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Gloomy year ahead under Covid-19 cloud

THE STANDARD INSIDER
By Daniel Wesangula | July 19th 2020
A man wearing a mask. Kenyans have been advised to wear masks following the outbreak of Covid-19 [Elvis Ogina, Standard]

Kenya’s coronavirus projections keep moving from bad to worse. New data from a government report paints a grim picture of the year ahead, what could see more than 30 million people infected with the disease.

And to keep up with the anticipated surge in infections, the country would require to do 10 million tests by February next year – way higher than the estimated current capacity of 2.6 million tests a year. 

It gets worse. With the soaring numbers, it is also projected that the country will run out of test kits when infection is at its highest, and transmission at its peak in September this year.

This could potentially leave millions of Kenyans suffering with the virus, but with no way of confirming whether they have the disease.

These two factors – a surge in numbers and lack of testing kits – could make for a devastating year ahead for a country whose public healthcare system is already on the ropes following years of mismanagement and inadequate investment.

The report, Targeted Testing Strategy for Coronavirus Disease in Kenya, projects that by November next year, 31 million Kenyans will have been infected by the virus, going by current transmission rates. And the death toll could reach heart-breaking numbers.

“In the worst-case scenario, up to 88 per cent of the population could be infected in the period between March 2020 to January 2021,” the data shows.

The new report that was recently shared with technocrats in the coronavirus task-force aims at defining the most appropriate approach to achieve the current testing needs of the country in a bid to manage the spread of the virus.

The Health ministry document, however, also uncovers some uncomfortable truths about what lies ahead and how the ongoing coronavirus response is close to collapse.

It details how precarious the country’s testing ability is at the moment, and just how close our national laboratories are to running out of key testing equipment, unless something drastically changes.

Biggest economy

Seven months after the pandemic broke out, Kenya, the region’s biggest economy, is still struggling to figure out how best to deal with it.

A key response to the disease globally has been mass testing of the population, a critical area that the country has been struggling with since confirmation of the first case on March 13.

“If 68 per cent of the population ends up infected, and assuming that 10-15 per cent of those will be symptomatic and will therefore need medical attention and testing, then in a population of 48 million people, at least 3.2 million to 4.8 million people will need at least two tests each.

"As per management protocols, these individuals will need one test to confirm their status, and a second test to ascertain their recovery. Apart from this, categories of individuals considered as potential super- spreaders and those at high risk such as truck drivers and remandees ought to be under constant surveillance, ideally receiving tests every two weeks.

“This approach will result into several hundred thousand tests over one year,” the report reads. “It is therefore safe to assume that up to 10 million tests will be needed by February 2021.”

But even if the country is able to acquire more testing kits, it has to surmount another challenge: it does not have the capacity to run the required number of tests to stay ahead of the disease.

"Laboratory testing for Covid-19 is critical in tracking the virus, understanding epidemiology, informing case management and breaking chains of transmission,” says the Health minis try.

But The Standard on Sunday has established that currently, only 28 laboratories countrywide have the capacity to successfully run Covid-19 tests. If all of them dedicate their existing equipment to the task, they can handle a total of 7,300 samples daily if all manual and automated platforms are utilised and, more crucially, if they have adequate numbers of reagents.

This translates to around 50,000 tests a week and 2.6 million tests a year. Although this looks impressive, it still falls short of the recommended Ministry of Health testing numbers.

According to the ministry, the country needs to conduct 10 million tests in the same period to stay ahead of the coronavirus curve. "The existing capacities for testing have been unable to match the demand for testing,” the report shows.

The country also does not have adequate testing kits. Since the outbreak of the disease, Kenya has so far procured 130,000 tests. According to the government, another 180,000 kits from well-wishers were received on June 11.

But the projected demand for test kits between now and September stands at 730,000, meaning the country may run out of this crucial equipment in the next few weeks.

The Health ministry, however, says it has placed more orders with four international companies: SD Biosensor, Roche, Abbott and Sansure. The kits are expected in the country between August and November.

Commenting on the report, Health Cabinet Secretary Mutahi Kagwe said testing ought to be targeted and, therefore, efficient.

But even if these orders are met by the manufacturers, the country will still fall short of its intended target by 255,472 test kits. Alarmingly, this shortfall could coincide with the projected peaking of the disease in September.

“There is an urgent need to plan procurement for the country going forward,” the report reads. “This plan will prevent stockouts to support the Covid-19 pandemic outbreak in the country.”

State agencies have come up with procurement plans that could see an enhancement of the country’s testing capabilities. But this depends on the global supply-demand chain as well as new emerging trends in the management of Covid-19 cases worldwide.

Health Principal Secretary Susan Mochache, however, said change of strategy in testing would be cost-effective and thereby maximise on the few available resources.

Director of Public Health Francis Kuria and Quality Assurance In-charge Simon Kibias led a team composed of local and international specialists, including the WHO and America’s CDC, in developing and testing the new strategy.

To deal with the health emergency, the government has formed a team to deal with procurement plans for these crucial test kits, testing equipment and reagents. “A committee has been set up with representation from all major testing laboratories to review requirements and to determine the quantities that each lab is allocated,” the report reads.

Kenya leads the region on numbers tested, number of positive cases as well as numbers of those who have died from the disease. But initial containment measures, originally thought to have slowed spread of the disease, have been lifted.

This has created fear that September will not only see the highest number of recorded cases, but also the highest number of fatalities from the disease. 

In the early months of the outbreak, testing posed a significant problem due to lack of supplies, as officials raced to understand how to best contain the disease. Four months after the first case, progress in containing the disease looks to be slow and painful.

The lifting of travel restrictions looks to have transferred this ill-understood and poorly handled problem to other parts of the nation that are hardly prepared to handle the projected explosion of the virus.

To date, the virus first discovered in the Chinese city of Wuhan is finding new victims daily. More than 450 healthcare workers have tested positive despite valiant efforts to be the vanguard against the disease.

Offices have not been spared either, with government departments and agencies confirming that scores of employees have contracted Covid-19.

More infections could follow from bars and restaurants that are operating under strict guidelines. Then there are the churches that have been allowed to reopen after months of closure.

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