Modelling the latest trend after the entry of new variants

A return to the tighter containment measures that restrict community transmission should be viewed more as a minimum pragmatic requirement than an extreme punitive intervention.

Key Highlights

The global case fatality rate has stabilized at 2.1% with Africa’s at 2.7%. The global recovery rate has stabilized at 89–90%, at par with Africa’s.

Africa’s share of the cumulative global COVID-19 cases and the active cases globally has been stable at 2.9%, but the share of global deaths ranging from 3.5–3.7%,has been higher than the expected equitable share.

At 0.07%, Kenya still maintains a higher probability of developing severe COVID-19 cases out of the cumulative cases, than the African and global average of about 0.05%.

Having been recording 3.5% of the total COVID-19 cases in Africa despite hosting 4% of Africa’s population, Kenya has been scoring higher on the danger side — through her higher shares of Africa’s active COVID-19 cases (14%) and severe cases (5–6%).

The latest mathematical model has informed a firm statement that starting May 19, shortly after the Indian variant was reported in Kenya, the country has lost the opportunity of the presumptive flattening of the third wave by June 12 at 172,354 cases. The total cases as at June 8 (173,072) were already 0.4% more than this simulated peak.

It remains likely, going by the latest business-as-usual trends, that the total cases in Kenya will hit 180,000 by July 1, 2021. A daily average of 297 new cases is likely, up to the first week of July, 2021. This business-as-usual assumption can be exceeded by a fourth wave, already determined in this modelling to be likely to pick up the pace in July.

Global Overview

As of June 8, there were about 483 COVID-19 deaths per million people on Earth and the global total of COVID-19 cases had topped 174.7 million, with more than 4.9 million in Africa (less than the 5.3 million cases in Turkey alone by then). Turkey, like Israel, was still boasting a striking combination of a lower than 1% case fatality rate and more than 97% recovery rate (99.2% in Israel). The global case fatality rate has stabilized at 2.1% with Africa’s at 2.7%.

The global recovery rate has also stabilized at 89–90%, at par with with Africa’s. In Kenya, the case fatality rate has stayed around 1.8–1.9% with the recovery rate at 68–68.5%. Rwanda has registered a lower case fatality rate of 1.3% and a higher recovery rate of about 96%. The equivalent metrics for Uganda, Ethiopia, Morocco and South Africa have been 0.7% and 87%, 1.5% and 91%, 1.8% and 98%, and 3.4% and 93%, respectively.

Generally, recovery rates have been increasing towards 90% and above, with the USA’s going beyond 82% by June 8, up from her low recovery rates of below 70% months earlier.

Testing Capacity Differences

As of June 8, 2021, the population-normalized testing rate in Kenya was still steady at 74.2 tests/million people/day, the metric was increasing in the neighboring Rwanda, reaching 247.5 tests/million people/day on June 8. Rwanda’s population-normalized performance was far ahead of Ethiopia’s (51.9) and Uganda’s (55.5). Top performers in Africa on this metric included South Africa (432.3) and Morocco (381.0). Brazil (498.5) and India (537.0) were scoring higher on this metric, but still lower when compared to Turkey (1445.4), Germany (1463.8), the USA (2917.3), Israel (3334.2), and the UK (5633.3).

It is clear from these normalized metrics that testing capacity is a key differentiator across countries, evident in their reported COVID-19 numbers and the amount of data-driven intelligence at their disposal for timely response. The positive impact of vaccination is also evident in the performance metrics of the countries that have vaccinated significant shares of their populations, the USA and Israel being key.

Kenya’s Past and Developing COVID-19 Scenarios

Behavior over Time (BOT) graphs are key scientific tools for mathematical modelling of complex systems. Over the last one year, BOT graphs have enabled this mathematical modelling series, which involves 32 countries — 16 in Africa and 16 outside Africa, to narrow the prediction error margin of business-as-usual (BAU) COVID-19 cases progressively from within 10% to 2%. For example, the model shown below closed the month of May 2021 with a 1.8% difference between the simulated BAU figure and the reported cases of COVID-19 in Kenya.

Kenya has been battling the third wave since March 2021. The cases in Kenya started soaring above the green BAU simulation line from May 19, shortly after the Indian variant had been confirmed to be ravaging the western part of Kenya. The cases in Kisumu have been increasing ever since.

Mapping the time-varying county shares of the national tally of COVID-19 cases across Kenya has also confirmed from this modelling series that the share of the lakeside city of Kisumu, where the first cases of the Indian variant were reported, has increased from 2% in April to about 3% currently.

At 0.07%, Kenya still maintains a higher probability of developing severe (serious or critical) COVID-19 cases out of the cumulative cases, than the African and global average of about 0.05%. Having been recording 3.5% of the total COVID-19 cases in Africa despite hosting 4% of Africa’s population, Kenya has been scoring higher on the danger side — in terms of higher shares of Africa’s active COVID-19 cases (14%) and severe cases (5–6%).

Kenya Hitting 180,000 Cases by July? Fourth Wave?

It remains likely, going by the latest business-as-usual model shown by the red line below, that the total cases in Kenya will hit 180,000 by July 1, 2021. The red line simulates a daily average of 297 new cases up to the first week of July, 2021. This business-as-usual assumption can be exceeded by a fourth wave, which had been determined in this modelling series over the last one year to be likely to pick up the pace in July.

The model also shows that Kenya has lost the opportunity of the presumptive flattening of the third wave by June 12 at 172,354 cases. The total cases as at June 8 (173,072) were already 0.4% more than this simulated peak.

Since herd immunity cannot be assured any time soon by Kenya’s slow rate of vaccination, further exacerbated by the attendant supply chain bottlenecks, self-discipline for compliance with containment measures and strict enforcement remain the thicker bulwark against the ravaging pandemic.

Conclusion

The wily, wavy attack trajectory of COVID-19 curves has already seen Kenya endure three ravaging waves. New variants complicate the prospects for full containment. From the increasing prediction accuracy of data-driven modelling as observed over the last one year, it can firmly be stated that Kenya must prepare for the likelihood of hitting 180,000 cases by the beginning of July, 2021.

For planning purposes based on the established severity probability of 0.07% in Kenya, there should be sound plans to cater for at least 126 severe COVID-19 cases (HDU and ICU) by July 1, 2021. It is also likely from the established wavy equation with a period of about four months that July is the month to watch for a possible fourth wave.

Since herd immunity cannot be assured any time soon by Kenya’s slow rate of vaccination, further exacerbated by the attendant supply chain bottlenecks, self-discipline for compliance with containment measures and strict enforcement remain the thicker bulwark against the ravaging pandemic. Consequently, a return to the tighter containment measures that restrict community transmission should be viewed more as a minimum pragmatic requirement than an extreme punitive intervention.