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With the coronavirus pandemic having hit the most dangerous phase—community transmission—questions are emerging over the capacity and level of preparedness for the counties to deal with the disease.

Although a number of counties have hit the ground running, designating isolation and quarantine centres, medical and disaster management experts are warning the pandemic could have a devastating impact should the cases hit the 5,000 mark by mid April and 10,000 at the end of the month as predicted by the Health ministry.

Health experts say only Nairobi, which has so far been declared the epicentre of the transmission, seems to be adequately prepared to deal with this eventuality, as a majority of the counties grapple with low bed capacity, lack of specialised health workers, low levels of awareness, prohibitive cultural practices and huge populations of elderly people.

“At the moment, we are praying and crossing our fingers the pandemic does not reach the level of what is happening in the US, Italy, Spain, China and other Western countries.

It could be worse here because we are vulnerable,” said Kirinyaga Governor Anne Waiguru.

Major challenge

According to her, apart from isolation wards, quarantine centres and food stocks in case of a lockdown, many counties are ill-prepared to deal with the pandemic as they lack specialised medicare and equipment.

The governor admitted that most county hospitals, which are Level Four, lack specialised personnel and equipment to take care of moderate cases of coronavirus.

This is besides the critical stage patients who would require admission in either Intensive Care Units (ICUs) or High Dependency Units (HDUs).

“Ït would be a major challenge for us if we reached this level of moderate and critical stages because our hospitals cannot handle such cases,” Waiguru said in a telephone interview.

On Monday, Health Cabinet Secretary Mutahi Kagwe warned that the pandemic had taken a new dangerous trend in which it was spreading through community transmission.

As part of the government’s precautionary measures, Kagwe implored Nairobi residents not to travel upcountry as they posed risks to people in the rural areas, many of whom are elderly.

“The disease is no longer being imported from outside but is here with us and spreading amongst ourselves,” the CS said on Monday.

And yesterday, the number of confirmed coronavirus cases in the country rose to 59 after the Health ministry’s Chief Administrative Secretary Dr Mercy Mwangangi announced nine new infections. 

Dr Nichodemus Nyandiko, a lecturer at the Masinde Muliro University of Science and Technology, warned that counties were lagging behind in preparedness for Covid-19.

“A lot needs to be done at the county level starting with awareness, coordination and putting in place legal mechanisms to enable Members of County Assembly to deal with the situation.

The counties are the weak link in the whole chain should this disease reach a full-blown level,” he warned.

 According to him, the national government needs to move fast and decentralise everything, particularly testing to ensure as many people as possible are screened.

“Apparently, everything seems to be done in Nairobi where the level of awareness is higher while the grassroots, with a higher concentration of uneducated people, are being left exposed.”

Idriss Chikophe, the secretary general of the Critical Society of Kenya, warned that though the government may have supplied equipment to counties through the leased Medical Equipment Scheme (MES), most of it is still lying idle due to lack of personnel.

But despite these challenges, counties across the country are rushing against time to put in place measures to contain the virus.

“We are trying to put in the best we can. In my case I am on the verge of employing at least 200 medical interns,” Waiguru said.

In Nakuru, the county has partnered with other Rift Valley and western counties to initiate a massive screening exercise in all its borders.

Addressing the press yesterday, Governor Lee Kinyanjui  said Nakuru being a transit town, it is wise to put in place precautionary measures.

“We may have to take precautions to minimise spread to other counties. We are in talks with other governors on measures we can take to prevent the spread of the disease including enhanced screening,” said Kinyanjui.

In Murang’a,  Governor Mwangi Wa Iria is proposing drastic measures as he urged the national government to impose total ban on public transport, saying it would help curb the spread of the virus.

Wa Iria  also proposes  that each county block its boundaries and contain its people for a period of one month.

“We may not be able to shut down the entire country at once but we can do it gradually starting with counties,” he said.

“This way we shall ensure there is no movement of people and if we have positive cases reported they shall be contained in that particular area,” he said. 

“Nairobi is the epicentre of the disease and we have people coming in and out this only means we can have the virus spreading to every corner of the country.” 

Block residents 

In Naivasha, health officials have expressed concern over mass movement of passengers from Nairobi which has been hardest hit by the virus.

This came as public health officers from Nakuru County launched an impromptu testing exercise on the Nairobi-Nakuru highway in Naivasha in a bid to stop the spread of the disease.

However in Kiambu, the County government says its hands are tied and can do less to block residents living in Nairobi to move to their rural areas as a measure to mitigate the transmission of coronavirus.

The county which enjoys close proximity to Nairobi is home for thousands of residents who commute for work to Nairobi.

Franklin Wambugu, the county’s director in charge of communication, said unless the national government orders total lockdown, restraining movement is hard.

Wambugu said that Sh70 million has been set aside for Covid-19 preparedness.

In Marsabit, County boss Mohammed Ali said all passengers plying Marsabit county route must undergo screening at the barriers.

In Embu, MCAs have urged the government to only resort to a complete lockdown if all other methods of preventing further spread of Covid-19 fail.

Kenya National Union of Nurses Secretary General Seth Panyako expressed concerns that nothing much has been done in counties and asked governors to put in place proper measures to curb the virus.

“Let our governors not play PR game with the war against the Corona virus. The truth on the ground is the most of the counties do not have screening machines,” he said.