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Counties lack means to manage virus cases

Health & Science - By Dr Mercy Korir | October 28th 2020 at 12:00:00 GMT +0300

Part of the 35-bed capacity Intensive Care Unit at Murang'a Level Four Hospital, on May 4. [File, Standard]

Whereas Kenya continues to report a surge of Covid-19 positive patients in need of hospital admissions, counties seem ill-prepared and lack enough Intensive Care Unit and isolation beds.

The Standard has established that some counties did not meet the 300-isolation bed capacity directive given by President Uhuru Kenyatta. The deadline for meeting this was July 7, 2020.

For example, Baringo County has 70 isolation beds at Mogotio sub-County Hospital, according to County Epidemiologist Dr Robert Rono.

The county has four ICU beds at Kabarnet County Hospital, for general management of patients in a critical state.

“The ICU beds are not specific for managing Covid-19 patients, but they can be converted if need be,” Rono said in a phone interview yesterday.

A doctor who requested anonymity said the isolation ward at Mogotio sub-County Hospital has beds only.

“Though patients are expected to be managed at the isolation unit, it is just a hall, and we cannot provide quality care in it,” said the doctor.

Nakuru County, which has in the recent past reported a surge in the number of Covid-19 cases, has 16 ICU beds.

According to Dr Solomon Sirma, county director of medical services, the beds are not specifically for managing Covid-19 patients but can be converted incase someone requires specialised care.

“There are adequate ICU beds to manage patients in need of intubation, distributed in various sub-counties,” Sirma said.

Though he did not give the total number of isolation beds, he said there are 28 at the Rift Valley Provincial General Hospital, 32 at Langa Langa Health Centre and 13 at Naivasha Hospital.

There are also 40 ventilators and all are at the Nakuru Level Five hospital.

At least seven patients in the county are in ICU and 22 on supplementary oxygen, according to the county Covid-19 report of October 25.

The Covid-19 fatality rate in the county is 2.1 per cent, against the 1.8 per cent nationally, with the overall positivity rate being 9.5 per cent.

Quality care

Nationally, the positivity rate in Nakuru Country from October 22 to October 26 has been between 12.98 per cent and 14.1 per cent.

Nakuru County received Sh201 million from the national government to help it in its Covid-19 preparedness, money that is yet to be spent according to health officials.

Goody Gor, the Central Rift KMPDU representative said most counties in the region are not prepared to manage the pandemic.

Gor said that Nyeri has only five ICU beds for managing general patients.

“Moving Covid-19 patients to general ICU beds is risky because they can infect others. It is unfortunate that we do not have an ICU setup for manning these patients.”

She said the county has 13 isolation beds at Mt Kenya Hospital, with a backup plan of converting Mukurwe-ini Hospital into a Covid-19 centre, incase of a surge in cases.

Gor says Kiambu has a Covid-19 isolation unit at Thika Level Five Hospital and Tigoni, with each having between 13 and 20 isolation beds.

Gor said though Murang’a has 35 ICU beds, the county is faced with shortage of healthcare providers to provide quality service to patients.

The ICU unit, she said, is manned by only two doctors, forcing the management to admit only 15 patients at a go.

“We are ill-prepared and in case of a surge, we may not give patients quality care,” said the union official.

Laikipia County has 400 isolation beds spread across the county.

It has nine ICU beds at Nanyuki Teaching and Referral Hospital.

An audit report by Kenya Medical Practitioners and Dentist Board of August 14 revealed that Kenya has 319 ICU beds.

According to the presidential directive, each county was to have 300 isolation beds, which was to translate to more than 14,000 isolation beds, exclusive of two referral facilities, Kenyatta National Hospital and Moi Teaching and Referral Hospital.

The report indicated that counties of Samburu, Marsabit, Bungoma, Busia, Tana River, Lamu, Kirinyaga, Siaya, Homabay, Migori and West Pokot did not have ICU beds.

Other counties without ICU beds included Uasin Gishu, Elgeyo Markwet and Baringo. Nairobi has the highest number of ICU beds (73).

Dr Patrick Amoth, Director General of Health said Kenya is witnessing a second wave of the virus, and directed counties to open up isolation wings and revamp home-based care to break the chain of transmission.

[Additional reporting by Allan Mungai]

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