Strengthen disease vigilance in frontlines

The raging coronavirus infections now named Covid -19 by the World Health Organisation (WHO) has precipitated panic on the global front. As more details about this viral agent emerge, its disruption on the movement of people and goods is threatening global commerce similar to the simmering Ebola outbreak.

While the focal point for the Covid-19 epidemic seems to be mainland China, specifically Wuhan region, its spread has been noted in almost all the corners of the world. Africa, the last bastion has now confirmed one case in Egypt. Locally, the handful suspected cases have fortunately all tested negative.

Mathematical modelling of the potential viral spread causes concern especially over our lack of preparedness. Given the widening contact between our country and China in terms of movement of people and logistics, we need to be prepared. Data from the Kenya Tourism Board shows Kenya received 81,709 visitors from China in 2018, a 4.03 per cent growth from 2017.

As was recently evidenced, local capacity to diagnose and manage those infected is doubtful. There are less than 200 isolation unit beds of guaranteeing safety for such potentially virulent infectious diseases. In the counties, this number could be almost zero, since most sub-county hospitals lack isolation units. These, account for close to three quarters of all admission hospitals.

A lack of preparedness is global, but, Africa bears a greater capacity deficit. In particular, lack of early warning systems EWS are partly to blame, though this is just a piece of a much bigger health system deficits ranging from human resource, equipment and skills.

From the Ebola epidemic, the epicentre oftentimes is contact between humans and wildlife. Those living in the peripheries and bordering wildlife areas or cultures with close intimacy with wildlife or habitats are more vulnerable. Kenyan communities eking livelihoods applied to such lifestyles are also marginalised and lack functional health services.

In one region, a needs-assessment indicated that out of the 23 health facilities, only five had laboratories, and even these were il equipped. Often times these facilities are basic, in terms of infrastructure, personnel or equipment.

Without ability to predict or identify epidemiological patterns quickly, we are all at risk. What needs to happen is collaborative working, especially with those in the private sector small clinics that are often the primary contact points for most patients.

For starters capacity to quickly detect such threats needs to be built via training of laboratory personnel, digitising medical records and harmonising information systems to accurately code diseases as per the International Classification of Diseases ICD 10 to help speak one language.

Likewise, unifying the veterinary diseases early warning systems with the botanical teams and the medical side’s disease monitoring would help. These should start with strengthening potential local epicentres.