15 counties will bear brunt of pandemic, say scientists

Friday, May 29th, 2020 00:00 | By
Prof Omu Anzala, Director of the Kenya Aids Vaccine Initiative, addresses the press at a past event. Photo/PD/FILE

Hillary Mageka @hillarymageka

Scientists project that 15 counties will bear the brunt of the Covid-19 pandemic when the full impact of the disease hits the country next year.

In a report tabled before a Senate ad hoc committee on Covid-19, scientists project that Nariobi, Kiambu, Meru, Machakos, Nakuru, Kakamega, Siaya, Murang’a, Homa Bay, Kitui, Makueni, Kisumu, Kilifi, Bungoma and Nyeri, will consume 57 per cent of the resource requirement for management of severe coronavirus cases.

“We also undertook additional analysis to identify the most at-risk counties for severe outcomes using different combinations of risk factors.

In these alternative analyses, Nairobi, Kiambu and Meru remained the most high risk counties,” said Prof. Omu Anzala, Director of the Kenya Aids Vaccine Initiative, who presented the report.

The counties were singled out because they have a big population that is over 60 years and high prevalence rate of diabetes, HIV/Aids, and hypertension, which place those who contract coronavirus at a higher risk of developing dangerous complications.  Indoor air pollution and overcrowding were also identified as risk factors.

Based on these projections, scientists are warning that by February next year when the disease will have hit the peak, the country will require 356,000 hospital beds and 115,000 ventilators to cope with the pandemic.

“Nairobi, Kiambu, Meru, Machakos, Nakuru and Kakamega will consume up to 30 per cent of the resources requirements for the treatment of severe cases,” said Anzala.

Lab technologist Willy Juma (left) takes a sample from Festus Makau during a Covid-19 mass testing at Eastleigh’s St Mary’s Boys Secondary School in Nairobi on Wednesday last week. Photo/PD/GERALD ITHANA

The scientists estimate that at the peak of the disease, Nairobi will require 4,420 ICU beds and 13,711 hospital beds; Kiambu 3,325 ICU beds and 10,315 hospital beds; and Meru 2,615 ICU beds; Machakos 3,629 ICU beds and 11,255 hospital beds.

Nakuru will require 1,623 ICU beds and 5,035 hospital beds; and Kakamega 4,271 ICU beds and 13,249 general hospital beds.

The model assumes uniform transmission across the country. However, the scientists are saying that with intensive preventive measures it would be possible to prevent transmission in particular regions.

In a worst-case scenario, the scientists estimate that at least two million Kenyans or 88 per cent of the population could be infected with the deadly virus by January 2021, if the restrictions put in place by the government are relaxed.

While a total of 355,909 people will present asymptomatic infections, 114,740 individuals will exhibit severe symptoms during the same period. People with asymptomatic infections do not show outright signs of the disease.

Minimise threat

Prof Anzala attributed the projections to the reality that a majority of Kenyan cases are asymptomatic.

 “The Ministry of Health should ensure that adequate measures are put in place so that the threat of the disease can be minimised as much as possible,” he told senators.

“Unless the virus mutates and its threat becomes minimal, definitely these peaks are going to come because of the contagious nature of these viruses,” he added.

On Tuesday, the acting Director, Ministry of Health, Dr Patrick Amoth, had projected that the country’s coronavirus peak will come in August and September.

Amoth noted there is a likelihood that during the peak period, Kenya will be reporting at least 200 positive cases a day.

“If we continue with the measures that have been put in place as of today, the peak period will be in August and September where it’s likely for us to report 200 cases-plus a day,” he said.

He asked Kenyans to continue observing mitigating measures, including regular handwashing with soap and social distancing, adding that cases will be on the rise as more people are tested.

“Remember modelling keeps on changing based on the variables you input and our wish is to continue with the existing measures because they have ensured our hospitals have not been overrun,” he explained.

Decreased mobility

Yesterday, Prof Anzala noted that the peak in health care utilisation would occur around February 2021.

“To determine the maximum resource needs for hospital beds and ventilators, we identified the peak in the outbreak using projections of the worst-case scenario and current projections and estimated resource needs at this point,” he said.

Kenya has so far registered 1,618 Covid-19 cases after 147 more people tested positive yesterday, with the number of deaths associated to the virus standing at 58 after three more people succumbed in the last 24 hours.

Anzala said the current government measures have led to decrease in mobility. However, the decrease was preceded by surges in travel across counties in early to mid March at the initiation of social distancing measures.

Among the existing restrictions being enforced to contain the spread of the virus is the dusk-to-dawn curfew and the cessation of movement in and out of Nairobi, Mombasa, Kilifi, Kwale and Mandera. The city’s Eastleigh estate and Mombasa’s Old Town have also been sealed off.

Other measures are limited unnecessary travel, working from home where possible and avoiding mass gatherings.

To further explore the effect of the government directives, the director said his team assessed local transport trends which revealed a drop in transport usage within Nairobi and Mombasa beginning mid-March 2020, with cumulative volumes of ride hailing taxi services, matatus and boda boda, seeing up to a 50 per cent drop in the number of trips.

“However, this also revealed a spike in travel between counties in mid-March 2020 and end of the month, around the same time the directives were announced,” he said.

The government is already mulling whether to re-open the economy amid realisation and acknowledgement that the virus is here to stay.

President Uhuru Kenyatta last week hinted that his administration was weighing whether to lift the restrictions in a bid to jump-start the economy that has received a major beating since the first case of infection was reported in March.

The new report was compiled by a research team from University of Nairobi, College of Health Sciences. 

It was led by Thumbi Mwangi from UoN and Washington State University. Members included Prof Anzala, Loise Achieng’ (UoN, and Infection Diseases Society of Kenya), Dr. Marybeth Maritim (UoN, and Infection Diseases Society of Kenya) and Dr. Jeanette Dawa (UoN, Washington State University-Global Health Programmes, Kenya office).

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