Valuable lessons for Kenya from nations hard hit by virus

In three months Covid-19 spread from Wuhan district in China to all parts of the world. The pandemic is sweeping across the globe like bush fire. Both rich and poor nations are equally affected irrespective of their economic might and technological advancement in health service delivery. The Covid-19 epidemic has astonished the medical fraternity. The number of cases caused by the pandemic as of April 8, is 1,455,996 cases and 83,688 deaths.

Lessons from Italy and Spain

Italy’s experience of the coronavirus provides lessons for the world. In the critical early days of the outbreak, Italian Prime Minister Giuseppe Conte and other top officials down played the threat and no serious action was taken. Italy’s bit by bit actions to stop the virus outbreak such as isolating towns, regions and then shut down of the entire country a strategy for containing the outbreak didn’t work. In March, the daily deaths were between 700 and 900.

The Italian government put in place more tougher measures- nationwide lockdown. The lockdown is believed to have reduced the cases, in April, the latest death toll was 525 people. Currently, Italy has 135,586 cases and 17,127 deaths. The tragedy of Italy now stands as a warning to other countries.

In Spain, the first mainland cases were confirmed on February 26 in Madrid and Barcelona, the public hospitals in Spain sounded alarm bells, asking the Ministry of Health to undertake more test as soon as possible. The measures were not promptly instituted until the number of cases drastically increased- we had one and half month to get prepared and respond appropriately after the first case and we had weeks to prepare after watching what was happening in Italy said Angela Henandez a senior official at a health labor union in Madrid the Spanish epicentre of the Covid-19 outbreak. Spain became the second most affected county in Europe after Italy with 146,690 cases and 14,555 deaths.

Similarly the US pandemic response was slow phased resulting in massive spread of the Covid-19. USA now leads in the number of cases in the world, 404,156 cases and 12,988 deaths surpassing China.

Lessons from China

China responded in a robust way. In mid-January, China stopped movement in and out of Wuhan the epicenter of the epidemic and 15 other cities in Hubei province restricting the mobility of 60 million people by suspending  trains and flights. Immediately after the first phase, China extended the lockdown to other cities restricting the movement of 760 million people. According to Mr Michael Osterholm an infectious disease scientist at the university of Minnesota, Minneapolis, USA, the extreme measures introduced by the Chinese authorities have been very successfully.

Which way for Kenya? 

Kenya is at a crossroads - will it go the Italy and Spain way or the Chinese way? Kenya should have put in place strong coronavirus outbreak response strategies long before the first case. The most effective disaster response approach including disease outbreaks is to anticipate, go into an emergency mode, put in place an emergency preparedness plan. When the first case was confirmed on March 12, serious emergency responses were required.

There were missed opportunities-quick banning of flights from affected countries, stopping of passengers from affected countries. Other misstep included poor management of quarantine and contact tracing. The cessation of movements of people from Nairobi and some coastal counties by the President was good but it is too little too late. In Kenya, we are still in the comfort zone and not responding appropriately.

The latest reports of the disease spread to new counties is worrying, another wake up call for the country. Do we have a high level of preparedness at the county level? No, are counties able to handle a disaster the level of coronavirus? No. Are there adequate equipment at the county? No. Do we have adequately prepared and motivated staff at the county level? No

In China, Spain and Italy, deaths of doctors, nurses and other cadres were reported. Kenya must considers this as a valuable lesson and take deliberate actions for protecting the health workers by drawing an irreducible minimum standards for health worker professionals in the Covid 19 war. Like Spain did, the best way forward will be for the President to declare this as a national public health disaster, the national government takes lead in the response and put in place un-precedented  national and county level emergency measures. If the Covid 19 epidemic has shaken the health delivery systems in the US, UK, Italy and Spain - is Kenya ready?

-The writer is a public health consultant