Risk high of second wave as infections surge in counties

Kenya is at risk of a second wave of Covid-19 infections just six days after the partial reopening of the economy.

Positive cases have dramatically increased, especially in rural counties, barely a week after President Uhuru Kenyatta eased containment measures to boost businesses. 

From the 21,958 tests conducted between September 22 and 27, there were only 1,036 positive cases. But from September 29 to yesterday, there were 1,259 cases from 22,068 tests, a difference of a whopping 223.

Speaking to the Nation, Amref Health Africa Group CEO, Dr Githinji Gitahi, said the trend was expected: “The curve had only flattened in urban centres. The cases were declining in Nairobi, Mombasa, Kiambu, Kajiado and Machakos. Unfortunately, the cases have started to peak in rural counties and thus affecting the positivity rate.”

Before the measures were relaxed, Kenya’s Covid-19 positivity rate was 4.7, but it’s now at 5.7. On Saturday, it was 7.7, the highest in over a week, followed by Friday (6.8) and Tuesday (5.8).

Highest caseload

On Friday, Nakuru recorded the highest number of cases ever, the sharpest increase in 24 hours after returning 75 patients against Thursday’s 13, edging out Nairobi and Mombasa, two of the five urban areas with the highest caseload. Kisumu had seven on Friday, against 37 on Saturday, a trend which is expected to continue in the rural and remote counties.

“The reopening of the economy will increase infections; we just have to be ready for a surge. The most important thing is for the counties to ensure that there is oxygen and enough Intensive Care Unit beds. Kenyans should now take personal responsibility; it is no longer an enforcement issue,” said Dr Gitahi.

With community transmission, there is need for “community ownership” of the containment measures, said the Amref boss, while calling on church and local leaders to lead grassroots efforts in combating the virus.

“We expect to see more deaths, especially of the elderly and that is why we need to protect them. Those with underlying conditions like diabetes also need to be protected. There certainly will be increased hospitalisation,” he said.

Dr Ambrose Agweyu, the Head of Epidemiology and Demography at the Kemri-Wellcome Trust Research Program, had earlier warned of a second wave:“A second wave is possible with the relaxation of containment measures, if we drop face masks, regular hand washing and failing to social distance, we will create an opportunity for the virus to spread.”

Test positive

According to the World Health Organization (WHO), a person can test positive one to three days after being exposed to the virus, before showing symptoms.

“Experience has taught us that we are most vulnerable and fragile at the moment where we think we have won. If we have won one battle against Covid-19, we have not yet won the war. The possibility of a second wave of this pandemic is real as we have seen in other countries,” said President Kenyatta when he partially reopened the economy.

However, social distancing measures are slowly being abandoned, especially by public service vehicle operators in rural counties. In Nairobi, face masks are only worn in the Central Business District. Last week, Health Chief Administrative Secretary Rashid Aman warned revellers against breaking the rules.

Meanwhile, in Turkana County, the authorities there have issued a red alert over the surge in cases, citing the Kakuma Refugee Camp in Turkana West Sub-county as an emerging hotspot. Deputy Governor Peter Lotethiro said that four refugees have died of the disease, with the total number of Covid-19 positive cases in the county currently standing at 267 since a refugee who travelled from Nairobi’s Eastleigh estate became the first case late May.

Isolation centre

“Turkana West Sub-county where the refugee camp is located has a total of 208 cases. Health officials in Kakuma are currently monitoring 54 people who are in quarantine in hospitals and 27 on home-based care and isolation,” Mr Lotethiro, who doubles up as the chairman of the County Covid-19 Response Team, said.

He noted that Lodwar GK Prison was also responsible for the rise in cases but added that the situation at the facility was under control.

“A total of 23 inmates at the prison who had tested positive have been discharged from Kanam Kemer Sub-county Hospital after a successful recovery. Security personnel are still hunting for five other inmates who tested positive but escaped from the isolation centre after cutting a metal grill at night,” Mr Lotethiro said. He observed that the escapees were a great risk to their families and the general public.

Mr Lotethiro said that the county’s effort to determine the extent to which the disease has spread especially in the refugee camp was being slowed down by lack of testing kits. The county relies on the Kenya Medical Research Institute in Kisumu, the Moi Teaching and Referral Hospital in Eldoret, and the Centres for Disease Control and Prevention (CDC) in Nairobi for testing collected samples whose number stands at 3,891.

Testing reagents

He said that the centres are affected by national shortage of testing reagents: “The county government and United High Commissioner of Refugees are prioritising on the establishment of a testing centre at Kakuma.”

County Health Executive Jane Ajele said 224 patients have recovered with 39 cases still active.

“The youngest Covid-19 case in the county is a three months old baby while the oldest is 67 years old.” Ms Ajele said. Turkana had reported 67 Covid-19 recoveries and 21 active cases by August 25 but the sudden surge caught the attention of the Ministry of Health, with Chief Administrative Secretary Mercy Mwangangi saying experts would be sent to investigate the situation. Mr Lotethiro urged locals to continue adhering to the guidelines.

“Even if President Uhuru Kenyatta directed all bars to operate, just taken one or two beers and go home but don’t idle there and interact carelessly,” he warned the locals.