Introduction

Globally 676, 264,168 cases have been reported with cumulative deaths of 6, 772, 226. Kenya has reported cumulatively 342817 covid 19 cases, 5688 deaths and 337 095 having recovered since Kenya reported the 1^st case in March 2020.

Various strains of covid 19 have evolved overtime as well as interventions to control the pandemic, restriction of movement, social distance, masks, hand hygiene, vaccines and now covid therapeutics. Covid has also been characterised with episodes of waves with different epidemiological patterns globally including severity of the disease.

CHAI INTERVENTIONs

Chai worked with ministry of Health to set up testing system through PCR leveraging on existing equipment in HIV program. This had various challenges with sample transport as testing sites were few supporting the whole country, including turnaround time sequentially affecting contact management. To address this challenge Chai worked with MOH and counties to catalyse utilization of POC antigen test at facility level to aid timely diagnosis in less than 20 minutes. Technical assistance was provided to MOH to include testing commodities both PCR and Antigen as well as oxygen in GF CR19 post donation.

Chai worked with MOH to have 1^st ever interim guidelines for case management of covid which defines treatment based on severity of disease. Worked to support Oxygen accessibility and availability in country for Severe cases.

Current gaps:

•  Testing currently is low due low threshold for testing, test kits expiring at facilities,
• Treatment not available for Mild and Moderate cases.
• No linkage for testing and treatment of covid
• Weak COVID-19 response coordination

To address the said gaps Chai through MOH will introduce a test and treatment model for Covid with introduction of covid therapeutics particularly antiviral Medicine (Paxlovid). Paxlovid averts approximately 88% of patients being hospitalised. For this to be adopted in the country Guideline, M&E tools, LMIS tools revision will be required to support the adoption.

INTERVENTIONS

Service delivery

Through an integrated approach will leverage on some approaches such as:

1. Case identification

a.     Active case finding to enhance bidirectional screening and diagnosis strategy for both Covid 19 and TB through lung health.

b.      All patients with chronic diseases and above 60 years to be screened for Covid

c.      Contact management

d.      Integrate COVID-19 into routine health care & Target high-risk populations for timely diagnosis

Areas of integration:

1. Linkage to treatment

All tested and positive covid cases appropriately graded for severity and put on treatment mild and moderate cases

Selected facilities will be used to test out the model to have experiences in guiding National scale up.

Supply chain

·        To enhance test and treatment model testing and therapeutic commodities will have to be guaranteed. Test kits and oxygen are already being funded by GF.

·        Through the catalytic donation 7000 doses of Paxlovid will be provided to MOH

·        Distribution system for covid therapeutics 

·        Transitioning funding to next GF funding cycle or MOH for Antivirals

·        Work with Global team for generic product availability and work out for other antiviral products for the country.

·        Forecast and quantification for COVID-19 commodities

Expected Outcomes

·        The introduction and scale-up of treatment is an opportunity to reduce mortality from COVID-19 and reduce the burden of future outbreaks on health systems.

·        Sustained test and treat model for COVID-19 cases at facility

·        Transition funding for covid therapeutics