturer and head of the Infectious Disease Unit at the Kenyatta National Hospital, said relaxed movement restrictions made the prospect of keeping children at home a difficult one.

She admitted, however, that it will be equally hard to ensure they are kept free of infection in the school environment.

"If people are moving around in large numbers, we cannot keep the children any safer by confining them at home. It is going to be a tall order but we have to try and minimise the risk of getting infected" she said.

Dr Ombajo said the government could be forced to close schools in case of a wave of new infections.

"We are open to the idea of closing schools if the numbers go up. Let us not try and crucify the Education minister too much over the issue," she said.

The medic said the relatively youthful African population could be one of the reasons why Africa’s numbers have generally remained low.

But she noted that it is to protect older people from getting infected by children going to school.

"People who are older or have pre-existing conditions should be shielded from infection. One of the best ways to do it is to make sure we are not taking the infection back to them at home," Dr Ombajo said.

She regretted the casual attitude Kenyans have adopted towards the pandemic, saying it is the main reason they have dropped their guard.

"It still surprises me that after seven months of the pandemic,  we still wonder whether or not the virus exists.”

She said the tendency for politicians to hold large rallies is also driving the abandonment of safety precautions among the citizens.

"Who controls the political rallies? In the midst of such a critical public health threat, why should you have a rally with hundreds of people shouting, singing and standing close to each other? Someone should crack a whip on the rallies.”

The basics

Amref Health Africa chief executive Dr Githinji Gitahi said the fight against the pandemic will only be won once Kenyans fully embrace the preventive measures from home.

He said the home environment is the most effective place for children to learn the best way to avoid infection.

"It's critical to understand that response is a national effort, not merely a government issue. Children watch and learn from adults. Whatever you do at home will affect your family," he said.

Dr Gitahi further said there is a need for Kenyans to adopt and embrace the handwashing measures recommended by the World Health Organization (WHO) and other health agencies.

He termed handwashing the most neglected public health measure yet it has the biggest impact on reducing respiratory infections and diarrhoeal diseases once adopted.

He said it is necessary for the government to ensure all schools have enough running water to enable learners practise effective handwashing.

"We cannot disobey the recommended measures while making noise about what we see as inadequate safety measures in schools.”

Both medics insisted on the need for Kenyans to wear masks, wash hands, apply cough etiquette and practice social distancing to stop the spread of the virus.

Risk remains

Dr Gitahi said it is too early for Kenyans to rest on their laurels as far as pandemic preparedness is concerned, noting the risk of infection will remain for as long as there is no vaccine.

"The risk of getting infected will not go away until we have a vaccine, and even this will not be seen as addressed until the majority of the population is vaccinated," he said.

Citing measles as an example, he said the population can only achieve herd immunity or communitywide protection against the disease after 95 per cent of the population is vaccinated.

"If we let the percentage immunisation coverage for measles drop from 95 to just 90 per cent, we will begin to experience outbreaks. This shows us how important it is to minimise the risk of future outbreaks by vaccinating as many at-risk people as we can," said Dr Gitahi.

The medic said a proper administration system must also be put in place before the vaccine becomes available in Kenya.

"We need a system to determine who gets the vaccine. This will prevent the possibility of influential people hoarding it for themselves once it arrives in the country," he said.

He pointed out that the World Health Organization (WHO), in recent estimates, said up to 10 per cent of the global population has been exposed to the novel coronavirus that causes Covid-19.

 "The 37 million cases that have so far been recorded worldwide account for only about 0.5 per cent of the global population. This means a large number of cases have not been accounted for through testing and treatment," he said.

Vaccine trials

Dr Ombajo said experts estimated that the earliest date a vaccine can be expected is between June and July 2021.

"The vaccines in development are undergoing tests and studies to determine whether they are effective and safe for use. Once the human clinical trials show they are safe, they can be produced on a large scale" the medic said.

Dr Ombajo further said it is important for African nations to get involved in the vaccine development process as this will place them in a prime position for initial doses.

"African countries have to sit at the table during vaccine development, otherwise we will find ourselves grappling with delayed access to the vaccines for up to five years," she said.

The expert called on the government to make available the pneumonia vaccine for children under five.

"We need a policy that allows administration of the vaccine to the elderly as well as another vaccine that protects against the bacteria that causes pneumonia," she said.

Echoing her call, Dr Gitahi said the country should vaccinate at least 95 per cent of the vulnerable population so as to achieve herd immunity for the country.

He rooted for increased testing and treatment despite the fact that most people who get infected do not require hospitalisation and other forms of treatment.

Increased testing and treatment will reduce or eliminate chances of transmission by infected people, he said.

"We still need to test and treat infected people so that the average force of transmission is reduced to one infected person infecting one another or less. This will ensure fewer people are infected or hospitalised due to infection. A scenario where one person spreads the disease to three to five people or more is dangerous as it is the community transmission stage that results in high numbers of people getting infected daily," he said.