Is Kenya staring at the third wave? Projections from tried and tested modelling experience
For reasons that this research has attributed largely to delayed response and low sampling and testing efficacies, the surge in COVID-19 cases in Kenya this modelling series simulated to happen after the December festivities and subsequent school reopening in January 2021 was 21% higher than the confirmed total of 100,773 cases as at January 31, 2021. This was the highest difference between the simulated and confirmed end-month totals for Kenya since this modelling series started in early 2020. Noteworthy however, the period January — February 2021 saw a significantly reduced testing rate in Kenya, leading to a stagnation in the long-term daily average population-normalised testing rate at 66–67 tests per million people per day. It was not until March 7, 2021, that this rate increased to 68.
Updated COVID-19 Statistics as at March 8, 2021
On March 8, 2021, the global total had exceeded 117.6 million COVID-19 cases. The global case fatality rate was still rather sustained at 2.2% (compare 2.7% for Africa) and the global recovery rate at 79% (compare 89% for Africa). Compared to the global population, the shares of COVID-19 cases have been disproportionately lower in Africa. At almost 4 million, Africa’s COVID-19 cases on March 8, 2021 makes up only 3.4% of the global total though the continent hosts 17% of the global population. On the same date, Kenya had 2.7% of Africa’s total COVID-19 cases despite hosting 4% of Africa’s total population. Kenya’s COVID-19 status map on March 8, 2021 had a total of 109,164 confirmed cases, 18% of them being active cases following a case fatality rate of 1.7% and a recovery rate of 80%. The serious or critical cases made up 0.4% of Kenya’s active cases, an increase from the recent 0.1% share.
Brazil is already bearing the brunt of another serious wave of the pandemic as new and more contagious coronavirus variants invade the globe without sparing the younger demographic in their destructive missions. With new variants already confirmed in several African countries including Kenya, the metrics on the share of active and critical COVID-19 cases must take precedence in policy and strategic decisions. Kenya’s active cases on March 8, 2021 made up 6% of Africa’s total active cases, punching above her 4% continental population share on this measure. On the same day, the sum of serious and critical cases in Kenya made up 3% of Africa’s total serious and critical cases.
The share of Kenya’s confirmed COVID-19 cases by County, mapped below, has consistently been higher in the main urban centres, the Nairobi metropolitan area, and along the major transportation routes. This spatial profiling could inform the level of strictness of containment measures by tiers whenever radical measures have to be advanced.
The Decisive Parameters
Kenya’s observed positivity rate took a consistently downward trend from 12.4% onDecember 2, 2020 to 2.6% at the end of January 2021. By the end of February 2021, pandemic fatigue and normalcy bias had set in. The majority lowered their guard as compliance rates with COVID-19 containment protocols plunged. With the first batch of a million doses of COVID-19 vaccines already in the Kenya, extra caution and awareness creation are necessary to avoid any further lowering of guard and agitating the curve upwards. The reported high percentage of citizens to be vaccinated for herd immunity, about 70%, makes the vaccination route a long-term containment measure as opposed to an instant panacea.
First though, some insights into the key parameters guiding this research series.
Why normalise the COVID-19 tests? Data blindness?
Put another way, what colour blindness is to visual accuracy, data blindness is to making informed policy and strategic decisions.
This modelling series has been calculating and applying the long-term daily average population-normalised COVID-19 tests for countries, in terms of tests per million people per day. This normalised measure of COVID-19 tests by countries removes the bias of wide variations in country population sizes and the dates on which they started testing for COVID-19. The resulting metric gives a fair performance indicator for cross-country comparison. Such metrics helping decision makers to better gauge performance disparities and inform adjustments to foster real progress and forestall slow but sure devastating consequences of the laxity inherent in ‘data blindness’. On this metric doesn’t matter that Rwanda has a quarter of Kenya’s population and Kenya’s population is a quarter Nigeria’s, or that they started testing on different dates. Put another way, what colour blindness is to visual accuracy, data blindness is to making informed policy and strategic decisions.
Key country examples on testing capacity
By February 22, 2021, Kenya’s effective testing rate on this normalised indicator, just 67, was far below the rates for Morocco and South Africa (421 each), India (393), Brazil (369), Rwanda (216), or Ghana (80). It was, however, a bit higher than Uganda’s (55) and Ethiopia’s (52). No country in Africa had reached anywhere near the advanced economies in the global north on this indicator. Israel had scored 3439 tests per million people per day on this measure by the same date, ahead of the UK (3256), the USA (2639), France (1977), Russia (1935), Canada (1533), or Germany (1299).
Sampling and geodemographic diversity
The needs-based testing that Kenya has adopted has become public knowledge. The choice of this kind of testing can be attributed more to a deliberate coping strategy due to limited testing capacity than to the full rigour of scientific sampling. The geodemographic diversity of Kenya, like for most other countries, calls for adequate and stratified population-targeted sampling and testing to draw nearer to the true picture on the ground.
Is it Kenya’s Third Wave?
Since the beginning of March 2021, Kenya has been recording higher and double-digit positivity rates while conducting more COVID-19 tests than the trend over the December 2020 — February 2021 period. Fears of a third wave have consequently risen to the top of daily conversations.
Going by the experience gained from the previous wavy styles of the COVID curve, expecting the third wave and preparing to contain it adequately is not just a good idea, but the pragmatic minimum for a country that has lost a whole school calendar to the pandemic and widened the existing inequalities in access to education amidst crippling structural divides in human and infrastructural resources.
From mid-February 2021 as the graph shows, the positivity rates have been on an upward trend, mostly staying above 5% from early March. Going by the experience gained from the previous wavy attack styles of the COVID curve, expecting the third wave and preparing to contain it adequately is not just a good idea, but the pragmatic minimum for a country that has lost a whole school calendar to the pandemic and widened the existing inequalities in access to education amidst crippling structural divides in human and infrastructural resources. Young learners are expected to be back home for holiday in March, hence the unavoidable movements across the country. It is, therefore, not the time to relax the routine COVID-19 containment measures or for citizens to lower their guard.
Probable Scenarios within the Model Boundaries
The graph shows the actual total cases confirmed in Kenya and the increasing positivity rates from January 14 to March 8, 2021. January 14 was the simulated peak of the previous curve at 103,188 cases, a theoretical figure which came to be 4.6% above the actual 89,771 cases recorded in Kenya on that date. The simulations shown are expected to remain within 10% of the actual cases.
Learning from the past trends, two model scenarios have been generated in this COVID-19 model:
- Business as usual (BAU) assuming the trend from January 14 — February 26 would maintain, simulating 115,896 cases on March 31, 2021
- Upper trajectory assuming the rising trend from February 26 continued, simulating 137,675 cases on March 31, 2021
Conclusions and Implications for Kenya
Facing the third wave — better safe than sorry
The wavy nature of the pandemic, studied over the last one year in this IBD modelling series, makes an upcoming third wave a highly likely yet inconvenient fact to face and adequately prepare to deface using all the proven containment measures: mask wearing, hygiene, social distancing, and adequate population-targeted sampling, tracing and testing. If the latest emerging trend in Kenya’s COVID-19 cases continues, it is possible to record a third wave rising to between 115,000 and 138,000 cases by March 31, 2021.
Testing efficacy — data integrity is critical
The recent increase in Kenya’s COVID-19 testing rate from late February 2021 is laudable. Adequate sampling, tracing and testing produces the data essential to knowledge-based and effective calibration of containment policies and strategies. Data integrity is critical, as is the building of public trust in the containment processes.
Spatial justice — are urban centres the hotspots or simply the most tested?
The COVID-19 map of Kenya has for long displayed the key urban centres as the hotspots of the rising number of cases. This outcome could inform extra care to help reduce transmissions in these areas, but it could also challenge the testing protocol adopted with respect to its spatial representativeness over the year. Data integrity remains critical to accurately timing and calibrating the containment measures against the resurgent pandemic.
Visualisation — how to influence the modern demographic
Communication is increasingly becoming visual, making visualisation techniques key to influencing behaviour change among the dominant demographic of this era. It is important to leverage COVID-19 data collection techniques and processes with location-based intelligence from spatial mapping. This step will help improve public engagement using mapped visual evidence at scale.
Curfew extension — a reasonable middle-ground for health and economy
For an economy recovering from the shocks of COVID-19 while facing the possible resurgence of its curve, softer movement restrictions such as relaxed curfew hours deserve to be retained as stricter enforcement of public health protocols take precedence. Reviving the economy is key, but even more so is protecting health for all with a keen awareness of the likely choices of the nation’s young and socially active citizens if all restrictions are removed.
School holidays — parental and community care to improve
Besides controlling mass gatherings as witnessed in many political rallies across Kenya, a big positive difference is expected if parents and the local community will assist their children, who are supposed to be back from school for holiday, to ensure compliance with all COVID-19 containment measures. A surge in cases is likely to grow worse if children and young learners engage in super-spreader activities while out of school. Complete removal of the curfew will be a highly tempting trigger of such activities.