March 27 Update on COVID-19 in Kenya
Global health partnerships always face challenges and obstacles. The COVID-19 worldwide pandemic challenges AMPATH in immense ways, but our commitment to partnership is stronger than ever as we meet new opportunities to help resource-limited people in Kenya and around the world.
CURRENT SITUATION IN KENYA
There are now 31 confirmed cases of COVID-19 in Kenya and one person has died. These cases include people in five counties, but as of today there are no confirmed cases in Eldoret or at Moi Teaching and Referral Hospital (MTRH). The Government of Kenya, Ministry of Health and our partners at MTRH used the weeks prior to the first diagnosed case on March 13 to establish a multi-disciplinary task force, create a 24/7 hotline, train healthcare workers, screen arriving visitors and prepare the medical infrastructure to treat patients.
Since the first confirmed Kenyan case, even more aggressive mitigation measures have been taken including:
· Closing educational institutions including Moi University School of Medicine
· Educational initiatives to encourage social distancing, more handwashing and other measures to prevent transmission
· Restrictions on the number of people in public transportation
· Prohibition on group gatherings, including church services
· Daily curfew from 7 p.m. to 5 a.m.
· Discontinuation of international flights
· Economic stimulus including lowering of the tax rate and other measures
AMPATH’S RESPONSE
The existing AMPATH infrastructure and relationships have been vital as we have worked with our partners to help ramp up the response to COVID-19 while simultaneously working to limit in-person interactions through clinical visits, research projects and daily operations.
1. AMPATH is focused on assisting MTRH and regional leaders to prepare and manage COVID-19 including supporting the Ministry of Health response, promoting social distancing and advocating for access to clinical trials of treatments and vaccines when available.
2. Importantly, AMPATH is working with MTRH and surrounding counties to maintain essential clinical services for current patients with HIV, chronic diseases and other conditions. Efforts are underway to ensure that extended supplies (3 months) of medicine are available for individuals.
3. Both Kenyan and North American AMPATH leaders serve on the MTRH task force and have leveraged existing AMPATH resources including infection control and clinical management protocols.
4. The AMPATH medical record system (AMRS) can aid in surveillance and measuring the impact on HIV outcomes related to the pandemic. Investigators in the AMPATH Research Network are actively responding to requests to contribute to research related to COVID-19 from the National Institutes of Health (NIH) and other organizations.
5. AMPATH teleconferencing facilities have been particularly important for trainings and remote meetings with chiefs, community health workers, police, doctors and clinical staff in the ten counties where AMPATH provides services. The ability to connect remotely will continue to serve a vital role in maintaining our partnership even while this situation forces physical separation.
Following the Level 4 Global Health Advisory issued by the U.S. State Department on March 19 and the announcement that Kenya would halt international flights, most of AMPATH’s North American faculty and staff returned abruptly to the U.S. or Canada with great regret. Following mandatory quarantine periods, many of these staff members will aid their home institutions in their COVID-19 clinical response while continuing to support AMPATH’s efforts in Kenya remotely until they can return.
IMMEDIATE NEEDS
The most immediate needs in Kenya are improved access to lab supplies, personal protective equipment, digital thermometers and infection control supplies. MTRH has 21 intensive care unit (ICU) beds to serve the western half of Kenya. Improving this capability by adding beds, monitors, ventilators, central line kits and expanding portable x-ray and ultrasound capability is a high priority need.
Overall diagnostic lab capacity at MTRH is limited. The technology to test for COVID-19 is available but viral media/swabs, and test kits/reagents are needed. Within the next two weeks, the HIV care lab may well be in a position to run tests for the novel coronavirus. Expansion of diagnostic lab capacity and increased awareness and implementation of infection control measures present two opportunities to contribute to the solution for the immediate problem while also building capacity for the future.
THE FUTURE
The current world situation highlights the importance of sound medical infrastructure and capacity for care in countries around the world. Your support of AMPATH’s work over the last three decades makes Kenya’s response to COVID-19 stronger, but the challenges ahead are daunting. Kenya needs the partnership and support of AMPATH now and will need it more than ever when this threat has passed in order to continue to build its health care system to confront the next threat.
Thank you for your partnership now and in the future.