By Blamuel Njururi, Kenya Confidential Editor-in-Chief, Nairobi – April 3, 2020
Nairobi County Governor Gideon Mbuvi Sonko has of late been active on his Twitter handle telling Nairobians that he is fumigating city streets and markets to protect them from Coronavirus contamination. That as may be commendable, he however, has not done anything in residential areas where large population can be wiped out by a breakout of the pandemic. He should.
The Nairobi County Government and all other property owners countrywide should take up the responsibility of fumigating their properties from which they collect rent every month. In greatest danger are those living in apartments where Coronavirus can spread like wildfire with infection of a single tenant in a block of apartments.
The spread of virus would be aided by staircase rails in most block that tenants use to support themselves and elevator buttons pressed by tenants to access their apartments in different floors. Most staircases are poorly ventilated meaning the virus can take residence freely for several days.
During the 2003 SARS coronavirus outbreak in Hong Kong, for instance, one patient infected many others living in the same complex of apartment buildings, resulting in 19 dead.
The spread of infection is thought to have been caused by airborne viral particles that were blown throughout the complex from the initial patient’s apartment unit.
As a result of greater viral exposure, neighbours who lived in the same building were not only more frequently infected but also more likely to die. By contrast, more distant neighbors, even when infected, suffered less.
The County government should immediately fumigate its apartment blocks and direct all other landlords to follow suit. Human habitat should take priority over roads.
From a medical viewpoint it would be unethical to experimentally manipulate viral dose in humans for a pathogen as serious as the coronavirus, but there is evidence that dose also matters for the human coronavirus.
Low-dose infections can even engender immunity, protecting against high-dose exposures in the future. Before the invention of vaccines, doctors often intentionally infected healthy individuals with fluid from smallpox pustules.
The resulting low-dose infections were unpleasant but generally survivable, and they prevented worse incidents of disease when those individuals were later exposed to smallpox in uncontrolled amounts.
Despite the evidence for the importance of viral dose, many of the epidemiological models being used to inform policy during this pandemic ignore it. This is a mistake.
People should take particular care against high-dose exposures, which are most likely to occur in close interperson interactions — such as coffee meetings, crowded bars and quiet time in a room with Grandma — and from touching our faces after getting substantial amounts of virus on our hands after handshakes.
Inter-person interactions are more dangerous in enclosed spaces and at short distances, with dose escalating with exposure time. For transient interactions that violate the rule of maintaining six feet between you and others (social distancing), such as paying a cashier at the grocery store, keep them brief — aim for “within six feet, only six seconds.”
Because dose matters, medical personnel face an extreme risk, since they deal with the sickest, highest-viral-load patients. We must prioritize protective gear for them.
For everyone else, the importance of social distancing, mask-wearing and good hygiene is only greater, since these practices not only decrease infectious spread but also tend to decrease dose and thus the lethalness of infections that do occur. While preventing viral spread is a societal good, avoiding high-dose infections is a personal imperative, even for young healthy people.
At the same time, we need to avoid a panicked overreaction to low-dose exposures. Clothing and food packaging that have been exposed to someone with the virus seem to present a low risk.
Healthy people who are together in the grocery store or workplace experience a tolerable risk — so long as they take precautions like wearing surgical masks and spacing themselves out.
Further afield, the Kenya Government must of necessity mount aerial campaigns using Army, Police Air Wing and private choppers to distribute Public Awareness flyers and preventive materials – even dropping such flyers from the air to impress Kenyans about the grave danger posed by coronavirus.
Kenyans are used to being politicians hopping around counties ranging from the president, his deputy and governors in choppers during elections, it is high time they see them distributing information and products that can save their lives to vote or reject them come 2022.