Plan to test anyone seeking treatment raises questions

Questions are being raised on the practicability of testing every patient visiting hospitals for Covid-19 even as the government reported 15 new cases yesterday.

The plan, as revealed by Health Director General Dr Patrick Amoth (pictured), is aimed at controlling the spread of the disease among patients already in the hospital and health workers, some of whom have tested positive.

He said the ministry is revising Covid-19 guidelines to include Covid-19 test for all new patients.

The effectiveness of this plan has however been put to question, considering Kenya’s capacity in healthcare services and the dynamism of hospital visits, which have gone low due to the fear of contracting coronavirus.

Abdi Mohamed, the chair of the Kenya Association of Private Hospitals, said instead of the government pushing to test every new patient, the criteria should narrow down to those who meet the case definition.

These are individuals who have symptoms which range from coughs, fever, fatigue and body aches. “So if someone comes to hospital with a fracture sustained from a motorbike accident, do you mean you have to test them first before you treat them? Also, these results do come after 24 hours, so will they be lying there waiting? Should you treat the fracture or test for Covid-19?” he posed.

Dr Mohamed said it is not yet clear how the government will work out this plan, considering there are more than 10,000 health facilities with just 16 testing centres so far.

“You will find 10 of these centres are in Nairobi. So what about the rest of the country?” he posed.

So far, the government has tested 33,916 samples in a span of two months since the first case was reported on March 13, 2020. This translates to about 566 samples per day.

At the moment, the government is waiting for about 24,000 test kits for a specific automatic testing machine by end of this week to ramp up testing, which explains the less than 1,000 sample tests reported in the past few days. The samples tested on Monday and Tuesday were 978.

The government’s challenge, however, has been to get people out to test voluntarily due to stigma and associated costs that might include quarantine. To encourage people to go for tests, Health Cabinet Secretary Mutahi Kagwe said the government will foot the bills.

“That move to test every sick person who visits hospital may scare some people. The question we should ask is, have we sensitised Kenyans enough to know that if one has diarrhoea or any other sickness for example they should visit the hospital? Do they have that idea?” posed Alfred Obengo, chairperson to National Nurses Association of Kenya.

Obengo said how the government has militarised Covid-19 does not make it friendly for people to visit hospitals. “The question really is not even if the plan will work, but once we have tested you, what next? How will you be treated? The pre-testing period is not an issue but post-test, what will happen to the patient?” he posed.

Obengo’s questions reflect what Kenya is facing in the fight against Covid-19, especially at the Coast where deaths occur at home or at the Accidents and Emergency sections in hospitals since people are avoiding being seen by health care workers.

In the daily Covid-19 status briefing yesterday, Health Chief Administrative Secretary Rashid Aman reported three more deaths, raising the toll to 36. Of the three, two died at their homes in Mombasa. He also announced eight new recoveries, bring the number to 259.  

“That is why we, from the civil society, have been insisting that the militarisation of the disease be lessened. Let it be friendly,” Obengo said.

When the government called for targeted mass-testing in hotspots of Nairobi’s Kawangware and Eastleigh and Mombasa’s Old Town, few people people turned up.