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Covid-19: How patients in home care become spreaders

 The ministry has admitted that doing a follow up on home-based care patients is a huge challenge. [David Njaaga,Standard]

Patients under home-based care might be super-spreaders of the virus, Ministry of Health has warned. According to a Covid-19 outbreak update report dated November 2, the Health Ministry said patients managed at home were not adhering to laid down protocols. “Cases under home-based care are not adhering to laid down protocols and continue to sneak out to interact with friends,” stated the report.

Director of Public Health Francis Kuria said patients under home-based care should take personal responsibility to contain the disease. “It all trickles down to individual responsibility. We cannot have everyone policed to stay at home,” he said yesterday. In Kericho, there are 153 people under home-based care, and they are all asymptomatic according to health records. On November 4, there were 88 patients admitted to hospitals. Health director Betty Lagat said those under home-based care are monitored daily.

She maintained that managing operation of patients at home was based on personal discipline. “Our public health officials visit the sick at home, but we cannot tell if they get out because we are not with them all the time,” she said.


Lagat noted that with proper counseling, patients should understand why they are confined to their homes. Baringo has 10 patients under home-based care and three are admitted at Covid-19 centre, at Mogotio sub-County hospital. County epidemiologist Robert Rono said lack of discipline among individuals has been a hindrance in managing patients under home-based care.

“Though we are doing a follow-up on patients under home-based care, controlling them is a big problem,” Rono said. In Nakuru, at least 478 patients are being managed at home. The county health report shows 4,072 contacts to the confirmed cases have been traced, quarantined and followed up. By November 3, 2,874, people were documented to have been infected by the virus, with 59 deaths.

According to home-based isolation and care guidelines set by the Ministry of Health, patients undergoing home-based care should clean hands frequently with soap and water. Patients should also stay in separate rooms from other family members, but if not possible wear masks and keep a distance of one metre from other people.

Caregivers on the other hand are directed to avoid unnecessary exposure to the ill person and avoid sharing utensils and towels. Patients should also have their health monitored for fever, cough and difficulty in breathing. Meanwhile, cost of treating Covid-19 patients range from Sh21,359 per day for asymptomatic patients to Sh 21,361 for those with mild symptoms.

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Between Sh24,705 and Sh51,684 is spent daily on a patient who requires supplementary oxygen. If a patient is in a critical state that may require ventilatory support, the figure goes up to Sh71, 000 per day. The major contributor to the high cost of Covid-19 treatment is the personal protective equipment most of which are single-use.

Covid-19 sample testing across the country is also hampered by lack of re-agents. The majority of the counties are taking samples to laboratories in Nairobi. Reports indicate there is a backlog of samples at Kenya Medical Research Institute (Kemri) in Nairobi. Kemri Kericho and Kemri’s Centre for Disease Control in Kisumu are among the laboratories experiencing a shortage of reagents and testing kits.

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