On September 18, when USA President Joe Biden said, “the pandemic is over,” Kenyans might as well have been ahead of him.
A spot check by Health & Science in Nairobi, Nakuru and Eldoret found that a few people were wearing masks. Social distancing has also been disregarded especially in entertainment joints which are full to capacity.
However, latest figures from the Ministry of Health are showing an upsurge in new Covid-19 infections.
It is not far-fetched to say that currently, many Kenyans are pretty nonchalant about Covid-19. But those who contracted coronavirus – and are still ‘sick’ – might offer a word of caution: that the disease may cause long-term effects.
As the world moves on evidence shows that millions - Kenyans included - are wallowing in the aftershocks of Covid-19 infection almost unrecognized.
Take Leah Chebitwey for instance. She says: “I have had to undergo physiotherapy to learn, again, how to balance and walk.”
It has been more than a year since she tested positive for Covid-19 but she is still struggling to get back on her feet.
Her biggest challenge is memory loss. “I have partially lost memory. I meet people who know me but I can’t remember them,” she says.
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Chebitwey spent close to three months in Intensive Care Unit battling the virus. She was discharged after testing negative and regaining the ability to breath on her own. However, it was after the discharge that real work to regain her health began.
“I struggled to converse. I had forgotten how to say some words. I couldn’t even open my mouth to talk. I had to write on paper to communicate,” she says.
“I have partially lost my memory. For instance, I don’t remember some critical events in my life before I was taken ill. I also don’t remember some faces. It is common for me to lose my trail of thought.”
“I have been getting better with each passing day. There are days I feel too tired to even take a walk: I just want to eat and sleep,” Chebitwey says.
At the height of the pandemic, World Health Organisation (WHO) advised that those who tested positive should isolate for 21 days: the period of active infection.
“After four weeks we do not expect the patient to test positive for the virus,” says Dr Salim Masoud, a chest specialist and pulmonologist at Nairobi South Hospital.
It is therefore strange that someone who is testing negative for the virus continues to be unwell months after healing.
“The phenomenon of long Covid is still being studied,” says Masoud. “As doctors, we are learning more about it as we go.”
WHO defines long covid as post Covid-19 condition, usually three months from the onset of symptoms, lasting for at least two months and cannot be explained by an alternative diagnosis.
In a recent interview on statnews.com, Dr Wes Ely, a pulmonary and critical care specialist at Vanderbilt University Medical Center in Tennessee, USA, had a humbling appreciation of long covid.
“What happens is that over ensuing weeks and months, your body takes on a new set of diseases that you did not have at the end of acute Covid,” he says.
Dr Shamsa Ahmed, the Head of Infectious Disease Unit at MP-Shah Hospital in Nairobi says: “Long covid is real. But the patient has no active virus. It is confusing. But think of it as the scarring left when a stab wound heals – it’s never quite the same as before the stabbing happened.”
When Wacuka Gichohi went back to her doctor, with a slew of symptoms, including migraine, heart palpitation, hallucination, buzzing noise, panic attacks, memory loss, severe fatigue, exercise intolerance and insomnia, the medic told her to seek psychological help.
‘In other words, it was “all in my head,”’ she wrote on her social media timeline in December 2020.
Gichohi says she contracted the virus in March 2020 after a trip to Europe. “I developed a sore throat, fatigue, acid reflux, a headache, body aches and chest pain,” she writes.
It was therefore a shock for her that in May, weeks after seemingly having healed from Covid-19, she was still exhibiting symptoms.
According to Gichohi, not many doctors understand long covid and are therefore dismissive.
She founded ‘Long Covid Kenya Support Group’ on Facebook, which by the time of interview had 128 members.
The true anatomy of long covid is yet to be deciphered. In fact, there is no test for long covid. However, emerging data from around the world offer valuable information.
For instance, Center for Disease Control and Prevention (CDC) June 2022 estimation shows one in five adults in USA with a known prior case of Covid-19, had symptoms of long covid.
New modelling by the Institute for Health Metrics and Evaluation (IHME) shows that in 2020 and 2021 at least 17 million people in the 53 member states of the WHO-European Region may have experienced at least one long covid symptom.
According to WHO the most common symptoms of long covid, are fatigue, shortness of breath and cognitive dysfunction.
Dr Masoud says: “Every patient is different. One patient’s symptoms may be very different from another.”
Patrick Kirimi, who was hospitalised for more than two months after he contracted Covid-19 in March 2021, says he has become increasingly forgetful.
“First, the process of healing was slow. Even after I was discharged I was constantly fatigued. I am still struggling with severe exhaustion. I am also very forgetful – something I did not experience before Covid,” he says.
One would expect long covid to affect those who were severely ill with the virus. But Dr Shamsa says the condition can affect anyone who got infected.
“You may have been asymptomatic but then suddenly you are experiencing extreme malaise from long covid,” she says.
Dr Shamsa warns that some categories of people have a higher probability of developing long covid.
“If you are obese, are older, have an underlying condition or are a woman, your chances of developing long covid are higher than average,” she says.
The US Census Bureau conducted a Household Pulse Survey 2022. A meta-analysis of data from the survey shows that women were more likely than men to currently have long covid: 9.4 per cent versus 5.5 per cent.
Evidence suggests that vaccination against the virus resulted in good outcomes; including reduced possibility of a patient developing long covid.
Another meta-analysis of 15 studies, done by the UK Health Security Agency, found that vaccinated people who are subsequently infected with Covid-19 are less likely to report symptoms of long covid.
The 2022 World Population Data Sheet (WPDS 2022) shows that in Seychelles – where 82 per cent of the population got fully vaccinated – there were no excess deaths that could be blamed on covid-19.
Published on September 8 by Population Reference Bureau (PRB), WPDS 2022 shows that Kenya experienced a 2 per cent jump in annual deaths during the pandemic than would have been expected in the pandemic’s absence. As at July 2022, just 32.3 per cent of Kenyan adults had been fully vaccinated.
“That is why I have advised my patients and Kenyans generally to get full dose vaccines, and if possible, booster shots too,” says Dr Shamsa.
In October, Chebitwey celebrated her birthday. She is placing hope on God to get her back to full health.
Gichohi is currently working with doctors, as well as other health professionals, with experience in alternative therapies to battle long covid.
“Things have never been the same again. I can’t say there are good days. But some days are better than others,” she says.
Kirimi is back to his exercise routine before Covid-19. Despite feeling tired and worn out on many days, he runs 12km every morning.
The pandemic is now in its third year. It has thus far led to 12 per cent more deaths globally – according to PRB’s WPDS 2022.
Even so, the world – Kenya included – is entering a new post-infectious phase of the pandemic with a lot of unknowns much like Covid-19 outbreak.