Worry as Covid-19 patients spend more time in ICU

Patients admitted with severe Covid-19 are staying longer in the Intensive Care Unit (ICU), which is stretching hospitals’ resources.

Dr Mwita Riro, a consultant physician at Kiambu Level Five Hospital, told The Standard that patients are sicker and staying in the ICU for an average of 10 days, three times longer than previous stays.

Luckily, most of the patients are also recovering, unlike in the past where majority died.

“Though we suspect we might be dealing with the Delta variant that is causing longer stay, more studies need to be done, and ICU revamped to provide quality healthcare,” he said, adding that admissions in Kiambu are not as high as before.

But a report by the Ministry of Health indicates there is a gradual increase in the number of admissions, and ICU services are in demand countrywide.

The country has 861 ICU beds, according to an April report by the Kenya Medical Practitioners and Dentist Council.

The Kakamega Level 5 Hospital has six beds but is not admitting more than four patients because of high oxygen demand. By yesterday, three ICU beds were occupied while the isolation ward’s 15-bed capacity was full.

Dr Stephen Ouko, the in-charge of Covid-19 in Kakamega County, said most patients are facing stigma from the society, an issue that contributes to delays in seeking health care.

Patients seek care when incapacitated, and have multiple organ failure that requires ICU admission, resulting in a longer recovery process, the doctor said.

On average, patients are staying in the ICU for 14 days and the “long stay in ICU is attributed to severity of the illness. Most patients have liver and kidney damage that requires specialised care,” said Dr Ouko.

According to hospital records, 31 patients died last month. “The cause of death is kidney failure, sugar problems, acute respiratory failure, and severe referral cases. Our ICU capacity is not able to accommodate cases of multiple organ failure,” said Dr Ouko.

He added that the facility is planning to open a 10-bed capacity ICU, but a major challenge is lack of trained human resource.

Kenya Society of Anaesthesiologist chair Stephen Okelo said there is need to train more medics to manage ICUs especially with the anticipated fourth wave.

The country has about 200 anaesthesiologists, according to the society, with 120 stationed in Nairobi.

“Patients in ICU require specialised care, the reason why there is need for more human resource equipped with skills and knowledge,” said Dr Okelo.

Doctors and nurses in the ICU work with a multi-disciplinary team of physiotherapists, nutritionists, laboratory technicians, and social workers.

Dr Neto Obala, a clinical pharmacist coordinating Covid-19 activities in Kisumu, said that most patients at Jaramogi Oginga Odinga Referral and Teaching Hospital stay for two weeks to a month compared to previous waves even after testing negative.

“Some take longer to recover due to organ damage and such patients continue being admitted in hospital while put on supplemental oxygen until they recover fully.”

Dr Obala attributed the situation partially to “many newer strains that have been spreading”, adding that “it is in the domain of Kemri to explain. But some patients present to the facility too late.”

Last month, at least 93 Covid-19 patients died at the hospital against 240 admissions.

Dr Betty Shiruli, a physician at Mbale Referral Hospital, has observed similar longer stays in Vihiga County. “Most patient are so sick, some are dying at the emergency and casualty. Those with severe Covid-19 have low oxygen levels and fatigue, with mild ones having sore throat.”