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Personal responsibility vital in curbing Covid-19 pandemic

By Jeldah Nyamache
Tuesday, September 22nd, 2020
Health Cabinet secretary Mutahi Kagwe. Photo/Gerald Ithana
In summary

The raft of strict public health measures which included lockdowns and movement restrictions for monthsto curb the pandemic are now easing across countries in bid to salvage economies left in shambles.

Local and international borders have reopened to allow for tourism and trade, key contributors to economic revival and growth .

To date, Kenya has reported more than 36,000 confirmed cases with more than 600 related deaths and still counting.

Confirmed cases are declining in Nairobi and Mombasa while rising in other counties unlike the past six months, probably due to  changes in restrictions.

The larger Nairobi metropolitan areas of Kiambu, Kajiado and Machakos were recently highlighted as such.

Indeed, a two-week steady decline in the number of new cases in each county would be indicative of limited disease transmission.

However, it would require a comparison with comprehensive surveillance and widespread testing of suspected cases as per World Health Organisation guidance.

Right from the beginning of our response to this pandemic; we did not institute widespread testing.

So far, in a population of 54 million as of September 2020, only 498,733 tests have been done cumulatively.

It also emerged, a few months ago, that there are asymptomatic carriers who can potentially spread the virus, although details of this are still under study.

In Kenya, there have been reports of declining numbers in testing and contact tracing in the past few weeks.

It is, therefore, difficult to judge on prevalence of Covid-19 based on cases reported.

Of note, severe cases and complications of disease have been associated with low immunity,  due to factors such as old age, co-morbidities and poor nutritional status.

Majority of the aged in Kenya live in rural areas. Additionally, people with co-morbidities in rural areas face immense challenges in accessing good healthcare and maintaining optimal health status.

Ease in travel restrictions leaves them vulnerable to exposure from probably younger and stronger carriers from towns.  

Political gatherings have recently gained momentum across the counties without obvious regard for safety measures.

There is a risk of the attendees getting and spreading infection to their kin due to non-adherence to public health measures. 

Readiness of counties with a robust public health system capacity should have been a strong criteria for ease of restrictions.

It would include the ability to detect, test, trace, track, isolate, quarantine and treat cases to quickly contain spread.

Emergency response kits including Personal Protective Equipment shortages for healthcare workers should have also been addressed as a matter of urgency. 

It is disappointing that this is still a major problem in many health facilities across the country; and it continues to put at risk lives of many healthcare workers on whom we heavily depend.

A point to note: between March and August 2020, more than 16 health workers had succumbed to Covid-19, while more than 838 others have been infected in line of duty. 

Ultimately, elaborate and intensified sensitisation on preventive measures for citizens by the government has a huge role to play.

Emphasis on use of face masks in public; enabling hand hygiene practices by provision of effective sanitisers or clean water and soap; minimising non-essential travel and gatherings are instrumental in reducing the occurrence of new infections going forward are all good.

These steps go hand in hand with availability and management of resources. 

Reopening the economy should hence be a slow and deliberate process. It ought to be done sequentially while monitoring results from a comprehensive surveillance and widespread testing plan.

A multi-sectoral and consultative approach needs to be emphasised with the main aim being to protect citizens’ health even in the counties as well as mitigate the worst effects on the economy. 

The re-opening of the country should not be interpreted as resumption to business as usual.

On the contrary, it is a call for all Kenyans to step up personal responsibility and protection measures as we settle into the new normal. 

There is only so much the government can do and just as the Ghanaian President Nana Akuffo Addo said, “We know how to bring the economy back to life. What we do not know is how to bring people back to life”.

Let us all be diligent enough to take personal responsibility against the pandemic. —The writer is a general medical practitioner in Kenya

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