Today marks a month since out first COVID 19 case was identified. 31 days from Patient 0 to 197. Its been 18 days since the last passenger flight touched ground. Which means the next ten days mark an important new phase for #CoronavirusInKenya . Why?

Ostensibly - all imported cases should be known by now. 18 days for the outer bound of quarantine for the last flights and 30+ days for those who arrived earlier. EXCEPT we have no line of sight on asymptomatic cases that may have come in before the mandatory quarantine period.

That said we haven't seen a sharp rise in COVID admissions or fatalities as we reach the outer bounds of unknown imported cases - which is great news! BUT we are basing a lot of what we know about COVID transmission on countries that have gone before us.... question is should we?

While the mechanics of the virus in a human body are the same, what's different here is both the disease and the population demographics. Most European countries are skewed towards older populations and non-communicable disease (NCD) health issues. We on the other hand...

have much younger populations and tend to deal more with the reality of infectious diseases. Which probably means that we don't have a good handle on what our prevailing co-morbidities will look like when under the strain of COVID. Not saying that they won't be as bad

that it *could* be a different picture. Unfortunately at this stage it's a wait and see situation. Interestingly what's our new ace upper sleeve is the huge leap in testing capability we have 37,000 a day (who knew that our HIV legacy would offer such an unexpected boon ?)

The big question now is who do we test? Imported cases are known, a few local transmission cases have cropped up but what would be the plan? That's why the next ten days are crucial for understanding #CoronaVirusInKenya. Our go early and go hard (closing schools immediately..

... curfew, stay at home, containing 4 counties) might have worked in our favour like New Zealand (which may have had the strongest contain and curb effect) BUT that's the biggest challenge in public health. Its always difficult to prove the counterfactual is a result of action.

If we have been successful in curtailing I hope folks won't be postulating about how we overreacted. Because Pandemic Preparedness 101 is this: What seems like an overreaction beforehand will look like an underreaction in hindsight... and many countries are living that horror.

Either way - April 23 should give us many the answers we seek. Are our demographics and @MoH_Kenya decisions working in our favour? ... or might we still have ticking time bomb silently moving in our midst? My prayer is the former but only time will tell. Aluta ...