How Kenya managed a low fatality rate

Health workers at work during the Coronavirus mass testing. [Elvis Ogina/Standard]

It has been 100 days since the coronavirus disease was detected in Kenya, with the number of confirmed infections rising steadily, reflecting an increase in the samples tested.

Health officials have tested slightly more than half the projected 250,000 people anticipated by the end of June, which suggests new Covid-19 cases will continue to be announced in coming days if mass testing is scaled up.

Major interventions were imposed to curb the spread of the virus in the early days of its landing within Kenyan borders, which has informed the rather slow rise in the number of new infections.

However, the limited capacity to test, even going by the government’s own projections, might be understating the extent of the disease.

Infection rate

Kenya has cumulatively identified 4,374 positive cases from 133,541 test samples, which presents an infection rate of 3.3 per cent.

Unless laboratories are able to examine more than 15,000 samples every day until June 30, the government’s goal of 250,000 tests is unlikely to be met. Among the reasons making the target largely unachievable is the limited number of testing kits and testing capacities in the private and government-owned laboratories.

However, on April 22, Health Cabinet Secretary Mutahi Kagwe indicated that there were enough testing kits to achieve the set target - but with the wisdom of hindsight, this may have been an overstatement. “Globally, every country is working on testing targets. All have fallen short of these targets because of disrupted global supply chain. Our plan is to conduct 250,000 tests by June,” said the CS in his projections.

He spoke on the day the country breathed a sigh of relief after its first coronavirus patient, who was identified as Brenda Cherono, was discharged from hospital, marking the first recovery from Covid-19.

Kenya’s first confirmed positive case was determined on March 12 and announced to the nation the following day. Daily deaths have since then remained in the single digits, until Wednesday when the number rose to 10.

It was the deadliest day for Covid-19, whose first victim, a 66-year-old man, died on March 26.

By yesterday, the death toll stood at 119, with a 2.7 per cent fatality rate.

But in all the data announced during the Ministry of Health’s briefings over the past three months, there has been a direct correlation between sample sizes and the number of confirmed infections, meaning if more people are tested then more patients are likely to be discovered.

Further, it has been confirmed that there is a huge population of infected people who are not showing any symptoms, an indication that the spread of the virus is being underreported.

But without a commensurate surge in unexplained deaths across the country, the government appears to have moved to reopen the economy, even as officials emphasise the continued need for the observance of public health guidelines, including physical distance, hand washing and the compulsory wearing of masks.

Hitting the peak

Projections based on official data on infections and deaths show the country is far from hitting the peak of the pandemic.

Joachim Osur, a medical doctor based in Nairobi, said Kenya’s progression in the number of infections and deaths has been significantly lower compared to several other nations, owing to early State interventions that included closing of schools. “I think we have done very well compared to many countries whose recorded number of infections and deaths has been huge,” he said.

“With the slow pace of progression of the disease, we have been allowed a lot more time to prepare to fight, including the expanded capacities in all healthcare facilities.”

In Osur’s estimations, which are informed by the daily statistics on confirmed infections announced by the Ministry of Health, the cases could peak in August or September, after which there should be a reduction in numbers.

The doctor concurs that increasing testing capacities would raise the number of new infections, and while many of them are likely to be asymptomatic, they may be at no risk of death but would be super spreaders of the virus.

The onset of the cold season could further inform a spike in new infections given the lessons learnt from the worst-hit countries, which all have colder climate and higher levels of humidity, Osur said.

Regionally, it has been difficult to compare Kenya’s situation to its neighbours, especially Tanzania, where authorities have ignored the virus and kept the economy open.

On June 8, President John Magufuli declared his country free of coronavirus, thanks to the prayers of Tanzanians. The country last released data on the viral disease on April 29, saying there were 509 cases, with 21 death. Last week, Magufuli said there were only four active cases.

Burundi, another neighbour in the region, has been accused of downplaying the spread of the virus. There were numerous reports that Covid-19 led to the death of its president, Pierre Nkurunziza, on June 8, but the official government statement said the long-serving leader died of cardiac arrest. At the time, Burundi had recorded just over 80 cases of Covid-19 and one death.