Covid-19 infection cases are now past the 7.5 million mark and just short of half a million deaths worldwide. This shows the concept of preparedness for potential future epidemics and pandemics has largely been ignored by many authorities across the globe.
Now that we are in the throes of the effects of this pandemic, making strategic steps forward is irrefutably necessary for Kenya to prepare the medical and public health systems for the growing numbers now and for the next possible pandemic.
Firstly, Kenya does not have an independent Infectious Diseases hospital, like the USA and Singapore, specialising in infectious disease prevention and treatment.
The Singapore situation is of significant interest. Singapore population is over 5.6 million compared to Kenya’s 51.4 million, according to 2018 estimates. Singapore, however, has in place the National Centre for Infectious Disease (NCID), a hospital mandated, funded and equipped to handle an infectious disease situation, the likes of which this novel coronavirus has created. The Ministry of Health in Singapore has the NCID plugged right into their framework for public health management.
Similar considerations should be drawn up and implemented for Kenya to improve her management of infectious diseases. The funding for this at the moment can be appropriated from the emergency Covid-19 kitty, which has not engaged in any infrastructural investment yet.
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The world watched in amazement as China, at the height of the rise in the infection, built a 1,000 bed capacity hospital in record time in Wuhan.
Seeing as that the resources and capacity to do that in Kenya is lacking, mobile infectious disease centres should be prioritised to enable the provision of treatment to the population closer to their localities as opposed to transporting infected patients long distances to a hospital, and even then, an ill-equipped facility to handle infectious diseases.
This mobile infectious disease hospital would then be outfitted with negative pressure isolation wards. A negative pressure isolation ward is a unit that is purposely built and designed to manage the airflow into and out of the patient containment unit to further prevent additional infections due to the presence of infected parties.
Under normal circumstance, this requires to be incorporated to a hospital’s ventilation systems to ensure that potentially contaminated air coming from the isolation pods where infected patients are enclosed does not find its way to other areas of the hospital or the atmosphere in general without having been filtered.
Building negative pressure wards as part of a mobile infectious disease hospital allows improved control of cross-contamination while at the same time providing accessibility of “NCID level” service to the public.
In the worldwide fight against the spread of the coronavirus, several countries have implemented negative pressure isolation wards, which have been instrumental in curtailing the spread of infection to the medical practitioners who are a key asset in surmounting this pandemic.
A situation of this magnitude gets dire very fast when the specialist medical officers suffer harm and fatalities. It is of importance to note that the provision and use of such a facility should be accompanied by a reliable framework for the management of all aspects of processes within the facility. This framework should include issues like ventilation systems management, functional zoning within the premises, logistics flow for all provisions to and from the hospital for sterile and contaminated items, physical human movement protocols for medical staff and patients into, within and out of the hospital among other systems of work.
Liberia, a country that suffered the maladies of the Ebola virus outbreak from late 2013, adopted measures that kept them fairly prepared in the wake of the coronavirus epidemic. Commencing screening of passengers earlier than most countries, training doctors and nurses on the identification of Covid-19 symptoms and making provision for treatment sites for suspected and confirmed cases has resulted in a lower corona caseload in comparison to Kenya.
Whereas there can be improvements in their implementation if one looks hard enough, a sit-and-wait approach cannot be deemed a plan for any country to adopt at all.
Economic and social effects of the resulting lockdown can be mitigated once such inexpensive solutions are implemented, allowing for economic activity to resume, which will prevent additional knock-on effects of the pandemic.
Just as we have a spinal injury centre and cancer centres, an NCID should be implemented expeditiously to increase our ammunition as a country when it comes to war against pandemics. We may be steps behind yet we still have the opportunity to better prepare for pandemics.
Khasokha Samita is a lawyer.