MINISTRY OF HEALTH DATA AS REPORTED BY 1700 HOURS 06 June

COVID-19 OUTBREAK IN

DAILY SITUATION REPORT - 81

1.0 KEY HIGHLIGHTS

1. One hundred and twenty-six (126) new confirmed COVID-19 cases were reported in the last 24 hours bringing the total number of confirmed cases in Kenya to 2600 cases as of 06 June 2020. One hundred and thirteen (113) of the cases are Kenyans of which seven (7) have a travel history. Eighty-three (83) of the cases are local transmissions. Thirteen (13) of the cases are non-Kenyans; Congo (1), Erirtea (3), Tanzanian (5) and Ugandan (4). Counties reporting new cases are (56), Busia (54), (8), Migori (3), (1), (1), (1) and Uasin Gishu (1).

2. Four (4) deaths have been reported over the last 24 hours. The total number of deaths reported since the beginning of the outbreak is 83, case fatality rate (CFR) is 3.2 percent.

3. As of today, thirty-seven (37) out of 47 counties have reported cases namely: Nairobi (1220), Mombasa (776), Busia (181), (88), (60), Uasin Gishu (41), (32), Migori (29), (20), (18), Taita Taveta (17), (16), (13), Nakuru (12), Machakos (11), (9), (9), Kisumu (7), Turkana (7), (5), (4), (3), Murang'a (3), (2), (2), Kisii (2), Laikipia (2), Makueni (2), (1), Elgeyo Marakwet (1), Embu (1), (1), Kirinyaga (1), Meru (1), Na (1), Nandi (1), and Trans Nzoia (1).

4. Mombasa and Nairobi City Counties have the highest attack rates of COVID-19 at 64.2 and 27.7 per 100,000 population respectively when compared to 5.5 per 100,000 for the whole country and need enhanced interventions. In addition, the COVID-19 outbreak has so far spread to 77 percent of the counties in the country. Risk communication, laboratory testing, isolation bed capacity and sub-national operational support have been identified as key challenges.

5. Two thousand two hundred and thirty-two (86 percent) of the 2600 confirmed cases are local transmissions.

6. In the last 24 hours, 3632 samples were tested across various laboratories of which One hundred and twenty-six (126) samples turned positive for COVID-19. A total of 94507 cumulative tests have so far been conducted.

7. H. E. the President addressed the nation on the COVID-19 pandemic.

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COVID-19 SITUATION UPDATE: 06 June 2020

Total Cases Male = 1755 Deaths =2600 Female = 845 =83

1.1 Epidemiology Since 13 March 2020 when the first case was confirmed in Kenya, a total of 2600 confirmed cases and 83 have died giving a case fatality rate of 3.2 percent have been line listed. Of these, 2232 cases (86 percent) were local transmissions and 368 (14 percent) are imported cases. The Figure 1 below shows trends of cases. Mandatory quarantine was instituted on 25 March 2020 with testing of all quarantined people starting on 29 March 2020. Figure 2 shows cumulative caseload. Figure 3 shows number of samples tested by date indicating the positive and negative results. Laboratory test rate currently stands at 1986.9 samples per 1,000,000 people.

Figure 1: Trends of COVID-19 Outbreak Kenya

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1.2 Cumulative Cases

Figure 2: Cumulative case load

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1.3 Laboratory Testing

Figure 3: Laboratory Tests Conducted by Date Results were Shared

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1.4 Distribution of Confirmed COVID-19 Cases by Presentation Of the 2600 confirmed cases, 337 (13 percent) presented with symptoms (Figure 4). Cough (49 percent) and fever (45 percent) were predominant presenting symptoms (Figure 5).

Figure 4: Distribution of Confirmed COVID-19 Cases by Presentation

1.5 Presenting Symptoms among Symptomatic COVID-19 Cases

Figure 5: Distribution of Presenting Symptoms among Symptomatic COVID-19 Cases

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1.6 Age and Sex Distribution of COVID Confirmed Cases and Deaths One thousand seven hundred and fifty-five (68 percent) are males and 845 (32 percent) are females. Most of the cases; 805 (31 percent), are in the age group of 30-39 years. Figure 6 below shows age and sex distribution of COVID-19 cases. Eighty – three deaths have been reported so far, 64 (77 percent) being males and 19 (23 percent) were females (Figure 7).

Figure 6: Age and Sex Distribution of COVID-19 Cases Kenya

Figure 7: Distribution of Case Fatalities by Age and Sex

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1.7 Distribution of Confirmed COVID-19 Cases by County and Transmission Classification Of the 2600 cases, 1220 (47 percent) are from followed by with 776 (30 percent) as shown in Figure 8. Mombasa County has the highest attack rate of 64.2 per 100,000 population followed by Nairobi City County at 27.7 per 100,000 population (Table 1).

Figure 8: Distribution of confirmed COVID-19 Cases by County and transmission classification

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Table 1: County Attack Rate/100,000 population S/ County Population (2019 Cumulative Cases per 100,000 No Census KNBS) Cases population 1 Mombasa 1,208,333 776 64.2 2 Nairobi City 4,397,073 1220 27.7 3 Busia 893,681 181 20.3 4 Kajiado 1,117,840 88 7.9 5 Taita/Taveta 340,671 17 5.0 6 Kwale 866,820 32 3.7 7 Uasin Gishu 1,163,186 41 3.5 8 Migori 1,116,436 29 2.6 9 Kiambu 2,417,735 60 2.5 10 Mandera 867,457 18 2.1 11 Wajir 781,263 16 2.0 12 Garissa 841,353 13 1.5 13 Isiolo 268,002 4 1.5 14 Kilifi 1,453,787 20 1.4 15 Siaya 993,183 9 0.9 16 Kitui 1,136,187 9 0.8 17 Machakos 1,421,932 11 0.8 18 Turkana 926,976 7 0.8 19 Nyeri 759,164 5 0.7 20 Nakuru 2,162,202 12 0.6 21 Kisumu 1,155,574 7 0.6 22 Laikipia 518,560 2 0.4 23 Murang'a 1,056,640 3 0.3 24 Homa Bay 1,131,950 3 0.3 25 Embu 608,599 1 0.2 26 Makueni 987,653 2 0.2 27 Kirinyaga 610,411 1 0.2 28 Elgeyo/Marakwet 454,480 1 0.2 29 Kericho 901,777 2 0.2 30 Kisii 1,266,860 2 0.2 31 Meru 1,545,714 1 0.1 32 Trans Nzoia 990,341 1 0.1 33 Nandi 885,711 1 0.1 34 Bomet 875,689 1 0.1 35 Kakamega 1,867,579 1 0.1 36 Bungoma 1,670,570 2 0.1 Kenya 47,564,300 2600 5.5

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1.8 Map of Kenya Showing Distribution of Confirmed COVID-19 Cases by County

Figure 9: Distribution of confirmed COVID-19 cases by County

MOH Kenya /06 June 2020 9 | P a g e 1.9 Status of Contract Tracing as at Today Of the 2600 confirmed COVID-19 cases a total of 7926 contacts have been listed, 328 contacts (4 percent) have tested positive for COVID-19. Of the 2338 currently on follow up 2183 (93 percent) were followed up today.

2.0 KEY ACTIONS

2.1 Coordination ➢ During the 8th Presidential address on the COVID – 19 pandemic to the nation, H. E. the President of the Republic of Kenya, he indicated that KES 5 Billion had been disbursed to County Governments to increase their healthcare capacity in view of the pandemic. He directed and ordered the following: o Convening an extra – ordinary session of the National and County Government Coordinating Summit of Wednesday 10th June 2020 to consider the following salient matters: (i) review the effectiveness of the containment measures in place, (ii) secure the undertaking of every County Government to deliver isolation facilities with at least 300 bed capacity, and (iii) to develop time – bound protocols for progressive re-opening of the economy. o The lapse of the cessation of movement into and out of the Eastleigh Area of Nairobi and the specific limitations in force with respect to the Mombasa Old Town Area that was in force, at 4:00 a.m. on 7th June, 2020. o The lapse of the cessation of movement into and out of the Counties of Kwale and Kilifi that was in force, at 4:00 a.m. on 7th June, 2020 as a result of the successful containment of the disease in the aforementioned Counties. o Issuance and publication of guidelines on a gradual and progressive return to normalcy in the education sector by the Third Term, from 1st September, 2020 following stakeholder’s consultations in the education sector - the Ministry of Education jointly with the Ministry of Health. Further, that the ministry announces the new school calendar by mid-August. o Constitution of an Inter-Faith Council by the Ministries of Interior and Health within seven days, following consultations with interfaith and religious organizations, to work out modalities and protocols of re-opening of the places of worship. o Extension of the ban on all forms of gatherings, including but not limited to political gatherings, social gatherings, including bars for a further 30 days.

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o Extension of international travel restrictions are hereby extended due to the evolving nature of the disease globally. In the meantime, the Ministry of Transport directed to engage all Key Stakeholders and develop protocols to guide resumption of local air travel within seven days. o Extension of the cessation of movement into and out of the Nairobi Metropolitan Area, Mombasa and Mandera by 30 days due to the increase in patterns of infections. o Extension of the nationwide dusk-to-dawn curfew that was in force until 6th June, 2020 for a further 30 days. However, the commencement time for the same has been varied from 7:00 p.m. to 9:00 p.m.; with the end time for the same being varied from 5:00 a.m. to 4:00 a.m. Therefore, effective 7 June, 2020 the national wide dusk-to-dawn Curfew will run from 9:00 O’clock in the evening to 4:00 O’clock in the morning. o In addition, recognizing the negative economic impact of COVID-19, the Government has made targeted interventions to protect the economy.

2.2 Case Management and Infection Prevention & Control ➢ The total number of recoveries are 706. ➢ Kenya Red Cross and Bamburi Cement is supplying food for the quarantine centres in Kilifi through an arrangement brokered by the CEC from their warehouse in for three months. The focus has now shifted to ensuring that quality food is cooked and that the people in quarantine enjoy their stay. ➢ These are the health facilities managing the COVID-19 cases across the country : o Nairobi: Kenyatta National Hospital, Mbagathi County Hospital, Nairobi Hospital, Aga Khan University Hospital, MP Shah Hospital, Avenue Hospital and Kenyatta University Teaching Referral and Research Hospital o Mombasa: Mombasa County Referral Hospital, Aga Khan Hospital, Pandya Hospital, Mombasa Hospital, Jocham Hospital, Mewa Hospital and Premier Hospital. o Nakuru : Referral Hospital o Mandera : Referral Hospital o Siaya: Bondo County Referral Hospital o Kilifi: Kilifi Wananchi Hospital o Homa Bay: Malela Isolation and Treatment Centre o Kajiado : Ole Kasasi Health Cente, Referral Hospital o Busia : Alupe Sub – County Hospital

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o Bomet : Longisa Sub – County Hospital o Machakos : Kathiani Level Hospital o Migori : Nyatike Sub – County Referral Hospital (Macalder) o Taita Taveta : Rekeke Healthcare o Wajir : Referral Hospital o Kisii : Kisii Teaching and Referral Hospital o Kwale : Referral Hospital o Uasin Gishu : Kimelel Isolation Centre o Garissa: Ifo 2 Hospital, Referral Hospital o Meru: Meru Teaching and Referral Hospital o Kisumu: Jaramogi Oginga Odinga Teaching and Referral Hospital o Turkana: Kakuma Refugee Isolation Centre o Nandi : Nandi Hills Sub – County Referral Hospital o Isiolo : Referral Hospital o Kiambu: Kiambu Level 5 Hospital o Kericho: Kericho County Referral Hospital o Bungoma: County Referral Hospital

2.3 Surveillance and laboratory and point of Entry ➢ In the last 24 hours, 3632 samples were tested across various laboratories of which 126 samples turned positive for COVID-19. A total of 94507 cumulative tests have so far been conducted. ➢ Referral Hospital has since stopped testing for covid-19 due to shortage of testing kits. Thus, the specimens are taken to Moi Teaching and Referral Hospital or KEMRI in Kisumu.

3.0 KEY CHALLENGES

➢ The long turnaround time for relying laboratory results to clients in Busia and Mombasa Counties.

➢ Sub – optimal operational support for the sub – county teams to investigate alerts, rapidly respond, list and follow up contacts.

➢ Sub – optimal bed capacity for isolation of cases.

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➢ Commodity insecurity (i) Personal Protective Equipment at the sub – national level, and (ii) Laboratory testing reagents for the testing laboratories.

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4.0 NEXT STEPS ➢ Extra-Ordinary session of the National and County Government Co-ordinating Summit on Wednesday 10th June, 2020. ➢ Increase isolation bed capacity in every county. ➢ Mobilization of support (operational and logistical) for the sub – national level. ➢ Strengthening COVID-19 emergency supply chain logistics for both diagnostics and personal protective equipment.

Emergency Operation Center: Telephone: 0729 471 414, 0732 353 535, 0800 721316(Toll Free) COVID-19 Call center: *719# (short message only), 719 (Audio) Email: [email protected]

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