The true cost of Covid-19

Depending on the severity of the disease, the cost of treating Covid-19 can range from tens of thousands to millions of shillings.

Research by Dr Edwine Barasa and Dr Angela Kairu from Kenya Medical Research Institute (Kemri) showed that daily treatment costs in hospitals should range from Sh21,359 per day for asymptomatic patients, Sh21,361 per day for patients with mild symptoms, Sh24,705 for patients with severe disease and Sh51,684 for critical Covid-19 patients in ICUs.

Going by those estimates, a patient with severe symptoms put in isolation for a week would be required to pay Sh345,870 as hospital bill or for a patient who is critical Sh723,576.

The reality of the bills

But the actual costs patients and their kin are incurring per day are worlds apart.

For instance, Isaac, a critical patient who was admitted in KUTRH ICU from the first day, was incurring an average of Sh76,000 for every day he was on treatment.

For Isaac’s two week hospitalisation at the government facility, his family is now facing a medical bill of Sh 1.1 million. The family has until the end of this month to raise any issues they have with the bill and settle it.

With Kenya’s predicted peak of September mere weeks away, thousands of people across the country are likely to be infected and may need to be hospitalised.

Granted, while most people who contract Covid-19 might not to be hospitalised, those who developed severe symptoms that require treatment at a hospital can expect big bills.

For each day that Isaac was in hospital ICU, he was being charged Sh25,000. Haemodialyisis, urea and electrolytes (UEC) tests push the costs even further.

But even that is a negligible sum compared to the Sh 35,500 that patients at private city hospitals have to part with.

They are admitted into the hospital, where they are put under intensive care for several days, or weeks.

What are you paying for?

Billing records provided to My Health by patients and relatives, some of who lost their kin, show just how expensive it is to treat the virus. The bills are broken down to the costs of:

1.     Professional care

2.     In patient stay

3.     Oxygen tank fees

4.     Ventilator charges

5.     Cost of drugs

6.     Cost of PPEs

7.     Dialysis

8.     Cost of medical equipment and devices

9.     Kidney function tests

The most significant costs in Issac’s case are those of pain medication. In Isaac’s case, it was Dexmedetomidine, a sedative and pain medication that he received over a hundred shots of. The cost of one injection is Sh 1,563 and Isaac’s ultimate bill for that was Sh170,367.

He also received injections of midazolam, a drug that is used as an anesthetic and to induce sleep, and 116 shots of Cisatracurium, a skeletal muscle relaxant. Each of those shots cost Sh415, the cost of treatment with the drug rising to Sh48,140.

Nursing care and doctor’s review added up to Sh75,000, the bulk of which went to nursing care.

The high cost of treatment is driven by PPE costs which accounts for approximately 65 per cent of total costs.

Private hospital

A bill by Maxwell Oloo*, admitted at MP Shah, a private city hospital, showed he was paying more than Sh60,000 every day for PPEs.

On the first day of admission, Maxwell parted with Sh174,000. He went on to incur of bill of Sh1.7 million over the 11 days he was in the hospital, eight of those spent in the ICU. In that isolation unit, he was admitted with three other patients.

Let’s breakdown his bill.

On some days, Maxwell was charged for six, other days 10 protective white disposable coveralls which cost Sh6,450 each. For the period of his treatment, the disposable coveralls used cost Sh206,400.

N95 masks cost Sh1,650 per piece and Sh85,800 for the entire hospital duration. Each head and eye shields cost Sh2,000 and while a protective isolation gown cost Sh4,104.

For instance, on his fifth day in hospital Maxwell was billed for eight

N95 masks, six head and eye shields and seven disposable coveralls. The total cost for PPE on that day was Sh61,350.

For a ventilator in a public hospital, the cost is Sh1,100 per day, so is a cardiac monitor. Comparatively, a ventilator in a private hospital is Sh5,000 each day, five times the cost levied in a public hospital.

But while public hospitals charge Sh5,000 each day for an oxygen tank, the charge is exorbitant put up against the Sh2,880 that private hospitals charge.

For every day that he was in hospital, the doctor was billing Sh8,000.

Luckily for Maxwell, with the help of friends and family, enough money was raised to pay the entire amount and he is now home and recuperating.

Does insurance cover Covid-19?

Insurance providers have been flip-flopping over their stand on the payment of Covid-19 bills.

Some insurers have communicated to their clients that they will only foot bills incurred in public facilities.

The Insurance Regulatory Authority, a fortnight ago, told the Senate that insurers would not pay for treatment in private hospitals.

The Association of Kenyan Insurers (AKI) on the other hand, is concerned that with the increasing number of Covid-19 cases and the eye-watering bills, the insurer would be unable to afford it.

Last month, National Hospital Insurance Fund (NHIF) issued a circular to hospitals that it would only provide cover for Covid-19 patients admitted at the Kenyatta National Hospital (KNH), Kenyatta University Teaching and Referral Hospital, Mbagathi Hospital and other Health ministry-designated hospitals in the counties.