When is Kenya’s Covid peak? Virus’ biggest mystery

By People Reporter
Thursday, August 13th, 2020
Mass testing at Biafra estate in Nairobi. Photo/PD/FILE
In summary
    • Intriguing queries: Medical experts are yet to comprehend the following;  why do some people get very sick, but others do not? Among others.
    • Difficult to tell: Researchers  believe it may be difficult for one to tell when the country will hit the peak because of the unpredictability of testing for the  virus.

In March, when the number of Covid-19 cases in the US hit 100,000, a journalist asked President Donald Trump how he would describe the pandemic to a child.

In his true characteristic fashion of never shying away from controversy, Trump retorted: “You can call it a germ, you can call it a flu, you can call it a virus.

You know, you can call it many different names. I am not sure anybody even knows what it is.”

Since it was first detected in China early in the year, Covid-19 has been characterised by extreme uncertainty, and to date, one of the few things experts know about it for sure is the identity of the pathogen responsible.

But much else about Covid-19 remains unclear, with researchers and medical experts left groping in the dark.

Why do some people get very sick, but others do not? Are the models too optimistic or too pessimistic?

Exactly how transmissible and deadly is the virus? How many people have actually been infected?  How long must social restrictions go on for? 

These are some of the intriguing questions Covid-19 has left unanswered since its outbreak.

In Kenya, no question has remained more complex about the pandemic than the issue of when the country would reach the peak and start flattening the curve.

Indeed local medical experts are divided over when the country is likely to experience its peak, and consequently see the curve flattening. “Covid-19 is a strange animal, never seen before.

It has left everybody guessing and groping in darkness for answers,” says Prof Matilu Mwau, the head of infectious diseases research and testing unit at the Kenya Medical Research Institute (Kemri).

Like many other researchers, Prof Mwau believes it may be difficult for one to tell when Kenya will hit the peak because of the unpredictability of testing for the virus.

“It is difficult to say when the virus would reach its peak in the country, because our testing is only limited to contacts and is not widespread like in the more advanced countries.

Results arrived at from contact testing are only indicative of the severity of the pandemic, and cannot be used to tell whether it has reached its optimum and started reducing,“ says Prof Mwau.

First predictions had indicated that Kenya would hit the virus peak between the end of April and May, which did not happen. 

The Ministry of Health then released a second modelling, predicting the peak to come between mid-August and September.  

Clear indication 

In mid-June, when the cases started rising significantly, Health Chief Administrative Secretary Rashid Aman noted that the surge was a clear indication the country was nearing the peak hence the need to tighten containment measures and avoid an implosion that would overwhelm the healthcare infrastructure.

“It is clear that Covid-19 cases will continue rising till we reach the much-anticipated peak in July or August as the latest modeling indicates,” Aman told a press conference on June 13.

“We have also observed that infections are moving from urban, metropolitan areas to rural counties.

This trend is worrying and there is a need for urgent intervention to ensure the vulnerable are protected,” he added. 

By that time, according to the ministry predictions, almost 18 million Kenyans would have been infected by the virus, with the death toll ranging in thousands. 

“About 40 per cent will have been infected, recovered and built resistance and our health systems overrun.

That is natural history,” said Prof Omu Anzala, a virologist and member of the National Emergency Response Committee on Covid-19.

However, uncertainty over when the country is likely to hit the peak continues, with some scientists now predicting it could occur between early September and October.

“We are far from reaching the peak. Due to our unpredictability in the number of people tested, no one can say when that period would be with certainty,”  Evanson Kimuri, the Kenyatta National Hospital boss told People Daily.

But  Dr Githinji Gitahi, the Amref Africa group CEO believes Kenya is likely to reach its peak between late October and November.  

Gitahi, like Prof Mwau, opines that the current testing trend does not capture everything to give a clear picture of the pandemic.

“At the moment we are like people climbing a mountain. Our peak period will reach when we start witnessing abnormally high new cases constantly, before we see them going down in equal speed.

That means that as many people would have turned positive to such a level that we are left with fewer and fewer cases turning positive,” he says.  

But for the country to reach that stage,  Gitahi argues, Kenya must maintain a constant testing capacity to enable the scientific modellers to get a cumulative figure of those who test positive vis-a-vis those who turn negative.

 Gitahi says the peak period will depend on the ability to consistently test, identify new cases, contact tracing and being able to see a sustained number of infections coming in through the period. This will be followed by a decline.

“Reaching a peak does not necessarily mean recording a high number of new cases on a daily basis. It is rather a cumulative figure that largely depends on the total number of those who turn positive from a given daily figure,” says  Gitahi.

And commenting on whether Mombasa had reached its peak due to the low numbers of new infections, both Prof Mwau and  Gitahi say the coastal town is yet to reach there.

“Covid-19 cases seem to be well entrenched in Mombasa, but what is happening is that people’s behaviour (wearing of masks, social distancing and maintaining hygiene) is bearing fruit. But these cannot be used as an indicative of a peak because the level of testing has gone down over the past month,” Prof Mwau stated.

On the other hand,  Gitahi says it is too early to declare Mombasa to have reached a peak until at least 10 per cent of the population is tested.

The two also agree that Covid-19 will remain unpredictable until a vaccine is found.

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