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Kenya opts for home-based care as hospitals begin to fill

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Asymptomatic Kenyans and those with mild coronavirus symptoms will now be put under home-based care by the government.

The government has at the same time announced the disbursement of Sh5 billion in conditional grants to the 47 counties to boost response to Covid-19.

Patients in isolation might soon be released after the Health Ministry admitted  some health facilities such as the Mbagathi isolation centre and the Kenyatta University Teaching and Referral Hospital were almost full.

The two have a bed capacity of 120 and 300 respectively.

In Nairobi, there are 60 quarantine centres with a bed capacity of 4,378. More than 800 Covid-19 patients are admitted in at least 35 hospitals across the country, the majority of them in Nairobi and Mombasa. 

The decision on home-based care was arrived at on the grounds that more than 80 per cent of patients in hospitals are asymptomatic and can be managed from home.

If this is implemented, the move will free health facilities from congestion.

“The ministry is in the process of actualising and indeed we have already completed the process of actualising home and community based care protocols for rollout and to be implemented countrywide,” Health CS Mutahi Kagwe said on Thursday.

“What this means is that a lot of people who are in isolation facilities will be released to be taken care of at their homes, provided it is in accordance with new WHO protocols that we are still looking at and trying to customize and domesticate to our situation.”

The World Health Organisation developed interim guidance to meet the need for recommendations on safe home care for patients with suspected Covid-19 who present with mild symptoms.

The global health agency recommends that for those presenting with mild illness, hospitalisation may not be possible because of the burden on the health care system, and will only be required in case of rapid deterioration.Health CS Mutahi Kagwe during the daily Covid-19 briefing at Afya House on June 4, 2020
Image: MAGDALINE SAYA

According to WHO, patients with mild symptoms and without underlying chronic conditions such as lung or heart disease, renal failure, or immune-compromising conditions that place the patient at increased risk of developing complications may be cared for at home.

A healthcare worker must assess whether the patient and the family are capable of adhering to the precautions that will be recommended as part of home care isolation such as hand hygiene, respiratory hygiene, environmental cleaning and limitations on movement around or from the house.

“It has to do with the facilities that families have, and where families are not able to either self-quarantine or self-isolate the government will still assist in the process,” Kagwe said.

The households should also avoid exposure to contaminated items from the patient’s immediate environment and should desist from sharing stuff such as toothbrushes, cigarettes, eating utensils, dishes, drinks, towels, washcloths and bed linen.

Kagwe had during a previous briefing said that though the ministry continues to have the same plan, high levels of indiscipline among Kenyans remain a great hindrance to the success of the programme.

“Over the last three months or so we have been in school learning how to manage this disease, understanding this disease but now the time has come when we must also begin to implement our own systems in our place depending on our own environment, because it is the only way that we can be able to cope with what we are expecting in the future,” he said.

Data from Thursday’s briefing showed that the number of positive cases in the country rose to 2,340 after 124 more cases were confirmed.

The 124 were from 2,640 samples tested. The total number of tests conducted since the first case rose to 87,698.

The positive cases include 119 Kenyans, two Somalis, two Tanzanians and one Eritrean.

Thirty-nine more people were discharged from hospital, bringing the total number of patients who have successfully recovered to 592.

The new cases are aged between one year and 80 years, comprising of 100 men and 24 women.

Out of the new confirmed cases, 38 are from Nairobi while 40 are from Mombasa. Busia has 26 cases while Kajiado has six cases, Kiambu three, Garissa two and Taita Taveta two. Murang’a and Elgeyo Marakwet have one case each.

Three more patients succumbed to the virus, raising the number of fatalities 78.

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