Covid surge: Hotels to admit patients

Kenya could be in for a second wave of Covid-19 with increased cases being reported in the country.

On Thursday, 1,068 cases were reported from a sample of 7,556 giving a positivity rate of 14.13 per cent.

The country also recorded the highest number of deaths in a week at 65, bringing total fatalities to 870.

Today marks the beginning of the 33rd week since the first case of Covid-19 was reported in Kenya on March 13.

Thursday's cases brought the numbers for week 32 to 4,069, which is the fourth highest count in a seven day period since March.

The last time the country recorded over 4,000 cases in a week was in mid-August when the government's imposed restrictions were still in place.

As a result of the surge, the Ministry of Health is renegotiating with more than 20 hotels to take in Covid-19 patients and their contacts for isolation to take the pressure off hospitals. 

With increased fear that the country could be headed for a massive second wave, the government is seeking to prepare, with some private facilities already reporting being overwhelmed.

The Kenya Medical, Pharmacists and Dentists Council said the country now has a total of 18,443 isolation beds. CEO Daniel Yumbya said those beds are enough but more might be needed if cases continue to rise. 

The council this month lost more than 200,000 quarantine beds following the phased reopening of schools and universities.

At least 40 hotels that were engaged as quarantine or isolation centres in May have since terminated the partnership and resumed normal business.

"We’re now back to negotiating with private hotels to charge the bare minimum for patients in isolation. We just do not want hospitals to be overwhelmed," Yumbya said. 

However, the isolated people—mostly asymptomatic cases who cannot self-isolate at home—would be expected to pay from their pockets the subsidised hotel costs. 

Yumbya said that of the current national isolation capacity, 13,272 beds are in health facilities and the rest in non-health facilities. 

By Thursday, the health facilities had admitted 1,121 Covid-19 patients, while 3,112 were under home-based care, with the numbers rising rapidly every day.

Speaking in Nairobi yesterday at a Covid-19 symposium hosted by the Aga Khan University, Yumbya said they were trying not to overwhelm hospitals with patients.

Health facilities are already hard hit and 217 health workers have contracted the virus this month alone, according to doctors' union leader Chibanzi Mwachonda.  At least 16 have succumbed to the virus since April.

Mwachonda told the Star cases have been rising since containment measures were relaxed by President Uhuru Kenyatta. 

"This is attributed to the disregard for recommendations of the Covid-19 human resources for health guidelines and protocols at work, lack of adequate personal protective equipment and staff shortage," Mwachonda said.

In Turkana county, services at the Lodwar County Referral Hospital were suspended indefinitely on Tuesday after 25 health workers contracted the virus.

County Health executive Jane Ajele said the infection may have originated from the many patients who presented to the hospital in the last three weeks with breathing problems. 

One of the doctors who saw the patients developed breathing complications last week and died suddenly. Postmortem results indicated that he died of Covid-19.

Ajele said they will still offer full inpatient services but only emergency services will be available for outpatients.

“We have not closed Lodwar County Referral Hospital but suspended a few services like outpatient department and mother and child health. Patients are informed to seek those services in the 11 nearby facilities around Lodwar town,” she told the Star.

In Nairobi, acting CEO of The Nairobi Hospital Margaret Sirima said they have added four wards to handle the rising number of Covid-19 patients.

In a statement on Wednesday, the hospital said St Andrew's, St David's, St Francis and the Short Stay Unit will be taken up for management of such cases.

"The hospital has been experiencing a surge in the number of confirmed Covid-19 cases requiring admission," she said in an internal memo. 

Sirima said they are soon opening a new, large Covid-19 treatment centre near the school of nursing. 

Last week, the Aga Khan Hospital, Mombasa, also said it was experiencing a surge.

"This is to inform all colleagues that we have noted an increase in the number of Covid-19 cases in the country over the last few days," the hospital said in a statement.

"Recent cases have been reported to have subtler symptoms such as altered smell and or taste, sometimes in the absence of obvious flu-like symptoms."

Despite the rising numbers, the Covid-19 National Emergency Response Committee yesterday advised against another national lockdown.

Amref Health Africa boss Githinji Gitahi, a member of the committee, said a lockdown cannot be a long-term response strategy.

"We only closed to prepare. Lockdowns cannot be a long-term response strategy. We must reopen the economy, understanding we’re now better prepared," he said. 

Gitahi also spoke against mass school closures saying the country recorded an increase in teen pregnancies during the lockdown.

"School is the best thing for a child. We also can't close borders forever so that we don't have Covid in our country," he said.

Gitahi said the country needs localised actions in areas where the virus is spreading. 

"The important thing now is to do precision public health so we only close clusters of origin. If one person coughs, you can't give everyone cough syrup."

Health CAS Mercy Mwangangi shared similar remarks, saying the economy must remain open.

"We must understand there will never be a time of zero cases, so we must balance and ensure there is continuity in the economy. So we need individual responsibility," Mwangangi said on Thursday.

The response committee is observing Nairobi, Mombasa, Kericho, Nakuru and Turkana and might propose some localised restrictions there.

Other counties fingered for increased cases are Trans Nzoia, Uasin Gishu and Nandi, where some government offices have been closed to stop transmission.

Yumbya said the country currently has 492 ICU beds. According to MoH's requirement, however, five to six per cent of total isolation beds should be ICU beds. Given that the total number of isolation beds is 18,443, it is expected, therefore, that the number of ICU beds should range from 922 to 1,107. 

"There is still an opportunity to increase the national ICU Capacity," Yumbya said. 

The figures come from a national assessment of all isolation facilities that the council conducted from July 14 to August 14. Forty-eight per cent of all isolation facilities scored above 60 per cent in preparedness.

"These facilities displayed high levels of capacity and preparedness to handle patients, as revealed in the availability of medical equipment, supplies, infection prevention and control, standard operating procedures, structures and services for staff and patients," Yumbya said. 

About 70 per cent of the 47 counties have oxygen plants, which is necessary for care of Covid-19 patients. However, 54 per cent of the assessed facilities are relying on external laboratories for testing.

"Lack of well equipped, dedicated county lab services, reliable transportation, long turnaround times for sample collection and results was seen as a weak link in effective management of the pandemic," Yumbya said. 

Health CS Mutahi Kagwe said despite the shortfalls, the country is still well prepared to handle the increase in infection. 

"The last few weeks have particularly witnessed a sharp increase in our positivity rate, with latest statistics of 10.1 per cent recorded yesterday (Wednesday)," he said in a speech read by his ICT counterpart Joe Mucheru at Aga Khan University. 

"We have scaled up our diagnostic capacity, which was defined by two testing laboratories prior to Covid-19, to 39 laboratories spread across 12 counties.