Every Cloud Has a Silver Lining

The novel corona virus pandemic is behaving like a big river whose flow can be slowed for some time by building dams. Building dams holds back the water but if heavy rains continue even the dam is unable to hold all the water and the excess either spills over causing damage or it is released in a controlled manner. This appears to have been the underlying principle when the Covid-19 pandemic public health campaigns were designed in the United Kingdom (UK). The UK government’s public health mantra was ‘Stay Home, Protect the NHS, Save Lives’ and the idea was to keep the levels of Covid-19 patients requiring hospitalization as low as possible so that the National Health Service (NHS) would not be overwhelmed. In UK like elsewhere in the world including Kenya measures were put in place to prevent new infections and hopefully halt the spread of the disease. However, stopping the spread of the disease completely has proved to be an almost impossible task due to the complexities of human interactions and other factors such as the sudden onset of demonstrations in many states in the United States (US) in the last week of May 2020. Carelessness, recklessness, indiscipline, ignorance, poverty and movement restriction fatigue are the other challenges faced by Covid-19 infection prevention initiatives world over.

We are apparently going to experience a prolonged Covid-19 epidemic curve in Kenya and the estimate by experts is that the peak of the curve will occur in the last quarter of 2020. The infection and crude fatality rates for Kenya and the rest of Africa remains relatively low compared to that of the rest of the world. Professor CF Otieno and other researchers in a paper accepted in May 2020 for publication in the American Journal of Tropical Medicine and Hygiene explored reasons for the low morbidity and mortality for Covid-19 in Africa. They concluded that the jury is still out but they postulated that a demography with many young people and favorable weather might be the reason for the low numbers. The other possible factors which they considered were: Effective infection prevention measures, low seeding rate and possibility of immunity acquired through prior exposure to a cross-reactive virus. Whatever it is that is responsible for this phenomenon can be said to be the proverbial Silver Lining in A Dark Cloud. This is because most of Africa is categorized as being of low socio-economic status and despite this the ravage caused by Covid-19 pandemic is much less than that experienced by the affluent parts of the world. This is surprising and contrary to what had been predicted by naysayers at the onset of the pandemic. It is however important to remain vigilant and to observe the infection prevention measures and especially frequent hand washing/sanitizing, social distancing including avoidance of hand shaking, respiratory hygiene and wearing of face masks when in public places.

Whereas complete cessation of further spread of infection is not feasible at this time scientists generally believe that herd immunity and development of a vaccine will end the pandemic There are concerted efforts to develop a vaccine for COVID-19 but it may be many months before an effective one is rolled out for use and our best bet therefore lies in herd immunity. Herd immunity is acquired when approximately 80% of the community is infected and the infectivity rate (referred to as R value or number by epidemiologists) falls below 1. The infection rate is the number of people to whom an infected person can pass on the disease. Vaccines facilitate acquisition of herd immunity and in the absence of it we can only continue with the other measures. The measures are targeted at not only limiting spread and maintaining manageable levels of the disease but also at preventing infection and mortality particularly among vulnerable groups. The UK government started easing movement restrictions in June 2020 and adopted a new Covid-19 public health slogan: ‘Stay alert, control the virus, save lives’ presumably in an effort to limit disease transmission through acquisition of herd immunity. Dedicated individual efforts translates into attainment of the greater goal of stopping transmission of the novel corona virus. Therefore continue being vigilant at the personal and community level so that you, your loved ones, friends and colleagues can stay safe and ultimately help to save many lives. 

Joseph Kimani Wanjeri, MB ChB, MMed (Surgery), IPTM (Tel Aviv), MPH

Lecturer & Web Champion, UoN Dept of Surgery


Acknowledgements: Dennis Omido Ochande – UoN CHS ICT Dept