Kenya kept COVID-19 infections low for months, but fatigue threatens gains

The novel coronavirus disease (COVID-19) cases continue to surge through Africa amid what has been labelled as the ‘third wave’. Like several African countries, Kenya has been witnessing an uptick in the number of cases since February — after experiencing an impressive decline in the number of cases from October-January.

The latest wave has seen the positivity rate climb sharply, picking to 17 per cent on March 16, 2021, when 1,064 infections were reported from a sample size of 6,151. The highest rate the country has ever witnessed is 18 per cent in October.

Kenya is among the African countries where the 501Y.V2 variant — first reported in South Africa — was detected. On March 3, the country received its initial consignment of the AstraZeneca vaccine containing 1.2 million doses procured through UNICEF from COVAX facility.

On the priority list would be over 400,000 health workers, followed by teachers, security officers and then those with underlying conditions.

As the continent battles yet another COVID-19 wave — threatening its gains of months — the government has introduced a slew of measures. The latest round has seen the government tighten containment measures since March 12, with President Uhuru Kenyatta extending the 9 pm-4am curfew for another two months.

He also outlawed political rallies for 30 days and put a cap on people attending religious or funeral events.

How it started

Kenya reported its first COVID-19 case in March 2020, prompting travel restrictions in and outside of capital Nairobi, as well as a 7pm-4am curfew and closure of all schools and learning institutions.

All gatherings, including religious, political or social meetings, were curtailed in a bid to enforce distancing. The measures were in place until June, when they were partly relaxed, allowing movement into and out of Nairobi.

But the positivity rate remained high, averaging at around 13 per cent in May and June. This was before the president lifted the blockade in and out of Nairobi and three other counties mapped as hotspots.

The easing was also accompanied by relaxation on closure of worship places, including churches and mosques, which allowed a small numbers of worshippers below 58 years of age to congregate at a time.

Despite the let-up in the control rules on gatherings and movement, infections continued to fall and the positivity rate dipped.

The encouraging trend continued throughout the month, prompting the president to review containment measures further on September 28.

Besides reducing the curfew hours to 11pm-4am (from earlier duration of 9pm to 4am), the president had good news for revellers and the hospitality industry crippled by months of closure of entertainment joints.

“The prohibition against the operation of bars and the prohibition against the sale of alcoholic drinks and beverages by ordinary restaurants and eateries shall stand vacated with effect from September 29,” Kenyatta had announced.

While the reopening of drinking dens was to be done in observance of curfew rules and general guidelines on distancing and hygiene protocols, these were tossed out of the window: The number of infections surged barely three weeks later.

Kenya hit positivity rate of 16 per cent in October and a high of 20 per cent in November (from 4 per cent in September), as captured by the global metric Corona Tracker.

The country had recorded a low of 53 new infections on September 28, which surged to 1,494 new cases at the end of October. More than 15,000 new infections and 300 deaths were recorded in October.

“In September, our COVID-19 bed occupancy went down 60 per cent. We had flattened the curve to below 5 per cent positivity rate recommended by the World Health Organization,” said the president in his address to the country on November 4.

“However, 38 days later, we have experienced a reversal. If COVID-19 bed occupancy had gone down by 60 per cent, giving us comfort to re-open in September, the occupancy went up 140 per cent during the 38 days of eased measures,” he added.

While the surge in infections were interpreted in some quarters to mean a second wave, WHO rejected claims that the new infections, which also affected South Africa and Ethiopia, amounted to a  second wave.

The infections that followed were not comparable to the second deadly wave that was sweeping across Europe at the time, according to Ngoy Nsenga, WHO-Africa COVID-19 incident manager.

“The fundamentals surrounding the virus in Africa remain the same as before negating the likelihood of a fresh wave. The dynamics are also different when Africa is compared to Europe,” Ngoy added.

The virus, according to the official, had remained unchanged, there having been no mutations at the time, he told Down To Earth in an interview.

He opined that the change in numbers had been informed by easing of interventions in September, leading to people ditching disregarding containment precautions.

The gains

Following the scare, Kenya moved to tighten some restrictions it had relaxed in September, reducing operating hours for bars and eateries and adding an extra hour to curfew duration. A fine of up to $200 was also imposed for those who did not wear a mask in public places.

The government also announced that all schools would open in January, a development that made authorities enforce measures even more strictly.

Restrictions were more robustly enforced by the police using the Public Health Act and the Public Order Act already in place prior to the pandemic. As a result, infections began to slow, dropping from a high of 18 per cent early November to around 10 per cent at the beginning of December.

The figures dropped 6-8 per cent through December, before stabilising at below 5 per cent in January as schools reopened. By February, positivity rate in mostly stabilised at below three per cent, according to health minister Mutahi Kagwe.

Kenya’s relative success has, however, not been without hitches and challenges. The testing capacity has remained low and as of February 27, cumulative tests stood at 1,295,556 in a population of 48 million people.

Authorities have struggled to procure testing equipment and reagents, amid bitter complaints of a shortage of personal protective equipment (PPEs) among health personnel in the public health care sector.

Health minister Kagwe in January announced that the government will procure 24 million doses of the Oxford-AstraZeneca vaccine, but it is not yet clear how far the plans have gone with regard to importation. The date for commencement of vaccinations has not been made public as well.

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