Poor virus preparedness dogs most counties

Thursday, June 11th, 2020 00:00 | By
Mombasa county medics at the Technical University of Mombasa Covid-19 isolation centre, which has 300 beds in preparations to deal with an upsurge of coronavirus cases. Photo/PD/NDEGWA GATHUNGU

Almost a week after President Uhuru Kenyatta directed counties to prepare for a surge in Covid-19 cases, it is emerging that majority of devolved units are not ready to deal with a spike in infections. 

Apart from Mombasa and Nairobi counties, the rest are far from reaching the bare minimum in terms of bed capacity at isolation centres.

Some of the counties have not even established a single isolation ward because there is no reported case in their areas. 

This means most devolved units will be severely overwhelmed in case there is a surge in infections.

Mombasa has surpassed the minimum 300-bed capacity as part of President Uhuru’s directives, which he said, must be achieved by all the counties to act as shock absorbers in case of any increase in coronavirus cases.

Coast General Teaching and Referral Hospital (CGTRH) currently has a bed capacity of 150 out of which 18 are Intensive Care Unit (ICU) fully fitted with concentrated oxygen and ventilators.

Procure beds

In addition, Mombasa Governor Hassan Joho  has since launched what he said is a 300-bed capacity isolation and treatment centre at the Technical University of Mombasa (TUM) to handle mild to moderate cases of the virus.

According to Joho, the isolation and treatment facility has capacity to be expanded to a 500-bed facility if need be. 

This means Mombasa has a 450-bed isolation capacity, way above the threshold of at least 300-bed capacity per county.

However, the capacity could be way below what is needed considering the growing number of infections in the county, which has now recorded over 800 cases of Covid-19.

County communications director Mudathir Ahmed said there is a planned rollout of another 100-bed Covid-19 hospital at the sub-county level “in the second phase for Mtongwe in Likoni and Marimani in Kisauni”.

“Mombasa was able to set the emergency response on Covid-19 committee in the first week of March. 

The committee is co-chaired by Governor Joho and County Commissioner Gilbert Kitiyo. 

“Under their leadership, the county was able to quickly set up technical teams and pull resources together to ensure that we were adequately prepared by the time we got the first Covid-19 case on March 19, 2020,” the director said.

Murang’a county has three Covid-19 isolation centres with a 184-bed capacity. Chief officer for Health Joseph Mbai says the county plans to establish more isolation centres. 

Maragua Sub-county Hospital has a 30-bed capacity while Muriranjas Hospital has 134 beds, Kaharo Health Centre (30) and Murang’a County Hospital (10). 

“We have additional 35 Intensive Care Unit beds and 91 for quarantine, so we have 310 beds set aside for corona patients,” he said. 

Release funds

Mbai said currently there are 27 people in the quarantine centre, five people in isolation and one patient who is positive. 

Over 300 people have been quarantined and discharged in Murang’a over the past two months. 

Kwale county, which recorded 31 cases as on Sunday, has only 60 beds at Msambweni Hospital according to the county director of communications Daniel Nyassy.

Being a border post county adjacent to the neighbouring Tanzania, the risk of more infections in the devolved is high. With tens of trucks going through Kwale’s Lunga Lunga border to and from Tanzania daily, the county has seen infections surge from just one in March to now 31, majority of these being truck drivers.

And recently, there were signs of community infections after new cases were picked from local villages in Msambweni and other areas.

Nyassy said Governor Salim Mvurya had more plans up his sleeves and had already procured an additional 290 beds, expected in the county “this week.”

“They are expected this week and will be taken to different hospitals in the sub-counties,” said Nyassy.

However, the situation is different in Kakamega. Governor Wycliffe Oparanya says he is waiting for the release of Sh5 billion allocated to the counties to help prepare for the fight against coronavirus.

Oparanya said counties had no funds to establish the facilities and asked the National Treasury to speed up release of the money. 

He said President Uhuru Kenyatta’s directives on all counties to have at least a 300-bed capacity in isolation facilities would only be realised if the counties were well facilitated with cash.

Oparanya, who is also the Council of Governor’s chairman, said most counties have no Intensive Care Units, proper isolation facilities and well equipped medical facilities.

“We are appealing to the National government to move with speed and release the Sh5 billion allocated to the counties in the supplementary budget to help in the fight against coronavirus. 

“Most of the counties have already been hit by coronavirus and they are not well prepared for the war against Covid-19. The earlier the funds are released to the counties the better,” said Oparanya.

Oparanya said his county was working on the plans of expanding its Kakamega Referral Hospital ICU capacity from six to 16 beds to help cater for more patients who need such services.

He added that he had hired enough medical staff who are ready to deal with coronavirus in the county.

“We are planning to expand our ICU facility to a bed capacity of 16 to enhance ICU services provision at our Referral hospital. 

“I have also hired enough medical staff to help in the fight against coronavirus.”

Vihiga Governor Dr Wilber Ottichilo said he had budgeted for an ICU unit at the county referral hospital.

Ottichilo said the five-bed capacity ICU at the referral hospital will be complete and functional by next month.

Deliver facilities

“We are working on the construction of a five-bed capacity ICU at our Vihiga County Referral Hospital that will be complete by July,” he said.

Tana River county, which has not recorded a single case, has only six beds, way below par, considering that it borders Kilifi, Taita Taveta, Kitui, Isiolo and Garissa counties, all which have recorded 100 cases as on Sunday.

During his eighth address on coronavirus pandemic, President Uhuru called on every county “to deliver isolation facilities with at least 300-bed capacity” as part of the condition for lifting the restrictions in place.

On the other hand, Kilifi Governor Amason Kingi unveiled the 150-bed Kilifi County Covid-19 medical complex which has since plunged the county into controversy amid graft allegations.

The ultramodern facility with six Intensive Care Units (ICUs) fully fitted with ventilators was unveiled a month ago.

Kilifi county has since been put under the microscope by Ethics and Anti-Corruption Commission over alleged irregular procurement of the tender for the construction of the facility.

Siaya county, which has been the centre of focus over lack of preparedness to deal with the spread of the virus, has said it has not spent any of the Sh254 million allocated towards enhancing preparedness of Covid-19.

According to acting Finance Chief Officer Denis Nyonje, the county received funds on Friday and none has been spent on enhancing coronavirus pandemic.

“There is no money spent on Covid-19 yet,” said Nyonje, adding that the county had spent Sh40 million from the development budget to establish a 10-bed capacity isolation ward.

Kisumu county has a 30-bed isolation ward. With Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) holding 26 ICU beds and the Kisumu County Hospital with a paltry four, Governor Anyang’ Nyong’o is still optimistic of hitting the required minimum in the shortest time.

“We are making plans with the little resources as a county and hope the national government can fast track its procedures to boost the efforts we already have,” the governor’s director of communications Atieno Otieno said.

The county has plans to increase bed capacity at JOOTRH to 70 while Kisumu County Hospital’s newly renovated maternity wing will host 120 beds. Otieno said Lumumba Hospital will have 120 beds.

Kisumu already has five Covid-19 patients, all who are being isolated at the JOOTRH.

Handle surge 

Nakuru county seeks to have at least 1,000 isolation beds for Covid-19 patients in a bid to comply with the Ministry of Health’s directive. 

Governor Lee Kinyanjui said they were racing to boost the government’s capacity to manage and treat coronavirus patients. 

Speaking while touring a Sh500 million outpatient complex yesterday, Kinyanjui said the facility would be converted to a Covid-19 treatment centre and have 500 beds within the next two months.

He observed that currently, the county has 175 isolation beds stationed in various hospitals, which include the Nakuru Level Five, Langalanga Sub-county Hospital, Gilgil, Molo, and Naivasha.

County Public Health Chief Officer Samuel King’ori said they have six GeneXpert machines to be used for testing of the virus.

“They are awaiting a cartridge from the Ministry of Health so as to begin testing. “Within Nakuru, we have eight patients who are undergoing treatment and observation,” said King’ori. 

Uasin Gishu county has a 30-bed capacity isolation centre. The beds are distributed in Kamalel Isolation unit and the Kenya Medical training College in Eldoret.

County Health Executive Everlyne Rotich dispelled fears that the devolved unit is not prepared to handle a surge in infections. 

“There is no cause for worry as the county is rushing against time to identify more hospitals and wards to be used by patients suspected to have contracted the disease,” said Rotich.

-Reporting by Reuben Mwambingu, Wangari Njuguna, Enock Amukhale, Eric Juma, Roy Lumbe and Winstone Chiseremi

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