It is a lonely life for patients in Covid-19 isolation wards

Stephen Haggai stares through the small window of his equally small cubicle at the Infectious Diseases Unit (IDU) at Kenyatta National Hospital in Nairobi.

His eyes appear ashen, his face emotionless. A concrete wall about two metres from his window blocks his view, and so even when he peeps outside, his eyes take in a vast expanse of nothingness, really. Atop that wall is an electric fence enforced with razor wire.

On Saturday evening last week he was cleaning the corridors and wards of the IDU unit at Mbagathi Hospital when he accidentally displaced the protective mask and goggles he was wearing.

He was immediately put in isolation pending the results of tests for the coronavirus. A day later, the tests came. Haggai, 54, had been infected.

Doctors transferred him from Mbagathi to KNH, where he has spent the last seven days staring into the nothingness outside his window.

When he is not standing at that window, he is sleeping in his small hospital bed or sitting forlornly and silently at its edge.

He smuggled a small transistor radio into his cubicle, but it runs on a rechargeable battery and his charger is not working.

His Nokia phone died two days after he was admitted to the facility, cutting him off from the cacophonic frenzy of the world across the wall.

LONELY NIGHTS

He had called his wife and four children back home in Butere to inform them that he had been infected with the virus and was being admitted to KNH.

But now, with his phone dead, he can’t reach out to his wife and children, and that guts him. Life, for Haggai, has become a dreary, monotonous affair.

He has no one to talk to other than the doctors and nurses who visit to check his vitals twice a day.

And when night falls, the eerie silence and darkness of the Nairobi sky distresses him even more.

About 10 metres away, another patient whiles away the days in her small cubicle, with the number 345 scribbled next to the door.

This is where Brenda Ivy Cherotich, the famous young woman who was declared healed on April 2, spent three weeks. Next to her, in room number 346, was Brian Orindi, who was also released from the hospital the same day.

The woman occupying Brenda’s cubicle is pregnant and was brought in here from a quarantine facility.

She is too distressed to talk, but agrees to open her door for greetings and a few pleasantries.

She is wearing earphones connected to her smartphone while a laptop computer rests next to her in bed.

EBOLA CRISIS

She does not appear to be in pain and smiles goodbye to us as we leave.

An obstetric gynaecologist has just visited her, but the consultation was via a window as the doctor is not allowed to go anywhere near her unless he is wearing protective gear.

He says both mother and baby are fine, but the anxiety and distress are taking a toll on the mother.

Welcome to Kenya’s ground zero in the fight against the coronavirus. This small facility standing on about three-quarters of an acre on the Kenyatta National Hospital grounds is where the war against the virus started.

Established in 2014 at the height of the Ebola epidemic, it also bore the brunt of the cholera outbreak of 2019 before, early this year, it became the launch pad of Kenya’s war against the coronavirus.

Dr Samuel Njenga, an infectious-diseases expert based at the facility, says that because there is no cure for the virus, the patients here only receive “supportive management”, meaning they get treated for symptoms brought about by the virus, such as headaches, fever, joint pains and, in some cases, anxiety bouts.

ASYMPTOMATIC

For the most part, the patients in this facility and at Mbagathi, about three kilometres away, only get nutritional support to strengthen their immunity.

Even though the country is in the process of initiating clinical trials for a regimen of drugs against the virus, these have not been approved yet.

Haggai says he feels quite okay. His temperature is fine, he is not coughing or sneezing, and has not complained of any chest pains or throat infections.

If he were let out, he would hit the city running. And because he is asymptomatic, he has not been given any medication.

Yet even in that state of relative health, he still presents a great danger to anyone who comes close to him.

His cubicle and the larger complex outside is out of bounds for unauthorised staff, and those who are allowed in must wear bulky protective gear.

He is among the 25 per cent of people infected with the new coronavirus who may not show symptoms, a startlingly high number that complicates efforts to predict the pandemic’s course and strategies to mitigate its spread.

It is because of these risks that the government broadened guidelines on who should wear masks.

Researchers do not know precisely how many people are infected without feeling ill, or if some of them are simply presymptomatic.

But since the new coronavirus surfaced, they have spotted unsettling anecdotes of apparently healthy people who were unwitting spreaders.

STAGGERING COST

One of those is a religious studies student who was discharged from Mbagathi last evening.

He told the Saturday Nation minutes after he walked through a heavily guarded door that he had been admitted at the facility for three weeks after he tested positive for the virus.

While inside the facility, he had only been given multivitamins, again to turbocharge his immunity. He had only presented with a slight fever initially, but that disappeared two days after he was admitted.

“I was okay,” he said. “Everyone inside is fine. If you brought a football here, we’d have a jolly time kicking it around.”

But he, like Haggai, is one of the many asymptomatic patients who present a high risk of initiating community transmission if allowed to go out while still infected.

Dr Evanson Kamuri, the chief executive of Kenyatta National Hospital, says the high number of asymptomatic patients could be related to the ratio of young, relatively healthy people who have the virus.

Of the 246 infections confirmed in the country by Friday, only 15 were above the age of 60..

But, while many of these patients feel relatively okay, the cost of managing their symptoms or underlying infections, accommodating them, feeding them and kitting the droves of medical personnel who attend to them day and night is astronomical.

Ms Susan Mochache, the principal secretary in the Ministry of Health, told the Saturday Nation last evening that in some cases, the cost of managing one patient “is slightly more than Sh1 million”.

NEW CHAPTERS

Dr Njenga, the infectious-disease expert at KNH, said it cost about Sh800,000 to keep Brenda at the facility for three weeks and Sh490,000 for Brian.

The disparity, he explained, depends on the medication used to manage symptoms, the number of tests carried out during the entire stay, and the number of times doctors visit the patient as they have to discard their protective gear, which costs about Sh20,000 per person per session. Bed charges at the facility are Sh4,000 per night.

At the slightly cheaper Mbagathi unit, two black lines on the floor of the entryway usher you into an eerie environment that is somehow made even more terrifying by banks of fluorescent lights on the ceiling.

This entryway is where patients who are confirmed to be positive first enter the isolation unit and receive psychosocial support before they proceed to the wards.

Before they enter the ward, the patients are asked to change into hospital gowns and then proceed through the long stretch that leads to the 60-bed-capacity wards.

On the ground floor is the men’s ward, which was half-full on Friday. The patients seem to be doing well enough to walk around freely with masks on.

One patient sits on his bed, his eyes glued to his laptop computer, while his cube mate is listening to music through earphones.

They seem to be home, to have somehow acclimatised to life here. Even in this sorry hospital environment, life must go on.

New friends will be made here. New chapters in the long book of life will start here.

HOMESICK

At the female ward upstairs, the rooms offer more privacy, with doors separating the cubicles.

Again, the patients appear jovial despite the confinement and the ominous threat of the coronavirus hanging over their heads.

Dr Mutua Mbuvi, who is guiding us through the tour, explains what a typical day here looks like, his small speech interrupted by the patients as they cheerily call out his name.

“Usually one doctor, two nurses and a public health worker do ward rounds once a day. We check their vitals and when we are done, the cleaner changes the linens and cleans the floor,” he says.

Back at Kenyatta National Hospital, Haggai has sunk into his bed. “What are you thinking about?” we ask him.

“Nothing,” he replies. “Are you okay? Is there anything we can do for you?” “Maybe you could get me a charger for my phone? I’d like to call my wife.”

“Of course, Haggai. We will get you a charger,” we assure him, and then ask him what he would like us to tell his wife and children even as we get him a charger.

“Tell them I’m fine,” he says. “Tell them I’m coming home to Butere soon.”