COVID-19 Wave: Ebbing in May, Rejuvenating in July?
Simulating the wavy flows of an increasingly familiar enemy in Kenya
The highest recovery rates globally have been more than 90%, Israel posting the highest rate of 99% currently with an impressive combination of a very low case fatality rate of 0.8% as of April 22. Turkey has similar impressive scores with a high recovery rate of 87% and a case fatality rate of 0.8%.
The fact that India and Brazil have stayed in the top-three global position of the ravaged league of leading COVID-19 country cases despite having lower population-normalised testing rates is telling: these two countries may in the long term turn the tables on the USA with high COVID-19 cases as they continue testing their large populations.
Out of purely data-driven scientific curiosity to feed policy advice, Kenya could be Africa’s petri dish for testing the inconvenient possibility of a fourth wave of the pandemic in the third quarter of 2021. Expecting the pandemic’s wave to die off suddenly without sustained disciplined action would be a Panglossian view that can easily consign the entire citizenry to irredeemable casualties of the putative Kenyan optimism.
Assuming high positivity rates and the continued laxity among the citizenry, Kenya’s simulated upper trajectory is a red line of danger that can reach 400,000 COVID-19 cases on May 31, 2021.
Kenya’s simulated ebbing trajectory, herein referred to as the green line of hope, heralds the possibility of reducing cases after reaching a cumulative figure close to 167,000 cases on May 26, 2021. This model assumes a declining trend in positivity rates sustained far below 10% and strict compliance with the prevailing containment measures.
Recent Developments in Global COVID-19 Curves
As of April 22, there were more than 145 million COVID-19 cases globally with a case fatality rate of 2.1% and a recovery rate of 85.1%. Africa had reported above 4.5 million COVID-19 cases with a case fatality rate of 2.6% and a recovery rate of 89.4%. The USA was still leading with more than 32 million cases, followed by 16 million cases in India and more than 14 million cases in Brazil. By reporting more than 314,000 cases in a day, India has tilted the scales with the world’s record in daily COVID-19 cases. As countries continue experiencing the second or third waves of the resurgent pandemic, some are contemplating the possibilities of a fourth wave amid new variants. Out of purely data-driven scientific curiosity to feed policy advice, Kenya could be Africa’s petri dish for testing the inconvenient possibility of a fourth wave of the pandemic in the third quarter of 2021.
The highest recovery rates globally have been more than 90%, Israel posting the highest rate of 99% currently with an impressive combination of a very low case fatality rate of 0.8% as of April 22. Turkey also had similar impressive scores with a high recovery rate of 87% and a low case fatality rate of 0.8%. The highest population-normalised COVID-19 testing rates were more than 3,500 tests per million people per day, as already sustained in the UK and Israel. As shown in the figure below, equivalent metrics for Brazil (320) and India (430) have been lagging on this measure. The fact that India and Brazil have stayed in the top-three global position of the ravaged league of leading COVID-19 country cases despite having lower population-normalised testing rates is telling: these two countries may in the long term turn the tables on the USA with high COVID-19 cases as they continue testing their large populations.
Africa’s Comparative Situation in COVID-19 Cases
Though the percentage of serious or critical cases out of the total confirmed cases has recently stayed at 0.1% of the total cases in Africa and globally, Kenya’s share on this measure had doubled to 0.2% by April 9, 2021 and has stayed so from the data reported up to April 22, 2021. The active cases in Africa made up 2.0% of the global sum of active cases, up from 1.4% on April 13, 2021.
As of April 22, Africa was carrying 3.1% of the total global COVID-19 case burden, 3.9% of the global deaths, 3.3% of the global recoveries, and 3.5% of the global serious or critical cases. With mostly 1.1% of her active cases classified as serious or critical in April, Africa had maintained a higher internal share of such severe cases than the global average, which was 0.4% most of March and had increased to 0.6% by April 18, 2021.
Kenya’s COVID Curve: Critical Metrics above Africa’s Average
As of April 22, the total cases reported in Kenya had hit 154,392 with a case fatality rate of 1.7% and a recovery rate of 68%, a significant reduction from the 80% recovery rate recorded months earlier. The country retained her top-ten (8th) position in Africa in terms of total confirmed cases. After recording the lowest positivity rate of 9.6% in recent weeks on April 19, the positivity rate has been taking an upward trend since, reaching 15.9% on April 22.
Statistics by devolved units
Because health is a devolved function in Kenya, the 47 devolved units of governance have a key role to play in containing the pandemic. The following heat map shows how the 47 counties variously contributed to the national COVID-19 tally as of April 21, 2021. The red signal is evidently spreading out of Nairobi to the western part of the country.
Share of active cases
As a share of Africa’s total active cases, Kenya was claiming 13% of Africa’s total active cases between April 9 and April 22, up from 12% on March 31. The share of active cases out of Kenya’s total cases has also been rising as recovery rates plunge. As of April 22, the share of active cases was 30.1% and on April 19 it was 31.0%, up from 30.7% on April 13 and 29.3% on March 31, 2021. As of April 22, these shares of active cases in Kenya were way much higher than Africa’s 8.1% (up from 7.9% on April 13) and the global mean of 12.8% (down from 17.4% on April 13).
Share of severe cases
The serious or critical cases in Kenya on April 21 were 0.5% of the total active cases nationally, an increase from 0.4% most of March, 2021. As a share of Africa’s total serious or critical cases, Kenya had 6.2% of Africa’s serious or critical cases on April 21, 6.6% on April 19, and 6.8% on April 12. It is crucial to note that these shares went up from 5.1% as at March 31, 2021.
Going by the limited bed capacity and oxygen supply that many countries have experienced during a surge in cases, a rising share of serious or critical cases is a red signal. Strict measures of caution are necessary to avoid the stress countries such as Brazil and India have been experiencing during these viscous waves of COVID-19 as pandemic fatigue and normalcy bias set in.
Though the analysed percentage changes are apparently small, their determinedly upward marginal surge has significant implications for COVID-19 containment policy and strategy. This is because of the fast-rising COVID-19 cases, which in Kenya had already exceeded 150,000 total cases with more than 47,000 active cases on April 18.
Projected Bandwidth of Probabilities for Kenya’s COVID-19 Curve
From the experience gained in this series by mathematically courting Kenya’s wavy COVID curves, several scenarios of possibility can be firmly stated. The graph below depicts the latest scale and character of the third wave currently ravaging Kenya. Based on the established sampling, testing, tracing, timing, and behavioural regime observed in Kenya over the last one year, the curve of confirmed infections has been assuming new mathematical equations every three to four weeks.
In the latest sector of this modelling series, a definite change in the governing equation has been observed from March 26, 2021. The compact bandwidth of probabilities gives the following scenarios.
Upper trajectory: Possibility of reaching about 400,000 cases on May 31, 2021. It assumes effective sampling and tracing as well as an aggressive testing rate averaging 8,000 tests per day and high positivity rates sustained at 10% and above — new and more contagious variants inclusive. It further assumes an environment of relaxed containment measures and pandemic fatigue in this scenario.
Ebbing trajectory: Possibility of reducing cases after reaching a cumulative figure close to 167,000 cases on May 26, 2021. It assumes a declining trend with positivity rates sustained far below 10% and strict observance of the prevailing containment measures.
Resurgent trajectory: Possibility of a fourth wave picking up the pace in July 2021. It assumes a repeat of the oscillatory character of the Kenyan COVID curve, whose period has now come to be known to be about four months.
Expecting the pandemic’s wave to die off suddenly without sustained disciplined action would be a Panglossian view that can easily consign the entire citizenry to irredeemable casualties of the putative Kenyan optimism. The implication for policy and strategy is to exercise extra care and strict compliance with all the recommended containment measures in Kenya. Not allowing pandemic fatigue nor normalcy bias to set in is the faster lane out of the bumpy road the ravaging pandemic has imposed on our lives and livelihoods.