Health system still ill-prepared to tackle virus

Kenya’s health system might collapse under the weight of coronavirus pandemic and other illnesses that still ravage citizens.

In the past week, there have been several reports about Kenyan hospitals buckling under the weight of the coronavirus pandemic, albeit silently, and with this information being contradicted at every corner, many are left wondering about the real state of affairs.

The Ministry of Health’s data on the number of confirmed cases in Kenya indicate that nine in 10 people with the virus have no symptoms. These ideally would be people who need not be hospitalised at all, but should be at home in self-isolation until the viral shedding is over.

The other 10 per cent with symptoms have had mild sicknesses. Unfortunately, some of those who had severe illnesses died. Those were patients with pre-existing conditions like hypertension, diabetes or cancer and the elderly, especially men above the age of 60.

By the end of last week, only 29 people were seriously or critically ill in Kenya. These patients are admitted to various private and public hospitals.

This begs the question, if the health system is overwhelmed, what is the cause?

Doctors working in several city health facilities have taken to social media to warn the public about how stretched they are because of the coronavirus patients.

In one of the high-end private hospitals in the city, the 11-bed ICU was full and seven of their patients in the unit had Covid-19.

One doctor said that if under normal pre-coronavirus circumstances, ICUs and HDUs used to get overwhelmed, the situation has got worse under the pandemic.

The reality, going by doctors’ sentiments, is that since there is an increase in the number of patients being diagnosed with Covid-19 and getting admitted to hospitals, getting a free bed is a tall order.

Hospitals still need to attend to other illnesses that would demand critical care even as the critically ill from coronavirus are admitted.

Going by the number of critically ill patients on paper, the country’s health facilities should be able to comfortably attend to them without breaking a sweat.

But going by the grapevine, there are many sick people who are yet to be diagnosed.

Preliminary data from a Kemri study estimates that at least 2.6 million Kenyans have been exposed to the virus. This would mean that many more might be critically ill, demanding critical care that is not readily available in Kenya.

The national and county governments had been given at least three months to put their houses in order and ensure that as many Kenyans as possible have a chance of surviving the virus.

According to best practice globally, hospitals need at least one critical care bed that is fully kitted for every 50 ward beds. Due to the unique demands of the pandemic, to prepare best would have been to increase this number to at least two beds.

Videos of Covid-19 patients partying and dancing in isolation centres indicate that resources are otherwise being wasted on people who should be under home-based care. This would automatically free bed space and room for patients who actually deserve to be admitted because of being symptomatic or being at risk of severe disease.

This would allow hospitals to improvise, if need be, and turn a space to a critical care one when the need arises.

Should the current containment measures and curfew be lifted without hospitals being prepared as the last line of defense, Kenyans will be exposed and left to their own devices.