•The plan was to avoid congestion in healthcare facilities should the numbers go beyond what the healthcare system can handle
•The previous model had projected at least 10,000 positive cases by end of April.
Image: MAGDALINE SAYA
The Health Ministry will not allow home-based care for coronavirus patients with mild symptoms just yet because Kenyans are indisciplined.
Health Cabinet Secretary Mutahi Kagwe says the plan has worked elsewhere but would be difficult to implement in Kenya because citizens will not obey the rules.
And as targeted mass testing that began on Friday continues, the number of coronavirus positive cases has risen and is expected to keep going up.
Initially, the plan by the government was to adopt home-based care for patients with mild symptoms.
The plan was to avoid congestion in healthcare facilities should the numbers go beyond what the hospitals can handle.
The previous model had projected at least 10,000 positive cases by end of April.
Kagwe on Friday, however, said even though the ministry retained the same plan, high levels of indiscipline among Kenyans remained a great hindrance to the success of the programme.
"Let us be honest, there is no other reason. In Germany and Sweden they have got basically perfect home care quarantine policies essentially because they will obey the law and the rules,” Kagwe said.
“We have ourselves seen the culture here. Home care programmes will be introduced very slowly and at a time when we think and know that we are taking this disease seriously.”
He said there had been special cases where the arrangement worked. For instance, some people who will be coming back from India this week, some who are hospital cases, will not be quarantined.
“We will ask their doctors to be the supervisors of their home care for the home care programme but as for the general public, we do not still feel confident enough to launch that programme.”
What WHO guidelines say
The World Health Organization developed interim guidelines to meet the need for recommendations on safe home care for patients of Covid-19 with mild symptoms.
The global health agency says that for those with mild illness, hospitalisation may not be possible because of the burden on the health care system, and will only be required in case of rapid deterioration.
If there are patients with only mild illness, providing care at home may be considered, as long as they can be followed up and cared for by family members.
According to WHO, patients with mild symptoms and without underlying chronic conditions such as lung or heart disease, renal failure, or immune-compromising conditions that place the patient at increased risk of developing complications may be cared for at home.
“This decision requires careful clinical judgment and should be informed by an assessment of the safety of the patient’s home environment,” the WHO guidelines say.
Where feasible, a trained health care worker should conduct an assessment to verify whether the residential setting is suitable for providing care.
“The HCW must assess whether the patient and the family are capable of adhering to the precautions that will be recommended as part of home care isolation such as hand hygiene, respiratory hygiene, environmental cleaning and limitations on movement around or from the house."
The family should be able place the patient in a well-ventilated single room with open windows and an open door, limit the movement of the patient in the house and minimise shared space as well as ensure that shared spaces like the kitchen and bathroom are well ventilated.
“Gloves, masks and other waste generated during home care should be placed into a waste bin with a lid in the patient’s room before disposing of it as infectious waste,” the WHO guidelines state.
The households should avoid exposure to contaminated items from the patient’s immediate environment and should desist from sharing things such as toothbrushes, cigarettes, eating utensils, drinks, towels, washcloths and bed linen.
Such patients with mild symptoms must only be released from home isolation after testing negative twice from samples collected at least 24 hours apart.
But should there arise a scenario where testing is not possible, it is advisable that the patient remains isolated for an additional two weeks after symptoms disappear.
Edited by Henry Makori