Delta variant ravages villages, aided by creaky health system

It all began with one family member falling ill with the 'flu'  two weeks ago. He died the same week.

James Mwangi, a resident of Mukurwe in Murang'a, says within that week, two more members of his family contracted the flu – now confirmed to have been Covid-19 — and died.

He says in his village two more people have died of the disease.

Murang’a is one of the hardest-hit rural areas, where Covid-19 has been spreading faster in its fourth wave.

A few days ago, a family in Gikambura village, Kiambu county, buried three of its members who died of Covid. 

The scenario is being replicated in different villages and towns across the country. 

The deaths in the villages are aided by a creaky public health system and the lethal Delta variant, which is 60 per cent more transmissible. 

Experts say this fourth wave will likely surpass the second and third waves this month.

Currently, 31 patients are admitted at Murang’a Level 5 Hospital suffering from Covid-19.

“On top of that number we have 14 Covid-19 patients admitted in the Intensive Care Unit at the County Referral Hospital,” Murang’a Health executive James Mbai said.

Health CS Mutahi Kagwe confirmed the current wave is driven by the Delta variant and echoed scientific predictions that an even worse variant could emerge.

It might be able to evade current coronavirus vaccines.

“This is the third variant we are experiencing, God knows which variant is coming next it, could be better, it could be worse," Kagwe said.

"But we are not taking anything for granted. We are assuming we are in danger and continuing to take necessary measures to protect ourselves against any variant, not just the Delta variant.”

Data from the Health ministry shows that by Wednesday, the proportion of adults who are fully vaccinated against Covid-19 was 2.46 per cent.

A total of 670,284 people have received two doses of the AstraZeneca vaccine.

These include 116,723 healthcare workers, 97,375 teachers, 53,605 security officers, 206,894 people aged 58 years and above while 195,687 are uncategorised.

At least 1,741,581 vaccines have been administered in the country so far.

Viral loads in Delta infections are approximately 1,000 times higher than those caused by previous SARS-CoV-2 variants, scientists say.

This means people infected with Delta shed more virus and thus infect more people.

By Wednesday this week, 4,025 Kenyans had been killed by the coronavirus.

Most cases have been coming from Nairobi, Nakuru, Kiambu, Kajiado, Mombasa, Nyandarua and Makueni in that order.

Private pharmacists in some rural areas report that since June, 60 per cent of their sales were drugs to treat upper respiratory tract infections.

“You cannot be sure whether it is a result of Covid-19 or the current cold weather. But yes most drugs I sell have been for chest and throat infections,” pharmacist Peter Kinyua, in Nyeri town said.

In Meru, Health executive Meshak Mutuma said although the situation in the county is not bad, they are worried.

“Meru is getting one, two cases per day. Those admitted in hospitals are 10. We are worried in other areas numbers are surging. People must take precaution,” he told the Star. 

Although the ministry says only about 4,000 people have died of Covid-19, some experts believe there are big data holes and not all deaths are being captured.

This could be caused by lack of testing and indirect deaths from other diseases because people decide not to go to the hospital.

"In rural areas, many people only go to hospitals when it's very late. Some even die from other sources aggravated by Covid-19. So it's not possible to capture all of them," global public health expert Dr Bernard Muia said.

County governments also admit they lack testing facilities.

Council of Governors chairman Martin Wambora said counties only recently received 17 PCR machines, which were distributed in May, but lack the reagents.

“We appeal to the Ministry of Health to now provide the counties with the much-needed testing reagents and testing kits,” he said.

Mombasa chief public health officer Pauline Odinga noted cases are also rising at the Coast due to community transmission.

"We have seen many cases coming at the Coast General Hospital, the facility is overwhelmed with cases coming from the community due to community transmission," she told the Star.

She warned home-care for sick people must follow the Health ministry guidelines.

"We have healthcare workers who are giving private treatment in the household without proper training and safety gear. They get infected and take the disease from those houses to their working place and back in the community," she said.

In Kisumu, Health chief officer Fredrick Oluoch said the positivity rate in the county is below five per cent.

“Currently, we are getting fewer than 45 cases daily, but this varies. Most cases are coming from Kisumu Central, Kisumu West and Nyando, which are within the urban areas.

"Our rural areas are good and the positivity rate is below five per cent,” he said.

Wambora said counties still have capacity but it’s being chipped away slowly.

The country has 7,566 isolation beds but 1,287 are occupied, so the free beds are 6,279.

He said of a total 512 ICU beds in 31 counties, 192 are occupied and 320 are free.

Cumulatively, there are 284 HDU beds in the counties, with 162 occupied and 122 beds free.

Wambora said counties are also scaling up oxygen supply at Levels 4 and 5 hospitals.

“This is being done in collaboration with the Ministry of Health and our partners, the  World Bank, USAID and the Global Fund,” he added.

Counties have embarked on short-term interventions, including procurement of additional gaseous and liquid oxygen to meet the increased demand. They are expanding piped outlets and repairing non-functional oxygen generation plants.

On Thursday, the Health CS  Kagwe warned that funerals and baby showers were fueling Covid-19 deaths in various parts of the country.

He said baby showers have resulted in infections in children as young as one and two years old.

On Wednesday, for instance, data from the ministry showed the youngest of the 1,335 new Covid cases was an eight-month-old infant. On Tuesday, the youngest was just three months old.

"Aside from political rallies, there are other social gatherings that are very dangerous: funerals and baby showers.

"Now we have started all over again and that’s why you are seeing the statistics, one-year-olds, two-year-olds,” Kagwe said.

“We like to attend funerals as a show of solidarity with those who have passed on. But this is a time when a show of solidary through a telephone call or other means may serve the purpose.

"There is no point of showing solidarity by following the deceased and this is happening all over the country,” he added.

The government directive requires that bodies be buried within 72 hours and funerals be attended by more than 50 people.

But Kenyans especially in the rural areas have defied the directive. Some who had attended the funerals die days later.

The failure to keep the number to a minimum both in funerals and political gatherings has seen the lethal.

This means the highly transmissible Delta variant sweeps through the villages leaving a wave of destruction.

“These are not the normal times, let us not pretend that it is because it isn’t. The infection rates in Kenya are now high and it is important for us to be honest with each other,” Kagwe said.

(Edited by V. Graham)