Communities are at the heart of the Covid-19 response.
This is the key message shared daily by public health experts as we navigate the murky waters in management of the pandemic.
However, it is sad to note that in some communities very little is happening to ensure that the transmissions are kept at a minimum.
Today we wear 4 lenses as we discuss the impact of Covid-19 in Africa, particularly in Kenya.
Each life matters.
It took 12 weeks for the world to reach 400,000 cases of COVID-19. According to the World Health Organisation, there have now been 12 million cases of COVID-19 and more than 535,000 lives have been lost, globally in seven months.
Closer home, the number of coronavirus cases in Kenya so far stand at 8,528 distributed in 14 counties with 169 deaths reported since the first case was reported in Kenya on 13 March, 2020.
Globally the following has worked.
Find, isolate, test and care for every case, trace and quarantine every contact, equip and train health workers and educate and empower communities to protect themselves and others.
But it has not been this easy and straight forward.
The sad news from health experts is that alterations to work and social life could last until a vaccine is available. As the outbreak accelerates in Kenya too, here are a few thoughts from two experts on coming days.
Prof Thumbi Mwangi, an Clinical Associate Professor at the Washington State University observes that even with the lifting of restrictions on movement in Kenya on Monday 6 June, the observance of the public health regulations will be a tall order.
Personal discipline to wear appropriate face masks, to wash hands with soap and water, to restrict movement to hot spots and observe social distance has proved a challenge.
“The opening of the borders is likely to cede new infections. We have several persons who seem healthy yet they are super spreaders of Covid-19,” Prof Thumbi said.
The only way we will maintain the cases at manageable levels now is to ensure that persons who have travelled from the hotspots observe social distance and continually wear masks, he added.
But is this realistic?
Your guess is as good as mine.
If we cannot obey monitored movement restrictions in and out of hotspots, do you expect the unregulated wearing of masks and other health measures to be followed?
As myths abound on the reason Africa is reporting fewer cases compared to other countries beyond the continent, the fallacies increase their believability every day.
A recent survey conducted in March and April in 28 cities across 20 African Union Member States, by the Africa CDC, the World Health Organisation, the World Economic Forum and other bodies formed a consortium, PERC, showed that less than half the people interviewed in a recent study conducted by on COVID-19 pandemic believed they faced the risk of contracting the virus.
In fact, more than 60% believed that COVID-19 could be prevented by drinking lemon or taking vitamin C.
And just over 40% believed that Africans could not get COVID-19. Another 7 out of every 10 respondents about 73% thought that a hot climate prevented the spread of the virus?
But how far is Kenya from flattening the curve?
According to Prof Thumbi, Kenya is expected to continue with the trend of a steep increase in the cases of Covid-19.
“We are on an exponential rise. Cases beget cases hence the more cases we test and report, the more we get,” he said. Prof Thumbi notes that the peak of cases is expected to be between September and October before the cases assume a downward trend.
Does opening the air spaces pose more dangers of spiking the in-country case
Prof Thumbi doesn’t think so. “The greatest danger is unlikely to be I due to the imported cases from other countries. We already have community transmission. There will be no big impact since we already have cases here in Kenya,” he said.
He called for concerted efforts to strengthen the health systems to take care of the increases cases.
On livelihoods, an April World Bank report observed that COVID-19 (coronavirus) is predicted to further reduce Kenya’s growth, with significant impacts on the services, manufacturing and agriculture sectors.
The World Bank observes that the cost of social distancing is aggravated by the country’s large informal sector, high poverty rate, and unemployed youth population.
“As we balance lives and livelihoods, this needs to be accompanied by measures that do not burden the health system,” Prof Thumbi said.
The World Bank further recommends strengthening the health system’s capacity to cope with potential spikes in COVID-19 cases, and to flatten
epidemic curve over the short run through health policy containment measures.
This should remain a top priority, the World Bank advises.
What’s in the long-term?
According to Dr Emmanuel Agogo who is the Nigeria Country Representative of the Resolve to Save Lives initiative, Africa’s swift response to the COVID-19 pandemic has bought valuable time for governments. “But to get ahead of the coronavirus, countries will need to build public health systems that are better able to find, stop and prevent new cases,” Dr Agogo said.
And as countries like Kenya opened up, Dr Agogo noted that governments should remain prepared to reinstate PHSMs should cases increase and engage continually with affected communities to keep them informed and involved.
WHO Director General Dr Tedros Adhanom Ghebreyesus has reiterated the need for robust and flexible health systems to cope with the pandemic while also ensuring the delivery of essential health services.
What are long term approaches can Africa employ to manage the increasing cases everyday?
A joint research paper published in the Lancet this week by Pascale Ondoa from the African Society for Laboratory Medicine in Addis Ababa, Ethiopia and colleagues calls upon countries in Africa to institutionalise knowledge and resources, to routinely collect and analyse information on the capacity and functionality of national laboratory networks.
“This will fast-track the selection of facilities most amenable to repurposing or upgrading testing services; calculation of fastest routes for transporting sample or supplies; and reduction of geographical areas with unmet demand for health services,” the researchers noted.
Secondly the experts challenged countries to implement national laboratory quality management policies to ensure routine provision of quality-assured results at all tiers of the national laboratory network.
Finally, a clarion call was made to Africa to reduce its dependency on external expertise for diagnostics.
“Africa needs to produce high-quality diagnostics,” the researchers concluded.