Officials explore home-based care for Covid-19 patients in Mombasa

More than 200 Covid-19 patients have been discharged from isolation facilities in Mombasa County to self-isolate at home.

The move which is a test of the home-based care stand to decongest the 450-bed capacity isolation beds in public hospitals in the County.

Mombasa county health chief officer, Dr. Khadija Shikely said self-isolation is crucial in dealing with the pandemic, however, she insisted it needs total commitment, discipline, and adherence to the ministry of health guidelines.

“We have released 80 patients from the Coast Provincial General Hospital, 129 from the Technical University of Mombasa isolation center, 3 from Mombasa Hospital and 2 from the Agakhan hospital. 62 have been isolated at home after tests,” she said.

Dr Shikely said asymptomatic only patients are allowed to self-isolate at home but they must follow the health directives. She explained that the spike in coronavirus cases is due to indiscipline.

The county chief health officer said for the health department to allow coronavirus patients to self-isolate, the individuals must live in a self-contained house to separate the patient from the rest of the family members.
A clinical officer will then call the patient now and then to check on their conditions.

"The clinical officer will call those who are self-isolating to check if they have temperatures, cough, tiredness, loss of breath among other coronavirus symptoms. But for the 14 days incubation period, you must stay indoors, no visitors thereafter you will recover from the disease,” highlighted Dr Shikely.

Dr Shikely said those hospitalized are given symptomatic treatment including antibiotics and vitamin to boost their immunity.

"We have three categories of patients, a suspected case is an individual who has symptoms but has not been tested for coronavirus. So we separate the patient from the rest, test to ascertain their condition. We also have those who have been tested and turned positive but have mild or lack symptoms. Last is a sick coronavirus patient, the individual is normally moderate or severely ill, they always have co-morbidities such as cancer, HIV, pressure, asthma, TB, and heart diseases,” explained Dr Shikely.

The chief officer said the elderly with opportunistic diseases are a major concern to the county whom she insisted must be admitted to the hospital.

She lauded Governor Hassan Joho’s leadership for his steadfastness in dealing with the pandemic stressing that the county has made strides by enhancing the health sector. The county has 450 coronavirus isolation beds.

"Mr. Joho’s leadership is exemplary; we are working with the donors and private sector who are supporting us in the fight against the virus. The private hospitals in Mombasa are helping us by donating their health workers in our public hospitals to deal with the pandemic” highlighted Dr. Shikely.

Support from USAID includes capacity building for health facilities, messaging. The World Health Organization has also supported the acquisition of medical and testing equipment.

“We should stop stigmatization against coronavirus patients. We have cases of many who are undergoing stigma after recovering from the virus, this is a disease that can affect anyone. It is not a lifetime disease, people heal. Let’s wash hands, sanitize, wear face masks and stay home, prevention is better than cure,” she said.

With the help from the USAID, the county has enhanced coronavirus sensitization in the villages.

When he was confirmed to be Covid-19 positive, Hussein Abdullah (not his real name) from Old Town was worried over stigmatization in Mombasa.

He really wanted to self-isolate at home to protect himself against the rife stigma on coronavirus patients.
Doctors were sent to his house to access the condition before he could be allowed to isolate at home.

“We have ensured no interaction with my family members because I live in a self-contained room where I cannot interact with my wife and three children who are negative,” he said.

“For any conversations, we interact through the door and the family WhatsApp group,” he added.

He added that in case of anything serious, and" if I needed anything, they would buy it for me and put it at the door where I stay and pick it up." Today, he is on his road to recovery.

The doctor further expounded on another family in old town area of Mombasa who has a Covid-19 patient self-isolating at home.

“The family requested for self-isolation and we had to send doctors to ascertain if they meet the requirements including separate room, sanitation facility, and a helper. The patient is still undergoing self-isolation at home and we are happy he is following the guidelines not to infect his family members;” she added.

According to Dr Shikely, the patient is taking his medication, eats a well-balanced diet, and has a doctor on call who checks on his condition.

“The doctor normally inquires if he has checked his temperature which he must check every day and note down in a book. In case of any slight changes, the doctor is dispatched to the home for further treatment. This model has helped us in managing Covid-19 patients at home, “she said.

She added Old Town which had the highest number of infections in the Coast region has a local model incorporating community health workers who assist in dealing with the pandemic.

"I am following the Ministry of Health guidelines to ensure I do not infect my wife and children. But I am lucky since our house is big so I am staying in my own separate self-contained room eating a well-balanced diet, getting counselling services, and living a day at a time,” said the patient.

Mombasa has 1641 cases and over 50 fatalities. Mombasa Deputy Governor, Dr William Kingi said the pandemic has affected the county’s economy with many rendered jobless. However, he assured the residents that the county government is receiving immense support from the USAID and the private sectors who are donating care packs to its over 200,000 residents to cushion them from the effects of the economic downturn.

“I advise the residents to eat a balanced diet and conduct exercises since lifestyle diseases make people vulnerable to the virus,” Dr Kingi said.

Dr Kingi said so far 50,000 people have received foodstuffs and they are distributing the food in phases until they cover the whole county.

“We are working closely with the Kenya Red Cross Society. We are looking at covering all 227,000 needy families in the County and ask them to follow the guidelines issued by the World Health Organization in the fight against Covid-19,” he added.

He said the county has conducted mass testing covering over 20, 790 residents.

The deputy governor said the county has also enhanced the supply of water to improve sanitation and hygiene, especially in the informal settlements.

“We have dug boreholes and set up water points especially in informal settlements in conjunction with stakeholders in areas that have challenges thus enhancing hygiene in those areas,” he added.

Kingi and Dr Shikely urged the residents to seek treatment in a hospital in case they fall sick.

“Don’t fear to go to the hospital to seek medication due to the pandemic. We have separated isolation wards from the general facilities to ensure we curb the infections and private hospitals have done the same. If you have any other disease, don’t fear to go to the hospital for treatment due to the pandemic,” he stressed.
They said the hospital is the safest place to be.