Corona threatens counties’ fragile healthcare systems

Wednesday, April 28th, 2021 00:00 | By
Koiwa Covid-19 isolation centre in Bomet county. Photo/Courtesy

Hillary Mageka @hillarymageka

The Covid-19 third wave is threatening to overrun fragile healthcare systems in counties.

Despite the national government imposing restrictions on movement and public gatherings and launching a vaccination drive to protect Kenyans against the contagion, it appears counties either relaxed their preparedness or were ill-equipped to counter new infections.

Latest data shows the burden of the disease is gradually shifting away from five counties under lockdown, which in March accounted for more than 70 per cent of the country’s caseload.

In the past one month, the infection rates have soared in counties outside the locked down areas of Nairobi, Kajiado, Kiambu, Machakos and Nakuru to Kisii, Kericho, Kisumu, Tharaka Nithi, Nyeri, Kitui, Mombasa, Murang’a, Laikipia, and Uasin Gishu.

A National Emergency Committee on Coronavirus (NERC) meeting on Monday is said to have discussed possibilities of imposing tougher containment protocols in Uasin Gishu, Mombasa and Kericho where the numbers of new infections are said to be growing exponentially.

Failure by the national government to release funds to devolved units is said to have compounded the situation further, rendering counties unable to contain the rising infections.

Medical experts estimate that it costs between Sh200,000 and Sh1 million to treat one Covid-19 patient who requires oxygen support.

Sources intimated to People Daily that a number of patients seeking treatment in public health facilities are being turned away by medical personnel who cite lack of Personnel Protective Equipment (PPEs), medicines and reagents for counties with testing capacities. 

 Kenya Medical Supplies Authority is said to have stopped providing counties with Covid-19 essentials, since it was engulfed in a multi-billion scandal, leaving them vulnerable.

“Though the central government says patients suffering from Covid-19 should not be charged because it is a pandemic, there is no support from it.

Matters have been left to counties, which have decided to pass the burden to the people,” a governor who sought anonymity said.

Various cadres of public and private hospitals are grappling with record numbers of critical-care patients, stretching a health system that was inadequate even before the outbreak of Covid-19.

Reports are also emerging that counties’ isolation centres are fast running out of space as more patients continue being admitted to various facilities with Covid-19 symptoms.

Besides, Intensive Care Units (ICU) are filled, especially in Nairobi, the epicentre of the pandemic, according to Nairobi Metropolitan Services and the Ministry of Health.

This is despite substantial gaps in ICU beds and ventilator capacity among devolved units.

Alarm bell

Counties, which are central to the fight against the pandemic, since they are in-charge of health services, are reporting that oxygen plants are almost being overrun by increased demand and they are straining to supplement the current capacity.

“This is an alarm bell that is being rang that there exists significant gaps in counties’ capacity to accommodate a potential surge in caseload due to Covid-19,” Dr George Ombati, Managing Director of Miriga Mieru Health Services told People Daily on Monday.

He added: “Alongside, efforts to slow and suppress the virus transmission, governors will need to implement adaptive measures and additional investments to expand hospitals capacity for the disease.” 

According to the medical microbiologist, additional investments will, however, need to be strategically prioritised to focus on strengthening essential services first, such as oxygen availability, before higher cost investments such as ICU beds and ventilators.

With no end in sight coupled with the rise in infections, he said, the much-touted resilience of county healthcare facilities to the disease is being tested. 

In recent weeks, the county governments of Nakuru, Kakamega, Meru, Uasin Gishu, Murang’a, Nyeri and Kisumu have reported an increase in the number of infections, which is likely to overwhelm their health systems if the situation persists.

There is also an emerging trend where some individuals who have been vaccinated are no longer observing  Covid-19 measures due to misguided notion that the jab guarantees immunity against the virus.

“This will defeat the effort by both levels of government and we call upon all Kenyans, to social distance, wear masks and cover both nose and mouth and wash hands and sanitise regularly,” Kisumu Governor Anyang Nyong’o said in a statement.

In the last one week, 31 county governments have increased their isolation bed capacity to 6,253 with 50 patients having recovered from infection.

During the same period, the total number of available beds in ICU was 297. This number has increased by 15 bringing the total number of available beds to 312.

The total number of available beds in the High Dependency Unit facilities was 114. This number has reduced by four, bringing the total number of available beds to 110.

On vaccination, cumulatively in 31 counties, a total of 469,496 doses had been received out of which 379,572 have been administered to healthcare workers (73,690), security (32,000), teachers (69,035) and others - 204,847.

“We note that the demand for the Covid-19 vaccine has increased over the week with more uptake by individuals above the age of 58. Counties have since increased vaccination, centres.” the statement.

High demand

In view of high demand for oxygen, counties such as Nakuru had increased production of oxygen cylinders from 40 a day to 120.

Additionally, Kisumu County has two oxygen generating plants with combined capacity of 375 litres per minute running at full capacity.  Further, the county has 6, 000kg of liquid oxygen storage tank with an average weekly usage of 3,000 kg.

As demand continues to rise in the Lake Region Economic Bloc, counties have put in place internal mechanisms to ensure they cushion each other in the event of a surge.

Tharaka Nithi Governor Muthomi Njuki has warned that health facilities put up to handle Covid-19 cases had been overwhelmed.

According to Njuki, the isolation wards at Chuka County Referral Hospital had no room for more patients.

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