End of coronavirus pandemic is nigh, as herd immunity in sight

JOACHIM OSUR

By JOACHIM OSUR
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At this point in time on the history of epidemics, it is expected that countries, including Kenya, would have increasing numbers of people getting infected with Covid-19.

Scientifically, it is not surprising, and it is a stage in evolution of an epidemic before it comes under control.

Being a pandemic means that the coronavirus is now widespread and even if we were to erect a stone wall around Kenya, unless it is controlled worldwide, it would only be a matter of time before we are hit again when international travels resume and borders reopen.

Secondly, infection rates are expected to rise among Kenyans. This may sound distasteful but is an important process in developing natural immunity and epidemic control.

Once a sizeable number of people recover from the infection, they develop immunity to the virus.

There may be cases of reinfection, and scientists are observing to see if people who have recovered can get re-infected and how severe their diseases would be.

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The hope, however, is that after a wave of infection many people will develop immunity to the virus, and that will break the chain of transmission. In science, this is called herd immunity.

Under normal circumstances, herd immunity is achieved by vaccinating as many people as possible. In the absence of a vaccine, herd immunity comes through natural infection.

As the number of infections rise, what should worry us is the rate at which the population gets infected.

If we get a large number of infections at once, too many people will need hospital care and we will run out of resources to manage them. Many who could have survived the disease would succumb to it.

We should manage the process well so that nobody dies. This is the “flattening the curve” that experts keep talking about.

Most of the people who get infected, 80 per cent, only have mild to moderate symptoms. Many may not know it and will not go for treatment.

It is the remainder, most of whom may have a chronic illness or be old with weak body systems, who suffer severe disease. Although people of all ages can get Covid-19, scientific approach calls for the vulnerable to be protected.

Assume you have a parent or grandparent who has diabetes, high blood pressure, has suffered a stroke or is bedridden for one reason or another, or it is a teenager who is malnourished or has low immunity due to other diseases such as HIV/Aids.

If such a person gets Covid-19, chances are that they will be very sick.

In the United Kingdom and the Netherlands, for example, the elderly live in old people’s homes and their governments have put a stop on anyone visiting them.

The hope is that, once herd immunity is achieved, there will be lower chances of passing the disease to them.

Vaccines and medicines are being developed and, if we buy time by flattening the curve and keeping the vulnerable safe, treatment will soon be available and the risk of death lowered.

Sadly, the moment the first Covid-19 case was announced, Kenyans started running away from big towns to their villages. This is where most old people live, and so this migration is spreading the infection to them.

Another worrying thing is that many Kenyans, the strong members of the population, are now waking up with no plan of engaging in economic activity.

If we become unproductive and end up without food, then we get a population which lacks nutrients, and with lowered immunity is vulnerable to all manner of other diseases.

In developed countries, governments have designated funds to cushion the economy from collapse.

There have been targeted financial support to individuals whose lives have been disrupted. Africa, without the financial reserves, may not afford this and many people are likely to slide into poverty.

The attempts by the government to cushion the vulnerable are good but inadequate. Corporate and personal initiatives are welcome.

Projections need to be made on a trajectory of numbers of infections for planning purposes on what our systems can handle.

Prof Osur is a public health and sexual medicine specialist and dean, School of Medical Sciences, at Amref International University. [email protected]


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