Kenya: What is the Connection Between Pneumonia and COVID-19?

Ruth Nduati, a consultant paediatrician, wears a mask during the launch of ‘Break the Chain Initiative’ at Apple Wood Park in Nairobi on March 30, 2020.

A couple of days ago, a story circulated in the media about the alleged deaths of 17 children in Kilifi caused by a “strange illness”.

My Mombasa colleague Winnie Atieno followed up the case and talked with the Kilifi County Hospital Medical Superintendent Eddie Nzomo.

Dr Nzomo said the county is working very closely with the Kenya Medical Research Institute Wellcome in the county to intensify screening.

He said that the children died of pneumonia.

However, this did not persuade Kenyans on Twitter that this was not Covid-19.

FEAR

It certainly does not help that the term “Covid-19 pneumonia” has been thrown around in the discourse about this pandemic.

This fear is understandable and it does not occur in a vacuum.

Pneumonia is Kenya’s number one killer of children. In 2017 alone, the Ministry of Health reported that it killed 21,584 people.

So let us do some clarification.

Yes, there is a connection between pneumonia and Covid-19.

Before it was renamed, the World Health Organisation reported that Covid-19, which is caused by the Sars-Cov-2 virus, started in December 2019 in China as a cluster of pneumonia cases with an unknown cause.

HOW PNEUMONIA DEVELOPS

In summary, this is how pneumonia develops.

Lungs serve the critical work of purifying the air we breathe.

In the lungs, there are teeny tiny air sacs called alveoli. When we breathe, the air goes through them and then straight into the blood vessels. When any infection injures these sacs, they get inflamed, and in severe cases, dead cells fill it up preventing oxygen from getting through them. This is what respiratory infections, including Covid-19, do.

STUDY

In Kenya, there is a history of connection between viruses and pneumonia. In fact, Covid-19 has come a year after a study revealed some interesting data on what actually causes pneumonia.

For a long time, pneumonia was thought to be primarily bacterial. In fact, in Kenya, physicians often prescribe antibiotics to patients after judging that they have pneumonia.

However, the Pneumonia Etiology Research for Child Health study, which was conducted in Kenya and six other countries, showed that viruses caused most of the severe pneumonia cases (61 per cent). The respiratory syncytial virus was the leading pathogen (31 per cent) at all sites in all the 30 pathogens.

BACTERIA

Bacteria, which are eliminated from the body by antibiotics, were only found to cause 27 per cent of pneumonia. Therefore, it is correct to say there are many types of pneumonia.

It may be too early to say that scientists will add the virus responsible for Covid-19 – Sars-Cov-2 – to the list of what causes pneumonia.

Some have told me they are hesitant because this pandemic may be a passing dark cloud.

But be it as it may, the studies that have been carried out so far show the most severe cases of Covid-19 will have an element of pneumonia. Severe, not all.

COVID-19

Those who are unlucky to ever get Covid-19 experience the disease in different ways.

Some are subclinical and asymptomatic, meaning they have the virus but do not present any symptoms. Others get an infection in the upper respiratory tract, which is easier to treat. Then there are those who develop pneumonia, fall very sick and need assistance in breathing through ventilators.

ELDERLY PEOPLE

The World Health Organisation has repeatedly warned that the elderly and people who have a history of immune compromising conditions such as high blood pressure, diabetes and heart problems, are more likely to experience more severe cases of Covid-19.

While this is comforting to children and young people, it is a call for them to protect themselves lest they infect elderly people, whose health countenance may not survive the virus.

Dr Jeremiah Chakaya, a practicing respiratory physician allied to the Respiratory Society of Kenya, says that every pneumonia case in adults in Kenya will be treated as a potential Covid-19 case until proven otherwise.

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