By Dr. Kevin O. Opondo
The COVID-19 disease continues to cause immense public health pressure in many countries including Kenya. Transportation by aeroplane has brought the disease to the doorsteps of now about 214 countries across the globe.
In Kenya, analysis of the daily data as reported by the Health Cabinet Secretary, Mutahi Kagwe, indicates that the number of cases arising from any single case is 4-5 new infections compared to world average of 2.5-3. Technically, this means that about 4-5 infected persons (diagnosed or not) in Kenya are interacting with susceptible individuals.
Transportation and movement from one city/town to another has been the main mode of spread of the virus. In countries with advanced transport systems like in Europe and US, the virus spread quickly in many regions before they could impose measures that limit transportation.
From the national data, and with limited testing capabilities, Kenya is unsure whether all the cases have been recorded to allow epidemiologists to study the trends. Soon, more counties will start reporting cases and the national numbers will double each day.
Kenya has county governments that can be useful in coordinating and limiting inter-county travels/movements. This presents a unique opportunity to limit and contain the virus in the few counties that covid-19 has been diagnosed in including Nairobi, Mombasa, Kwale, Kilifi and Turkana and possibly Nakuru.
Human Resource for Health (HRH) stands at 10 per 10,000 population in most counties, far below the recommended 23 per 10,000.It means the country does not have enough health workers to respond to COVID-19 patients in all counties.Limiting the disease to the few counties where it has been reported allows us tomaximize our HRH and a possibility of sending additional health workers to support the 5 counties. This offers unequivocal advantage on the need to ban inter-county movement and enhancing testing at highway border points.
Further, Kenya is not adequately prepared to handle more than 500 severe cases of COVID-19 disease due to limited health care facilities.These patients need to be handled with the utmost care and precaution due to the high rate of spread to susceptible individuals.Presently, health care systems outside Nairobi especially those around Lake Victoria handle major diseases like HIV/AIDS, TB, Malaria, diarrhoea, worms and other tropical diseases and they must not be further burdened by COVID-19 patients.
With a stressed health care system and no known cure for the COVID-19 disease, prevention is the best action for Kenya. If COVID-19 spreads, its patients will take the resources (practitioners and commodities) that would have otherwise been used by other ailments.
Limiting the spread means we can focus on the major diseases in Kenya.
Economists may offer suggestions on how to deal with the economic impact of inter-county travel restrictions. An exemption could be given to suppliers of food and basic commodities to ensure continuous supply of basic goods and services. For example, Kisumu County depend on neighbouring western counties for food. Counties could create task-forces that coordinate the collection of food/commodities from farmers for onward distribution.
(The author is a disease Control Expert. Views expressed here are his and does not represent views of the organization he works for)