How does one fight an invisible, insidious, and all but intractable foe worth 30 kb in size? In Kenya, the hundred and fiftieth day of COVID-19 passed on 9th August 2020, nine months after the virus manifested itself in the Chinese province of Wuhan. The pandemic has brought forth some key learnings in the process.
Even though modern science has risen at breath-taking speed, the most effective tools are still the public health measures, from the 19th century – quarantine and social distancing. The crisis has given us an opportunity to witness the speed and volume of innovation from local innovators and universities to give doctors a broader range of weapons. The lack of enough personal protective equipment for health workers that have been certified and approved by the Kenya Bureau of Standards for use and inadequate isolation and quarantine facilities to cope with the exponential rise of new cases across the country are among the key challenges to the COVID-19 response.
The current emergency has made it critical to rethink our manufacturing and supply chain systems. And this has presented an opportunity to shift to approaches that meet and amplify the needs of Kenyans using the available resources and raw materials. Against all odds, we figured out how to be innovative and mass produce low-cost critical care beds, disinfectants and other items used to suppress this virus. There is an increasing likelihood that companies will now require innovative skills that were previously untapped to fill in new demands. Startups will likely emerge from the recently launched great COVID-19 innovation challenge by the Kenyan Government to harness the collective capability of Kenya’s tech ecosystem in addressing grand challenges in health and food systems innovations and the future of work amidst the pandemic. The “Buy Kenya, Build Kenya” strategy has also convinced entrepreneurs to begin producing masks and ventilators.
We now know that we face a risk of COVID-19 inequality according to recent analysis and government official reports concerning the education and food due to impacts of the pandemic and this has created an easy prey for a virus that turns our bodies against us. The Integrated Food Security Phase Classification estimated 980,000 people in 29 counties in Kenya’s arid and semi-arid lands were expected to face food crises or worse for the period April–July 2020. According to the Ministry of Education, about 20 million children have also been affected by the nationwide closure of schools due to the COVID-19 pandemic, putting an end to school feeding programs that would otherwise improve their health and nutrition levels. The recently launched radio lessons by the Kenya Institute of Curriculum Development have locked out students from disadvantaged households, especially in slum areas and refugee camps, and those with disabilities or affected by mental issues with no access to such devices.
Inequalities in data capture and modelling that do not account for the spread across the population and inform control measures, compounded by factors such as weak health information systems, competing social priorities, politics in health, gender inequalities and cultural differences have become more pronounced amongst vulnerable populations with COVID-19. This is especially seen in those who are pregnant, or are affected by HIV, TB or other non-communicable diseases and persons with disability, with data being virtually non-existent. It is in this populace that we need to pay more attention to avert mortality and leave no one behind.
Everyone deserves access to healthcare, and the coronavirus which struck against a backdrop of floods, the cholera outbreak and locust invasion, limited our overall effective response to COVID-19. Challenges in contact tracing and limited laboratory testing reagents have been identified as key gaps and include a lack of protocols and approvals at the points of entry in the country. The challenge for policymakers and public health officials is that, because we shut everything all at once, it’s hard to know which measures worked best and which can be improved.
There has been a lot of talk about when things will return to normal. Normal is a public healthcare system that has been starved of funding. Normal is having limited career options for researchers. Normal is inadequate medical supplies and medicines in our health facilities. The choice of how we achieve this is not simple, even though the picture is. Kenya’s national response has been critical, but not enough. With the utmost gratitude, we celebrate public health professionals as heroes who are risking their own lives to keep the rest of us safe. Our focus going forward must be to develop a robust public health strategy. Finally, as the government loosens up on movement restrictions, contact tracing will be key to avoid flaring up of cases and until a vaccine arrives, we have to be careful not to be over-simplistic in our definition of recovery.
About the author
Allan Ochola is a graduate student in microbiology at Kenyatta University in Kenya and 2019/2020 eLife community ambassador. Twitter: @allanochola
Acknowledgement
This blog responds to a call by BMJ Global Health, in conjunction with the Emerging Voices for Global Health on COVID-19 in Sub-Saharan Africa.
Competing Interest
No competing interest