- Hospital-based, patient-centred care models are inadequate to deal with a pandemic.
- We need to mobilise resources to activate a community-centred health delivery system, buttressed by robust syndromic surveillance and testing.
Caught between two rights and placed on the ‘horns of a dilemma’, President Uhuru Kenyatta was persuaded by science not to reopen the country. A raft of restrictions to contain the spread of Covid-19 will remain in force for a further 30 days.
Faced with one of the most consequential decisions of his presidency, Uhuru made the right, but certainly not the easiest, call. Kenyans are eager to return to houses of worship. Parents are exhausted from having children at home since March. Those who love to be merry and to mingle want their favourite bars and clubs open.
The 2022 clock is ticking and politicians are itching to get on the campaign trail. And most importantly, we all want to get on the road and travel upcountry to see our folks. Businesses and employees are starved of income. The government is haemorrhaging revenue.
The President disappointed many, including himself because he wants to open at the earliest opportunity to get the third largest economy is sub-Sharan Africa going at full steam. But we all must wait for three reasons.
First, Covid-19 infections are surging, not declining. Second, we do not have adequate capacity in our healthcare system to deal with the recent surge. DesignatedCovid-19 hospitals are full. Mama Lucy Hospital in the densely populated Eastlands has been designated as a Covid-19 isolation facility. Third, our systems for surveillance and contact tracing are not robust.
While we must ramp up hospital bed isolation capacity, we must not learn from the experience of Europe, the United States of America and Brazil. At peak infection, hospitals become a vortex of Covid-19 transmission, putting at risk an already thin and fragile health workforce.
Hospital-based, patient-centred care models are inadequate to deal with a pandemic. We need to mobilise resources to activate a community-centred health delivery system, buttressed by robust syndromic surveillance and testing.
All 47 counties must be at the forefront of the fight against Covid-19. Our community health centres, public dispensaries and public health centres present an elegant health system structure for mobilising grassroots surveillance and activating community-centred care through an army of community health workers.
Don’t get me wrong, we must still expect county authorities to deliver at least 300-bed isolation capacity. But hospital beds must not be the fulcrum of our effort to manage the imminent surge.
Moreover, local communities must be at the forefront and now is when Nyumba Kumi comes in handy; tracing the contacts of those who have tested positive and ensuring that those who are asymptomatic or present with mild Covid-19 self-isolate effectively.
The President has set a most high bar for reopening the economy; bending the infection curve, providing adequate care capacity and a robust capacity for surveillance, testing and contact tracing. We have work to do.
The closing words of President Kenyatta’s June 6 address to the nation are worth repeating. “This disease is beatable if we work together, and keep our eyes on slaying the enemy”.