I might be speaking for myself here but when the virus was first reported, in China to be specific, I didn’t give much thought to it. “It’s quite far and plus China can handle this” IBrushed it off as am sure most people did. But as days turned into weeks and weeks into months the numbers kept rising and more countries became affected, and we all watched as the virus slowly turned into a global nightmare and right into our doorsteps.

After the Government and your organizations measures to protect you were effected, you attended (and maybe still do,) sensitization meetings on Zoom because you needed to learn. You are scared and desperate and any information you could get even if it means tattooing it on your skin you will do it. You go to the supermarket to buy a hand sanitizers and do some shopping but due to mass shopping panic that happened a while back, you can’t get some Items you would normally pass. They literally moved from being unwanted to essentials!!  After a Month or so, cases of Layoffs and Unpaid leaves grace your Television Screen, things got thick real first!   

Since the first case was reported, Kenya has put in place measures to prevent the spread such as encouraging social distancing and isolation for 14 days to visiting persons in the Country and as the confirmed cases rose, a curfew was introduced. The airspace in most countries were closed with only evacuations allowed for a limited time. The global space has shrunk all thanks to the virus.

We all know the extent of the effects to which the Virus has caused. Countries on lockdown, deaths and generally an awful way to end the first quarter of the year. Though a terrible disease, I want to look at it from another perspective. It has uncovered a lot of gaps, gaps which needless to say we must address. As a nation we must honestly evaluate the capabilities of our health systems and ask ourselves pertinent questions. What are the gaps we ought to address within our health care systems? Are we able to take care of the vulnerable groups?  As citizens are we going to stop maintaining the practice of hand washing with soap and water after the virus is long gone or contained?  Among others.

I may have a few ideas and so do you but I what I stand by, is this. We must maintain the hand washing practice at ALL cost. This virus has proven to us that it can be done and we need to continue with it. It should be done before boarding a public vehicle, entering a Government institution, offices, places of worship, school, Ferry you name it. This will not only help reduce the spread of this virus but also a load of other public health concerns such as Cholera and even TB.

Speaking of TB, there are tons of similarities between the symptoms of TB and COVID 19,  and maybe the few lesson we have learnt on TB could apply observing general hygiene practices like  covering your mouth when you cough and/or sneeze, and if you generally feel unwell visit the health facility near you .  Likewise we can protect ourselves from COVID-19 and TB by practicing safe distancing. If you can work from Home then do it, Wash your hands frequently and avoid touching your face in general as that is a point of entry for the Virus. Take care of your mental health it’s okay to be scared. We uncover new things about it daily, so do whatever you can do to remain sane. Exercise daily there is a ton of YouTube tutorials that can show you easy and not so easy work out exercises. Do the FIVE. 

With the partial lockdown of Nairobi, Mandera Mombasa, Kilifi and Kwale Counties, TB patients who need to transverse between Counties such as Kwale and Mombasa will be affected. Greatly! This may contribute to an increase in defaulter case and relapse cases in the coming months if we do not put proper strategies in place such as drug refill for a longer time for those that are in continuation phase. This will also affect the nutrition aspect of the patients as Nutrition in TB is important. Contact tracing is affected hence the visible signs of the effects of the Virus will be visible in the coming months after the COVID-19 is managed. As for now, if we can continue to give the much needed attention to the Virus and also not neglect the other diseases that need our attention we will have a medical crisis of its own kind. 

After the world has recovered, we will need to seriously look into our health care systems. Can Universal Health Coverage fill in the gaps in our health care system? Can making NHIF a Social Insurance help in health financing? All this we need to put it in out to-do list of the year because it’s safe to say some for your new-year resolutions are not going to be met this year. I have not yet made peace with that. I believe things will not go back to normal because normal is what got us here in the first place and what we do right now will affect how we will operate in the remainder of the year. This pandemic is both a lesson and an experience and we have to live it.

Stay Safe. Be well. Stay Positive

By: Sammy Kihiu, TB program Assistant

 As we ease into the seemingly new normal in compliance with ‘Social and distancing’ and minimizing unnecessary movement, in response to the COVID-19-pandemic and as this new culture takes shape, it is not without culture shock. The stark glare of the pandemic, the fear, the uncertainty, the distantness and abrupt proximity of the danger, the confusion and the ostensibly unending days are unfolding all at once.   The pandemic which was first reported in China in December 2019, surpassed over 1 Million Infections   as of April 3, 2020 and 52,238 deaths recorded so far.

Ordinarily, work flexibility would be seen as a privilege only a few get to enjoy, but what about the circumstantially imposed remote working?  It is also worth noting that these are not necessarily “ordinary’ times, a global pandemic is unfolding as we watch! What’s worse is that there is no time to stand by and watch because life must go on and one important aspect of it is continuing to work albeit from home.

For the employer questions of productivity and value for money linger especially if and when flexi hours is on a first time basis yet a necessary evil. For the employee even more questions suffice; how to   set up the infrastructure to effectively bring the office into the house and deliver. For those with families, how to balance the work schedule and family while in the same space for extended hours becomes a daily affair. What about productivity both qualitatively and quantitatively? What next after the seemingly infinite lockdown will I still have a job?  Uncertainties loom as employers also have to deal with unchartered territory.

As a human being, and being used to routine, first you are also tasked to explain to your children (if you have them) why you have to work with the TV on even when you said TV should always be off when focusing on serious matters, but you need to stay on top of things as far as the pandemic goes, by hopefully catching real time updates.

For most of us, the adult life has meant an 8am-5pm job, and this has for the longest time helped define the line between our homes and the workplace, but overnight these walls have collapsed and no one knows when they will be rebuilt, although we are asked to keep the hope alive. The world has been ushered into the cruelty of a virus so lethal, which has not just put our humanity to test, but also gripped us with fear and lots of introspection. But we know that life must go on, bills must be paid and mostly importantly we must safeguard our health as we all have a lot of rebuilding to do after this turbulence is over. The transition has yet gain brought out the resilient nature of human beings, and working from home has been one of those novel experiences that is laden with lessons for many who haven’t done it before:

Drastic changes requires drastic adjustments.  For most of the people who have always separated the office and workplace function, the sudden move of the office to your home means re adjustment to bring the office amenities to the household. Beyond the need for infrastructure( computer, internet), is the need for a quiet working space, and for most people this has become either the dining table or the bedroom but  if you have the tiny  running, hyper active and over energized soldiers then  your best bet is the bedroom  working under lock and key.

Time management is an utmost discipline. Suddenly we all have a lot of time in our hands but confronted with very few options. An old adage goes, to whom much is given, much is expected, and this time we are almost all equally gifted with long extended hours at home. Managing this time becomes critical to achieve an effective work and life or is it home balance. Once we have attended to the work needs, we have been forced to become creative in spending time to make the stay at home interesting. 

Technological savviness is inevitable: With the transition almost all services have become virtual, with technology   being employed in sharing, meetings, group tasks and even conferences.  Suddenly distant IT terms like ‘Microsoft teams, drop box, we transfer, documents collaborations etc have become inevitable. Needless to say some people are more challenged than others, but one thing that is clear is that we cannot avoid technology.  Virtual IT support has become the norm but this means you have to work on the nuts and bolts of learning software yourself. But take it in stride, it’s all in the learning curve!

Work life balance taken literally– for the longest time we’ve been guilty of tossing the statement work life balance and especially in relation to the family. However the full experience had been limited to the weekends that are further disrupted by personal errands, limiting it to a few hours of interaction. However, the experience of being under the same floor with our families for extended houses 24/ 7 is almost surreal. Gone are the days families would exchange small talk and pleasantries between catching up on news, doing homework and having dinner together before catching sleep for a few hours before the routine replays.  With no school or much engagements outside, there is all the time and suddenly there is need to have longer and hopefully meaningful and impactful conversations as a unit. Consequently, many people are relearning their children, spouses, and partners and even rediscovering themselves and their hidden talents and gifts, given the time in our hands.

When to hold and when to let go: When initially catching up on the news every second was critically important for most people, as the pandemic evolves, some people have sometimes opted to have a media   block. This could be so as to avoid unnecessary panic but also to focus on works or maybe it’s the adjustment setting in, that actually working from home can happen. In the face of such a pandemic, psychologists have advised that keeping off the negative news is important, as it may have negative consequences on your health.

The true value of colleagueship- Once upon a time before COVID-19,   weekends and sometimes working away from the office was one of those welcome breaks from sometimes monotonous office spaces with the same people and same vibe. But  as the days go by, and with  every  consultation coming  at a cost, and brainstorming sessions having  to be preplanned unlike when you’d just walk up to a colleague to pick the brain on an issue, the invaluable importance of the these engagements is becoming avid. We are slowly learning that the 8 hours that sometimes came across as toilsome, offered a lot in terms of comradeship that we may have often downplayed.  Boundaries have not just been challenged but thoroughly redefined.

Health is the greatest wealth; with the globe grinding to a halt because of the virus, there has been great introspection of what ones health and the health of a nation means and the need to safeguard health as the greatest wealth.

As we continue to novel our experiences, we must remain positive and hopeful, because after this tide, we have an opportunity to not just rebuild but to better what we previously had.

By Wachira Charity- Communications Officer KANCO.

A trait common in both Tuberculosis (TB) and COVID-19 (Corona Virus) is the characteristic fast and easy spread in the absence of – or non-adherence to – strict prevention measures. Their highly communicable nature can easily overwhelm a health system with adverse fountain effects to normal life.

Over the last one month, most of the world’s crucial activities have wound down with some countries and cities completely ground to a halt following the exponential spread of COVID-19.

With the pandemic having grabbed total global attention, the World TB Day 2020 may pass unnoticed or receive very little attention if any.

The World TB Day is an important marker of the global TB response where countries take stock of their achievements, challenges, highlight plans and recommit, yet again, to ending TB.

If WTBD 2020 passes silently, as it may likely do with all the attention directed to COVID-19, we may miss a good chance to reflect on our proactiveness, and/or readiness to deal with such diseases.

Historically, most countries capitalize on March 24 (World TB Day) and the run up days to create awareness, galvanising political goodwill, setting targets and outlining goals in efforts to eliminating the menace.

Without overemphasizing on the attention given to COVID-19, it is almost unfair that the much older and more persistent TB has not drawn such immense response. 

As a matter of fact, mortality due to TB, largely compounded by poor housing and living conditions in low income communities, has not triggered as much enthusiasm in addressing the squalid living conditions or the weak health systems and extremely limited political will, supplies and human resources to catapult preparedness as its younger counterpart COVID-19 has done.

Whereas this comparison may be criticised, the uniqueness in the COVID-19 response lifts the lid on our shortcomings in salient responses towards strengthening the fight against communicable diseases like TB.

First, it has managed to garner global attention and concerted efforts not just by leveraging great political good will across global leaders, but also has revolutionised research efforts globally, with scientists working round the clock to find relief / cure for this virus.

Secondly, it has reinvigorated philanthropy towards combating it as well as great citizen support for the cause.

Thirdly, there has been a remarkable breakthrough in technology and health systems strengthening. China set the pace with the construction of a state of the art quarantine facility in a record 10 days. I use the word quarantine emphatically given that its one of the biggest challenges we have in African health systems in the TB response, despite being an important structure in the TB management and control we still are lagging behind being in setting out this isolation facilities.

Fourth, the information flow through concerted global media efforts has been commendable. Citizens have had real time updates both from global and national media on the disease evolution, with messages on prevention, spread and who is vulnerable circulating every second.  These efforts have gone a long way in spreading awareness and inspiring citizens to be cautions but also in underscoring the implications of their actions on the wellness of their communities. It is however worth mentioning that in this internet age, this period has also seen the fuelling of many untruths and stereotypes especially on social media, detrimental to the global efforts in the fight against the virus.

Fifth, there is a general increase in health seeking behaviour, citizen heath policing, an array of emergency health hotlines and greater communications on the preparedness of the health systems to offer services related to the COVID-19 response. In Kenya, there is an emergency 24 hour hotline for the COVID-19 response in all the 47 counties as well as a clear and continuous communication on the risk factors and what needs to be done. There are general community and health systems coordinated efforts in the response. Furthermore, government efforts on contact tracing have been commendable, a strategy that has been traditionally used in TB management albeit not with such   thoroughness. The briefing on the death toll and the full understanding of the implications of the epidemic and our individual actions may have been instrumental in promoting citizen vigilance on the pandemic.

Back to TB. Drawing comparison with the COVID-19 response, TB claimed 1.5 million people in 2019, and there is an estimated 10 Million cases of TB per year while COVID-19 had claimed nearly 10,000 deaths as at March 20, 2020 and over 250,000 infections since it broke out according to WHO.

Further, for TB, a huge number of the new cases go undetected.  This fuels fears that  the WHO’s end TB strategy   by 2020 may not be on track given that only a 6.3 percent drop compared to the 20 percent drop target in 2019 has been recorded. The death toll has fallen only by 11 percent compared to the 35 percent target.

WHO further points out that the fight against TB is chronically underfunded, hampering efforts to strengthen its combat.

Despite decades of ongoing advocacy for increased political good will to end TB, increased resources for TB, strengthening of the health systems to effectively address TB, and bold commitments such as those made at the + United Nation High Level Meeting, globally  we are  still far from ending TB.

Bearing in mind the devastating effects of TB and the catastrophic cost of addressing the disease, one wonders why  we  are yet to pronounce it as a global epidemic to garner  more political goodwill and resources that are needed to make eradicating TB a reality. Sadly, most countries are yet to allocate adequate resources to curb the disease despite being signatories of the global commitments to end TB.

In Kenya, up to 40 percent of all TB cases are still missing (and potentially spreading the disease).  TB literacy still remains very low with new or emerging guidelines in the TB management and control, rarely reaching the communities especially in comparison to the COVID – 19 information flow in the short time it has been here. 

As we mark this rather quiet World TB Day, it is imperative that we truly introspect on what is needed to realistically address TB and what role each person should play to end  it.

As economies take a beating with the World economic Forum, estimating COVID-19  to cost about $1 trillion and as nations  turn to research and faith in effort to defeat this virus, we must remember that TB remains one of the leading communicable diseases, compounded by the evolution of the bacteria to more  multi-drug resistant strains, and truly commit to ending TB for good, because every life matters.

By Wachira Charity-Communications Officer, KANCO

References