Mystery of PS, MP quarantined for 60 days

Thursday, July 16th, 2020 00:00 |
Matilu Mwau.

A Principal Secretary, a senior Member of Parliament and two judges are among several high-ranking Kenyans who have been forced to remain in quarantine for the last 60 days after testing positive for Covid-19.

Also forced into isolation is an Under-Secretary in a government ministry and the head of a leading government institution.

They are among about 100 individuals who have remained positive for the deadly virus for more than the 14-day World Health Organisation (WHO) stipulated recovery time, despite not showing any signs or experiencing any medical complications.

The revelation comes in the wake of demands by employers that their employees who test positive for coronavirus obtain certificates indicating they are free of the virus.

Already, Kenya Medical Research Institute (Kemri) has taken a keen interest in the individuals who have been forced to remain indoors until their tests turn negative and they are given the all-clear to resume normal operations.

The second-term MP, who holds a key position in the National Assembly, and the PS have been forced to delegate duties to their colleagues as they await tests to turn negative.

The two judges—a male and a female—have passed on their workloads to colleagues at the Court of Appeal and High Court, respectively.  

Some of the affected individuals, who had experienced constant coughing, running nose, headaches, difficulty in breathing and fever at the time they were taken into quarantine, are now worried Covid-19 could cause long-term health problems after they tested positive a record eight times within a 60-day period.

Although WHO has ruled out possibilities of an asymptomatic person being infectious after 10 days, researchers at the State agency are trying to determine the individual persons’ viability to carry the virus for that long.

“Interestingly, the cycle threshold (ct) value of some of the individuals in question registers between 24 and 27, which is an indication the virus is still active.

For somebody to be safe from the virus, their ct must register above 30,” says Prof Matilu Mwau, the head of Kemri’s research and testing unit, who is leading the study.

He says though the persons in question cannot be infectious, his team is looking at the development of Covid-19 antigens in their bodies.

Mild and asymptomatic Covid-19 cases typically recover within two weeks, while those with severe or critical diseases may take three to six weeks.

Mwau says it is unusual for somebody to remain positive for more than 60 days.

“We do know when people are infected, after they recover they may continue to cough up and excrete viral debris for some period of time,” he said.

“And it is not necessarily something that reflects infectiousness or contagiousness, although many hospitals and nursing homes require a few negative tests after somebody has recovered in order to clear them.

It is possible the virus could be detectable in the upper or lower respiratory tract for weeks after illness onset.

At the moment, nobody knows the duration of viral shedding and the period of infectiousness for Covid-19.”

The development has put doctors in a dilemma on whether to clear people who have tested positive after the WHO 14-day stipulated time frame or wait until one becomes negative.

The situation becomes more complicated for persons whose employers have made the acquisition of a Covid-19 certificate as a prerequisite to return to work.

Dr Githinji Gitahi, Amref Africa chief executive, who is also an infectious diseases specialist, says Kenyans should not get bothered over the latest development.

“That should not be of much concern because after 10 days, the person infected cannot transmit the virus.

But for purposes of taking precaution, it is advisable for one to remain in isolation for at least a week,” Gitahi told People Daily by telephone yesterday.

According to Gitahi, it is as a result of the possibility of an individual remaining positive for a long period that WHO and the Centre for Disease Control and Prevention recommended two different ways for use to determine if a previously infected person can safely leave isolation.

Viral remnants

He says one way is to conduct tests until there are two consecutive negative results, taken no less than 24 hours apart.

“Not everybody needs to get this two-test type of protocol because it is usually used for someone being discharged to a nursing home.”

The other way to determine recovery, he says, is symptom-based. “If a patient is without symptoms for a week and has not had a fever for three days (without relying on fever-reducing medications), then they can be considered recovered.”

Gitahi says the asymptomatic individuals who test positive after two or three weeks do so because their bodies “still contain viral remnants of the virus”, adding the tests could detect these remnants for weeks at a time for some patients.

“It is highly suspect that these people are having viral debris that are still in their nasal passages that are being picked up by the tests. So there is nothing to worry much about,” he said.

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