KISUMU, Kenya – Before the President of Kenya and other leaders arrived at the end of May to mark a major holiday, health officials in Kisumu on Lake Victoria saw disaster brew. Coronavirus infections were skyrocketing, hospital isolation units were filling up and the highly contagious Delta variant had been found in Kenya for the first time – in Kisumu County.
Dr Boaz Otieno Nyunya, the county health and sanitation executive, said he and other health experts have advocated and advocated for politicians to hold a virtual celebration and avoid mass events in person who can amplify an epidemic. Weeks earlier, huge political rallies had helped fuel the catastrophic wave of Covid-19 in India, where the Delta variant first appeared and became dominant.
Their objections were dismissed, health officials said. President Uhuru Kenyatta, Vice President William Ruto, former Prime Minister Raila Odinga and others descended on Kisumu, drawing large and mostly unmasked crowds who thronged the streets to watch their slow processions across town and gathered to hear them in markets and parking lots.
In the weeks that followed, all reports show an alarming increase in infections and deaths in the county of just over 1.1 million people, with the virus mostly sickening young people. Dr Patrick Amoth, acting director general of Kenya‘s Ministry of Health, said the Delta variant was behind the recovery.
With medical supplies exhausted, vaccines scarce, doctors lamenting physical and mental fatigue, and hospitals turning away patients for lack of beds or oxygen, health officials fear a wave like the one that ravaged India April and May are not looming in Kisumu.
âThe example of India is not lost on us,â said Dr Nyunya.
Although data on infections and deaths is patchy, more than 23% of those tested for the virus in Kisumu last week were positive – more than double the national rate. Kenya’s overall positivity rate is similar to that of the United States when the pandemic peaked there in January. But the Delta variant was still rare at the time, the US healthcare system is much more robust than Kenya’s, and the US government was ramping up vaccination on a large scale.
All of Africa is vulnerable, as the latest wave of the pandemic sweeps across the continent, driven in part by more transmissible variants. Less than 1 percent of Africa’s population has been even partially vaccinated, by far the lowest rate of any continent.
âI think the biggest risk in Africa is to look at what happened in Italy earlier and what happened in India and start to think we’re safe – to say it’s very far from us and that we cannot follow the same path, “said Dr Mark Nanyingi, infectious disease epidemiologist at the University of Liverpool in Britain. He called the surge in western Kenya a “storm on the horizon”.
Covid-related deaths in Africa rose nearly 15% last week from the previous one, based on available data from nearly 40 countries, the World Health Organization said. But experts say the true scale of the pandemic far exceeds figures reported in Africa, where testing and tracing remains a challenge for many countries, and many countries do not collect data on mortality.
To prevent the current crisis, Kenya’s health ministry last week imposed a restriction on gatherings and extended a dusk-to-dawn curfew in Kisumu and more than a dozen surrounding counties. But the measurements were too late for Dr Nyunya, who said that looking back on the deliberations – which involved County Governor Peter Anyang ‘Nyong’o, a former national health minister – during last month’s celebrations, “It makes you feel helpless”.
In Uganda, which borders Kenya near Kisumu and has announced record cases and deaths, President Yoweri Museveni has imposed a strict 42-day lockdown. Just a few weeks ago, Rwanda hosted the Basketball Africa League and other major sporting events, raising the possibility of a full reopening. But after a spike in cases, the government introduced new foreclosure measures Monday.
The Democratic Republic of the Congo – where the virus has claimed the lives of more than 5% of lawmakers – grapples with a third wave as it falters in vaccine rollout. South Africa, the continent’s worst-affected country, has reported a doubling of new infections in just two weeks, with the largest increases in major urban centers. Tunisia, where hospitals are full and oxygen reserves are low, is experiencing a fourth wave.
“New, higher transmission variants are creating a precarious situation in many countries with weak health systems,” said Dr Ngozi Erondu, senior health researcher at the O’Neill Institute at Georgetown University.
WHO attributes the outbreak in Africa to lack of vaccination, insufficient compliance with precautionary measures like mask wearing and social distancing and Delta and other variations.
In Kisumu, health authorities first detected the Delta variant in early May, among factory workers who had arrived from India. It has since spread to neighboring counties, with doctors saying patients have more severe symptoms than those they encountered earlier in the pandemic.
The rise in infections has put a strain on public and private hospitals, with many saying they have refused patients or referred them to hospitals as far away as Nairobi, the capital, more than 350 km away.
The Aga Khan Private Hospital in Kisumu typically saw two or three Covid patients at a time earlier this year. But on a recent visit, the hospital had 18 such patients, with only 12 beds specifically dedicated to Covid treatment.
Kisumu County Hospital only had one out of 13 beds available in its isolation unit, said Salome Situma, the warden of the Covid-19 unit. The hospital does not have piped oxygen and all five portable cylinders were in use, she said.
The Jaramogi Oginga Odinga Teaching and Referral Hospital, the region’s main public hospital, has 130 isolation beds but has been inundated with referrals from neighboring counties, according to its chief executive, George Rae. At times, Dr Rae said, he felt “under siege” and worried that oxygen supplies might be depleted due to increasing demand.
âIf Kisumu represents the African situation,â he said, âthen Kisumu needs a national plan to fight this virus, to get everyone vaccinated, so that everyone has the knowledge to do it. prevent, so that everyone wears a mask and everyone away from the crowd.
In Kisumu, the human toll of the virus affects all segments of society.
Musa Ismail, the president of the Kisumu Muslim Association, said the Muslim community has sometimes buried two to three people a day in recent weeks, compared to only one every two or three months. Zablon Awange, the executive secretary of a county teachers’ union, said he had buried several teachers in recent weeks. County assembly member Sally Okudo said there had been a sudden spike in deaths among her constituents.
Dr Patrick Eshiwani of Aga Khan Hospital said that at the beginning of June there was at least one death per day in the hospital. âThings were going very badly,â he said with a sigh.
In rural areas of the county, there has been an increase in deaths without a recorded cause, indicating that the Covid toll far exceeds official tally, said Dr Nyunya of the health department.
Health workers in public facilities say many of them are infected even as they wait for their second dose of vaccine and lament the lack of protective equipment and health insurance.
âWe buy our own gloves and masks,â said Dr Onyango Ndong’a, chairman of the local Kenya Medical Practitioners, Pharmacists and Dentists Union. âWe are covering the government’s shortcomings. We are tired now. We are stretched.
For now, families who have lost loved ones are adjusting to a new reality.
Edward Onditi, 33, lost his brother and mother to Covid-19 this month. He said he left Nairobi to come and help his family after his brother, Herbert, whom he considered a best friend and mentor, fell ill.
For weeks, the family transported Herbert, 43, between three hospitals in two counties – a distance of 70 miles in total – so he could get high flow oxygen. The day before Herbert died, Edward had fish, his brother’s favorite dish, delivered to his isolation ward and promised to take him on vacation once he was out.
âI am so touched,â his brother said in a text message sent on June 2.
Barely 12 hours later, he was gone.
A few days later, their mother, Naomi, who was ill, also succumbed to complications from Covid-19.
“It was one of the most difficult times of my life,” Onditi said one afternoon recently, his eyes filled with tears. âThings just don’t work. They don’t add up. “