Surveillance and epidemiologic evaluation of COVID-19, DFID-2019 Serosurveillance Project

With more than 10 million confirmed SARS-CoV-2 infections, 500,000 deaths reported by 1st July 2020 and enormous costs to the global economy, the coronavirus disease 2019 (COVID-19) pandemic ranks among the most urgent crises in recent history. While
high-income countries appear to be approaching their first epidemic peak, most Lowand Middle-Income Countries (LMICs) are anticipating an exponential increase in cases. In Kenya, over 6,000 cases have been confirmed among more than 170,000
individuals tested and close to 150 deaths reported as of 1st July 2020. The national COVID-19 response is led by the National Emergency Response Committee overseeing the Emergency Operation Centre (EOC). EOC coordinates technical activities at
national level and with counties through Rapid Response Teams implementing case identification, contact tracing and isolation.

RT-PCR assays from nasopharyngeal (NP) and oropharyngeal (OP) samples remain the molecular test of choice for the aetiologic diagnosis of SARS-CoV-2 infection currently taking place at six laboratories across the country (including KEMRI Centre for
Geographic Medicine, Coast). The sudden increase in demand for nasopharyngeal swabs and viral transport medium generated by the pandemic has exerted pressure on global supply chains for these supplies and hampered mass testing in the country.
The government has instituted measures to slow the progression of the pandemic in Kenya, including promotion of hand hygiene, cough etiquette, and wearing of face masks in public areas, limiting social gatherings, suspension of international passenger
flights into and out of Kenya, extended school and workplace closures, introducing a nationwide curfew, restricting travel into and out of “hotspot” counties, and mandatory quarantine for suspected cases. These interventions are aimed at “flattening the
epidemic curve” to avert deaths arising from a surge in demand for services exceeding the capacity of the health system. However, these measures are also associated with substantial economic and societal costs. Governments are therefore faced with the
dilemma of choosing between minimizing deaths arising directly from COVID-19 and the negative secondary impact of the mitigation measures. The optimal solution to this dilemma relies on the availability of accurate and timely surveillance data to inform
planning while strengthening health service delivery.