No Beds for Covid-19 Patients Amid Fears of a Second Wave

Saturday, October 24, 2020

A ward at the Koiwa Isolation unit in Bomet County on September 4, 2020.

Ondari Ogega | Nation Media Group

By Angela Oketch & Nasibo Kabale

During a Covid-19 symposium hosted by Aga Khan University on Thursday, KMPDC chief executive Daniel Yumbya said 17,951 of the available beds are for isolation while the remaining have been set aside for intensive care cases.

Of the national isolation capacity, some 13,272 beds are in hospitals and the rest in non-health facilities.

Only 18,443 isolation beds are available for use by coronavirus patients against the national target of 30,500 units.

This is despite fears of a rapid increase in infections.

The Kenya Medical Pharmacists and Dentists Council (KMPDC) says by October 12, some counties had not met the 300-bed capacity target as directed by President Uhuru Kenyatta in July.

The sustained rise in infections is indicative of a second wave of the Covid-19 pandemic, experts say.

In infectious disease situations, waves describe the curve of an outbreak, reflecting a rise and fall in the number of cases.

During a Covid-19 symposium hosted by Aga Khan University on Thursday, KMPDC chief executive Daniel Yumbya said 17,951 of the available beds are for isolation while the remaining have been set aside for intensive care cases.

Mr Yumbya said the number of ICU beds in the country is not enough.

The recommended number by the Ministry of Health is five to six per cent of the total isolation beds, which should bring the figure to about 1,000.

Isolation capacity

Of the national isolation capacity, some 13,272 beds are in hospitals and the rest in non-health facilities.

With the growing number of infections, the council is worried hospitals could be overwhelmed and has since started engaging at least 20 hotels to admit Covid-19 patients.

The 474 quarantine facilities in learning institutions with a capacity of 142,492 beds, have been closed as the country prepares to reopen schools.

“There is still opportunity to increase the national ICU capacity,” he said.

A total of 631 cases were recorded from a sample 6,142 yesterday, bringing the country’s caseload to 47,843.

Fourteen people succumbed to the virus, bringing the total deaths to 884.

The country reported a record 1,068 cases from a sample of 7,556 on Thursday, a positivity rate of 14.13 per cent.

This brought the case number for week 32 to 4,069, which is the fourth highest count in a seven-day period since March.

The last time the country recorded more than 4,000 cases in a week was in mid-August, when strict restrictions were still in place.

 With the increase in infections, deaths and number of patients in ICU, experts are warning of a dire situation should Kenyans continue disregarding guidelines and protocols given by the Ministry of Health.

Some 95 patients were in critical care yesterday, with 20 in ICU, 59 on supplementary oxygen and 16 in the high dependency unit.

A total of 1,142 Covid-19 patients are admitted to hospital while 3,238 are on home-based care.

“The second wave is with us yet we are doing badly as a country,” Health acting Director-General Patrick Amoth said.

“Most people are not adhering to the measures. Perhaps we will get serious the moment we will see people dropping dead on the streets.”

Mr Yumbya highlighted limited health infrastructure, delayed test results and inadequate supply of testing kits as some of the challenges hindering the war on Covid-19.

The workforce in most referral and top private hospitals is overwhelmed.

Nairobi Hospital will set aside four of its wards for coronavirus patients.

“This is to inform you that the hospital has been experiencing a surge in the number of Covid-19 cases requiring admission,” Nairobi Hospital Acting CEO Margaret Sirima said in a communication to employees.

Kenya Medical Association President Andrew Were said hospitals are witnessing a rise in ICU cases.

The Council of Governors has raised concern about the rising number of infections.

“Nairobi and Mombasa continue to record the highest Covid-19 infections. We encourage the public to remain vigilant and implement the guidelines put in place,” council chairman Wycliffe Oparanya said.

Experts say there is no formal definition of a second wave, but they know it when they see it because the curve tends to rise after flattening.

Flattening the curve is a strategy to slow the spread of the virus.

The curve is a visual representation of the number of infected people in need of health care.

A flatter curve indicates the infection rate is falling. It means the same number of people may get sick, but the infections happen over a longer period. In such a situation, hospitals can treat everyone.

“It’s often clear. I believe we are in our second wave. By the end of last month, we were witnessing an increased positivity rate. Data from the ministry shows a characteristic upswing in positivity and daily cases,” Pathologist Lancet Kenya CEO Ahmed Kalebi said.

The peak

Kenya’s Covid-19 cases shot up in July and August and then edged downward.

According to a study by Kenya Medical Research Institute and the Health Ministry, the peak happened before the end of July in “some major urban counties”, with between 34 and 41 per cent of residents infected.

Since the beginning of this month, the country has seen a steep increase in the number of confirmed cases, surpassing recoveries.

What is worrying, however, is the fact that a huge number of patients is being admitted to hospital.

Aga Khan Hospital chief of staff Majid Twahir said the correct term of what the country is experiencing is a “second peak” because even as the numbers took a downward trajectory, they never got to zero.

Fewer cases

Numbers should be desegregated to find out where the peak is coming from.

It would then be easy to understand that some counties that had fewer cases are now reaching their peak.

“The virus is spreading progressively from the epicentres. Counties like Uasin Gishu and Nakuru are reaching their peak and contributing significantly to the number of new infections,” Dr Twahir said.

He added that the virus is spreading in rural areas where a majority of elderly people are.

The rural areas lack good medical facilities, meaning Kenya could experience a higher mortality rate.

His concern, much like the ministry’s and that of health workers, is that the country could fail in its fight against the virus, owing to stretched facilities.

Even as the debate over the second wave rages on, Dr Twahir said we still do not know the virus well and there are a significant number of reinfections, which, added to the fact that there is no evidence of how long one’s immunity lasts in the body, this cluster of people could be contributing to the increased infections.

knasibo@ke.nationmedia.com; AOketch@ke.nationmedia.com