Emergency centre has greatly boosted Covid-19 response

A health worker carries out a Covid-19 test on a man?. [Courtesy]

A critical responsibility of a healthcare system is to conduct surveillance and coordinate rapid response to public health threats and events that could affect populations and overwhelm the health system.

Covid-19 is one such threat that requires continuous surveillance to ensure it does not overwhelm the healthcare system. Other threats that require continuous surveillance include haemorrhagic fevers like Ebola, Rift Valley Fever and Yellow Fever, cholera and vaccine-preventable diseases like polio and measles.

Aware of the critical need for this surveillance, the Ministry of Health, with the support of the World Health Organisation inaugurated the Public Health Emergency Operations Centre (PHEOC) in May 2016. The centre, domiciled in the ministry’s Directorate of Public Health is responsible for the collection, collation, analysis, presentation and utilisation of health event data and information; timely, event-specific operational decision-making using available information, policy, technical advice and plans, coordination of response to public health events with all relevant stakeholders as well as mobilisation and deployment of resources, including surge capacity, services and material to support all PHEOC functions. Others are designing appropriate health messages for the creation of public awareness, community engagement and social mobilisation and monitoring financial commitments and providing administrative services for Health ministry emergency responses.

This requires expertise from various health specialists including epidemiologists, clinicians, infectious disease experts and statisticians, among others. The leadership at the Health ministry led by CS Mutahi Kagwe ensured there was not only enough manpower but also the adequate infrastructure to deal with emerging surveillance needs.

Since inception, PHEOC has been able to monitor disease and public health events, conduct and participate in simulation exercises.

It has also conducted a baseline assessment on the establishment of virtual PHEOC in four pilot counties; Busia, Turkana, Nairobi and Garissa and also coordinated response to disease outbreaks and emergencies in the country.

These include coordination of polio supplementary immunisation activities in 2019, monitoring of the 10th Ebola outbreak in the Democratic Republic of Congo, and response to different outbreaks, such as cholera, in various counties.

It is no wonder therefore that when the first case of Covid-19 was detected on March 12, 2020, Kenya was able to quickly swing into action.

Courtesy of the efforts of officers at this centre, it was possible to quickly identify the first Covid-19 case of a 27-year-old Kenyan who had arrived from the US via London. By March 18, 2020, 44 contacts linked to the first case had been traced with two persons testing positive. The 14-day follow-up for contacts of the first case ended on April 1, 2020.

Prior to that, PHEOC had developed a robust contingency plan for the response to the pandemic. Guided by this plan, the centre deployed staff to carry out screening of travellers at all points of entry where tests were carried out on all suspected cases.

PHEOC’s enhanced response activities, which included receiving alerts through the 719 hotline, rapid response to the alerts received for suspected cases and screening and testing of suspected cases has led to the detection of over 38,700 cases from 552,000 tests to date.

Contact tracing

Additionally, PHEOC has facilitated contact tracing of over 42,000 persons, actively coordinated evacuation and quarantine of over 38,000 people and assisted in the training of staff both at county and sub-county level on Covid-19 response. Further, community sensitisation in identified high-risk counties has also been going on while continuous mentorship and support supervision of the county and sub-county groups has been ongoing.

Other institutions critical in the preparedness and response activities for Covid-19 include Kenya Field Epidemiology and Laboratory Programme, WHO and other UN partner agencies, the Centre for Disease Control and Prevention and non-state actors like the Kenya Red Cross, Kenya Health Federation and the Development Partner in Health in Kenya.

While Health ministry has effectively responded to public health emergencies, lessons learnt from the pandemic demonstrates the great value of the establishment and operationalisation of PHEOC as a part of deliberate measures for preparedness, prevention, detection, mitigation, response and recovery from public health emergencies and crises.

 

Dr Amoth is the Acting Director General, Ministry of Health