This archive report was first published on 13 July 2020.
On March 13, 2020, Kenya confirmed its first case of Covid-19, and the government set out to stop the virus with a strategy of testing, tracing, and isolating infected individuals. The goal was to test and find infected people, isolate and treat them, as their close contacts were traced and put under watch in quarantine.
However, four months later, the country seems to have lost the plot, with some of the measures being abandoned as infections continue to soar. A spot-check by the Nation reveals that political announcements and the reality on the ground parted ways, with patchwork and appendages now underway on the initial strategy.
One of the key areas where the ball may have dropped is testing. From the beginning, the country had a monumental problem with testing, managing a dismal 50 tests per every positive case in May. In contrast, South Africa, Uganda, and Rwanda were conducting 200,000, 333, and 100 tests respectively.
Things have improved in recent weeks, with 207,897 suspected cases being tested and 9,726 found positive. However, this falls short of the government's target to test 250,000 people by the end of June. As the cases continue to rise, demand for testing has soared, surpassing capacity and creating a new crisis.
Targeted mass testing that had been launched in virus hotspots has since stopped. The Kenya Medical Association Vice-President, Prof Lukoye Atwoli, said the country's capacity to test has not increased as anticipated, and many people could have the virus and are not aware of it.
Prof Atwoli added that asymptomatic patients are likely to continue spreading the virus unknowingly, with the recent relaxation of containment rules. He believes that more testing is needed to detect the actual number of people who have the virus in the community.
Dr Andrew Suleh, a consultant physician, renal, and tropical medicine specialist, said a combination of factors has fuelled the problem, including a shortage of testing kits and materials, backlogs at laboratories, and a surge in cases that have spread to 41 counties.
Dr Suleh also noted that the government's reliance on donated kits has been detrimental to the testing component of the strategy. He suggested that the government should have considered testing high-density and traffic areas.
Another area where the strategy may have failed is contact tracing. When the first case was reported, the government swung into action and traced all those who had come into contact with the patient. However, as the cases crossed the 2,000 mark, things became thick, and Mr Kagwe revealed that some suspected patients were even giving false phone numbers to avoid quarantine.
The ministry's latest situation report notes that little contact tracing is ongoing amid community infections. Only eight out of 47 counties are submitting reports, and 28 counties with active cases did not submit their updates on contact tracing.
Dr Majid Twahir, the associate dean for clinical affairs and chief of staff at Aga Khan University Hospital, said that contact tracing was working in the initial stages because there were few chains of transmission. However, as the cases kept rising and spreading to almost all counties, especially in rural areas, it became hard to do effective contact tracing.
Dr Twahir proposed that the government consider getting more community health volunteers to do contact tracing, moving forward, as this will ensure reduction in transmission and allow the reopening of economic activities while attaining a manageable impact on the healthcare system.
Professor Atwoli said tracing of people who have interacted with Covid-19 patients may have failed because it requires a significant resource outlay. He suggested that countries that have introduced contact tracing apps that track the location or identify contacts to automatically gather data and inform people if they need to self-isolate.
Dr Francis Kuria, an incident commander, Contact Tracing and Data Management, said human resources is a big challenge. He noted that they only have four employees, while the remaining 28 are volunteers, and managing volunteers is not an easy task.
Dr Kuria also said that tracing and calling one person costs Sh50, and on average, one person has about 15 contacts, and millions of people are being traced. He noted that you cannot trace everyone and that when a contact is missed, a track is lost.
Isolation and quarantine were aimed at preventing exposure to people who had or were suspected to have Covid-19. However, a spot check in various quarantine facilities has revealed that a majority of people in those sites are those who have travelled from abroad without Covid-19 free certificates or those who had not applied for home quarantine prior to their travel.
