Dr. Jason Kindrachuk, an infectious disease expert, discusses the impact of the Covid-19 pandemic on scientific research efforts with colleagues he’s worked with in Kenya.
I miss Africa. I grow more enamored with the continent each time that I go back. My last trip was nearly five months ago and, due to the uncertainty of the Covid-19 pandemic, I have no timetable on when I may get to return. I miss my colleagues and friends as well as the atmosphere – the people, sights and sounds. My first trip was in 2014, a volunteer deployment to Monrovia, Liberia, to provide frontline support for the Ebola virus disease epidemic. Over my deployment I realized that wherever my research career took me next, Africa would somehow be a focal point with capacity building and training being a centerpiece.
In January, I spent three weeks at the University of Nairobi Institute for Tropical Infectious Diseases in Nairobi, Kenya, providing emerging virus research training to students and staff through a travel award from Academics Without Borders. However, the continual escalation of 2019 novel coronavirus (as it was known at the time) infection cases in Wuhan, China, quickly shifted our research training sessions from “emerging viruses” to “this virus”. I traveled home in early February as cases began to spread into Europe, wondering how this virus would affect public health systems across Africa, in particular those in the most vulnerable regions.
How would a pandemic affect international research programs that have provided support for so long to combat infectious diseases and reduce social stigmas across the continent? How might this virus affect the training of local students and scientists that are pivotal for the long-term leadership of African research programs? Here, I have had the unique opportunity to interview colleagues and trainees for their insights on these questions.
How has Covid-19 affected international research efforts in Kenya?
Dr. Keith Fowke, Head of the Department of Medical Microbiology & Infectious Diseases at the University of Manitoba, has been intertwined with Nairobi for more than three decades. His work as a graduate student helped demonstrate that some women who were involved in sex work in Nairobi were immune to HIV. I have had the pleasure of spending time with Dr. Fowke in Nairobi multiple times and am continually inspired by how importantly he views his relationship with the local community as a true partnership. This has included continuing to work with the original cohort of sex workers from his investigations in the late 1980s. Through these efforts he has helped enable social networks for these women that have provided much needed support systems. Covid-19 has changed this dynamic.
I asked Dr. Fowke about the effects of Covid-19 on his ongoing research in Nairobi. “All of our research has ground to a halt in Nairobi” Fowke explains. “We were intending to start a small clinical trial but have not been able to as our lab staff have had to remain at home. We have a grant focused on improving communication between research participants, the first part of which saw four research trainees from our university travel to Nairobi where they met with peer educators in our program and went with them into the community to see how they live and work in their daily lives. The second part of this exchange was to have four peer educators to come to Winnipeg to observe what happen with the samples that they donate, provide research seminars and participate in a national symposium on respectful engagement with research participants. All of this has been cancelled with no current timetable for rescheduling.”
“The public health measures, including a curfew, have dramatically impacted the ability of our research participants to earn a living.”
I also asked Fowke how he has been able to communicate with his Kenyan trainees and collaborators in the absence of travel. “I’ve maintained connection with everyone through email and video conferences,” he says. “The students have training modules they are working on from home and I’ve maintained close contact with local collaborators. Scheduling meetings have been easier as everyone is close to their computers.”
But what about the potential impacts of Covid-19 on HIV programs in Nairobi?
“We had spent three years preparing for our clinical trial and now that has postponed and we are not sure how willing people will be to sign up for a research study following the Covid-19 crisis,” Fowke says. “The public health measures, including a curfew, have dramatically impacted the ability of our research participants to earn a living, as most work as daily income earners. We are worried for the health of people who are having an especially hard time finding enough income for food and lodgings.”
“In times of crisis, long-term health considerations, such as protecting oneself from HIV and other sexually transmitted infections, become secondary,” he continues. “We are concerned that people are engaging in risky behavior and that rates of these infections may increase because of the Covid-19 public health measures. A real danger is the redirection of our funding to Covid-19. We have already been asked to make provision for dealing with a 25% decrease in our budget due to funding redirection. This will have the impact of closures of some of our clinics and not being able to reach as many people for HIV prevention and care services. This is definitely taking a step back after having fought for slow progress over the years.”
How has Covid-19 affected Kenyan infectious disease students and trainees?
During my training session in Nairobi this past January I had the distinct pleasure of working with an amazing group of Kenyan research trainees. Covid-19 has impacted research efforts and training programs across the globe, including for students within my own laboratory, and it is currently unknown how this will affect the progress or scientific career aspirations of our trainees. For this article I wanted to focus on the effects of Covid-19 on international research trainees in low-and-middle income countries. Ms. Delories Sikuku and Ms. Peggy Obam are Master’s students and Mr. Ken Omollo is a PhD student, all enrolled in their graduate programs at the University of Nairobi. Their work on HIV is facilitated through a collaboration between the University of Nairobi and University of Manitoba.
I first asked them when they became aware of Covid-19 and any potential impact on Kenya. Delories responds: “I personally got wind of the existence of the virus in China in early January 2020, a little later than I should have, considering my affiliation to an Infectious Minds Journal Club besides being a Medical Microbiology and Infectious Disease postgraduate student. Nevertheless, I did not pay much attention to it because I assumed it would likely not spread far from the initial infectious epicenter. Despite the alarming spread over January, it still never occurred to me that it would get to my very doorstep. The virus ultimately spread across Asia and beyond within just a few weeks. Africa, especially Kenya, was not exempted from this.”
“The pandemic has brought our research to a halt because we have been encouraged to stay home in order to stop the spread of the virus.”
She continues: “The arrival of the pandemic in Kenya and its impact dawned on me on the morning of March 15th after a notification of closure of the University of Nairobi. I already had speculations on the impact the pandemic would tag along but wasn’t ready to come to terms with this. Earlier on during a journal club session, we had had an informative talk and discussion about Covid-19. You had voiced your concerns about our preparedness as a country and a continent to handle epidemics, citing the Ebola epidemic that had paralyzed West Africa in the recent past.”
Ken provides some additional insights: “News about the outbreak of a respiratory illness in Wuhan started streaming in Kenyan media the first week of January. I got in touch with a friend studying in Wuhan who confirmed that indeed people had fallen sick in the city and at their Institute. Kenya and China have extensive trade links, with several direct flights operating from Nairobi to cities in China. The port of Mombasa also receives ships from China. The outbreak in China posed a direct threat to Kenyans due to the passenger volume between the two countries.”
I asked Peggy how the pandemic has impacted both her research and non-research life. “The pandemic has brought our research to a halt because we have been encouraged to stay home in order to stop the spread of the virus. I am not able to go to work, nor can we collect or run samples,” she says. “Our research project which was to start in April has been put on hold because of the pandemic and we really don’t know when we will resume work.”
Delories also provided insight: “The pandemic has brought the project my team and I were working on to a standstill. We are now working from closed doors in the not-so-work-inspiring comfort of our homes due to the government-imposed restrictions aimed at limiting the spread of the virus. Online learning has been a challenge given the poor connectivity in residential areas, not to mention the expenses incurred on data since not every house has a VPN. As a postgraduate student, I feel the delay in reopening will impact significantly on my studies.”
Ken adds: “As a PhD candidate, working from home has given me quiet time to focus on analyzing data, polishing manuscripts and writing my thesis. I also spend some time writing short reviews of Covid-19 papers for Immunopeadia and answering my friend’s questions about Covid-19 on social media.”
“There is a great need for public health education on the misconceptions surrounding infectious diseases.”
Lastly, I asked all the students if Covid-19 has impacted their views on careers in infectious disease research. All the students had similar responses. “It has increased my desire in infectious disease research because I would like to know more” Peggy explains. “I would like to know more about the transmission, pathogenesis, treatment options and prevention measures of infectious diseases as well as what we can do better in terms of surveillance, trained workforce, laboratory testing and emergency management systems.”
Ken echoes these thoughts: “I feel emboldened to continue pursuing a career in infectious disease research. Our labs have the physical infrastructure for research of high-level pathogens and I think it’s time to tackle emerging pathogens like SARS-CoV-2. I feel there’s a gap in scientists’ engagement with the public in dissemination of the right information during pandemics like this. However, there’s opportunity for us to get community engagement and scientific communication skills to be able to educate the public at national and grassroots levels”.
Delories is equally enthusiastic: “Personally, my interests in infectious disease research have grown immensely. The pandemic has enhanced my love for infectious diseases.”
She also echoes Ken’s comments on the importance of science communication: “There is a great need for public health education on the misconceptions surrounding infectious diseases – especially on their origin, spread, treatment and control. This needs to be a focus for us in populations where literacy might also impact these misconceptions.”
It is important to recognize that Covid-19 had drastic effects on education and training programs around the globe, including in regions that are already highly vulnerable to public health crises. However, it is equally important to recognize the resiliency in researchers and, importantly, young investigators and trainees – an aspect that we so desperately need for future spillovers and outbreaks the world over.