Covid-19: Nairobi healthcare system facing severe strain, specialist says

Nairobi County’s healthcare system is at risk of getting overwhelmed by the Covid-19 pandemic as it continues to record more cases than other counties, infectious disease specialist Dr Loice Ombajo has said.

Speaking in a television interview on Tuesday, Dr Ombajo said, “If Covid-19 patients take up more than 50 per cent of the bed capacity in public and private health facilities, we can say the system is overwhelmed.”

She added, “Covid-19 cannot replace all the other diseases that require care. If we allow the viral disease to fill hospital beds with patients,  those with other critical conditions will also begin to die because they will not get admitted to these facilities.”

INCREASED TRAVEL

Dr Ombajo, who heads the Infectious Diseases Unit at Kenyatta National Hospital (KNH), spoke in the wake of President Uhuru Kenyatta’s relaxation of travel restrictions in areas considered Covid-19 hotspots.

Dr Ombajo said the intensive case unit (ICU) at KNH, the country's largest referral hospital, is currently occupied, meaning no more patients can be admitted.

"When patients in the ICU improve, we can transfer them to the general wards to make room for the critically ill. In situations where the ICU is fully occupied, we refer patients to other facilities so that they can get immediate medical attention.”

Dr Ombajo said the relaxation of  travel restrictions could see other counties record more cases as city dwellers from counties that had been locked down - Nairobi, Mandera and Mombasa - travel upcountry.

“Nairobi’s position could change as counties with lower bed capacities in hospitals and fewer health workers begin to report more cases,” she said.

ASYMPTOMATIC PEOPLE

As of July 7, 8,250 cases of the virus had been recorded in Kenya, with deaths numbering 167 and recoveries 2,504.

Dr Ombajo also noted the possibility of infected but asymptomatic Kenyans transmitting the disease to relatives upcountry.

“We believe asymptomatic transmission occurs despite the recent publication of statements by some scientists doubting it. I have personally seen a case of an infected family of eight with none of the members showing any signs by the time of admission. This is why Kenyans should avoid exposing their loved ones by avoiding unnecessary travel upcountry,” she said.

She added, “Depending on their immune system’s strength and underlying conditions, different people will show symptoms of infection at different times. Some will be admitted in hospitals at a stage we call the pre-symptomatic stage, when the infection is yet to show symptoms. This does not mean they cannot shed the virus or infect others.”

PEAK SEASON

Dr Ombajo further said the pandemic’s peak infection season will likely fall between September and October if Kenyans do not strictly adhere to preventive measures.

“If we disregard the preventive measures and disobey the rules that restrict social interaction, we are likely to see the cases peak between these months.””

Dr Ombajo, who also lectures at the University of Nairobi’s School of Medicine, said if the public observes the rules, the peak season could be delayed to between December and January.

She cited handwashing, observing cough hygiene, social distancing and adhering to rules including the curfew

The specialist said Kenyans can no longer afford to disregard guidelines announced by the Ministry of Health and the World Health Organization (WHO).

“Personal responsibility for prevention is the best solution for controlling the pandemic,” she said.

To win the war against the pandemic at facility level, she said counties must ensure they have enough health workers, a reliable supply of oxygen, ventilators for critical patients and enough beds for isolation and ICUs.

“These are the bare minimums if they are to be able to manage the rising numbers of Covid-19 patients,” Dr Ombajo said.