Even with over 130,000 Covid-19 tests done in the various hotspots countrywide despite the myriad constraints, the government has to urgently increase its capacity to test, trace and treat patients while maintaining essential health services.
While Health ministry’s infrastructure to communicate results and manage patients in in-patient settings is welcome, there’s a need to escalate mass testing to reach all Kenyans.
A whole-of-government, whole-of-society approach to the Covid-19 response, mobilising all available resources to keep health systems functioning, is necessary. And to have that, we need a policy framework for Private Health Sector Engagement (PSE).
MASS TESTING
Effective PSE amid the crisis means having the capacity to quickly understand what is going on in the private health sector, select a fit-for-purpose fit-for-context strategy to engage the private health sector as part of the response, identify and use the appropriate instruments for engagement, and involve a broad range of private providers of health products and services, be they NGOs, faith-based organisations, individual private practitioners or businesses in the national response.
Mass testing, which involves the test-track-and-trace approach, can allow health officials to separate the infected from the healthy and stop the virus from spreading. The logic behind mass testing is suppression — efforts to reduce the infectivity of a pandemic.
Testing and isolating people who are positive seeks to reduce the R-naught to less than one. Studies in Wuhan and elsewhere show that, when unchecked, the R0 of Covid-19 is between two and three — meaning every infected person infects two to three others.
Besides mass testing in Kenya being hampered by lack of testing kits, the biggest challenge has been contact tracing, identifying and then alerting people who have been within the infection range of a confirmed positive case.
NOT FEASIBLE
Drawing on private sector resources and capacity is critical. In low- and middle- income areas, the private health sector provides a significant proportion of essential services and products to the population.
Unfortunately, contact tracing, which has involved state and local public health departments, has also not been feasible in identifying individuals who may have been infected with the virus and those whom they have been in touch with.
This may have been the greatest contributor to the rapid spread of the infections and fatalities. Delay fuels the pandemic and causes panic.
Contact tracing was effective for communicable diseases such as measles, chicken pox and sexually transmitted diseases.
While the World Health Organization advises that aggressive measures to find, isolate, test, treat and trace are the best ways to stop the spread of this virus, public health interventions to “flatten the curve” may slow transmission and mitigate peak capacity needs.
A strong biomedical workforce must be on stand-by to provide broad testing in a bid to stop new patients from rekindling a widespread outbreak. This is through a new multifaceted strategy that leverages public-private partnerships.
The collaborative efforts will be coordinated by the national or county government and implemented by both entities until a vaccine is available.
Dr Gachii is the director of medical services at The Nairobi West Hospital. [email protected]
