Covid-19 patients on home-based care as numbers surge in Lake Region

The surge in Covid-19 numbers in the lake region has overwhelmed health facilities, which are now referring the more stable patients to home-based care.

The isolation centre at the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), the largest referral facility in the region, is already full and is relying on amenities of lower health facilities to cope with the rising numbers.

Kisumu Governor, Anyang Nyong’o, yesterday confirmed the worsening situation, a day after Kisumu took the lead in new infections reported in the country.

Focus has now shifted to the preparedness of health facilities in the 14 counties of the Lake region to handle the rising Covid-19 numbers.

Kisumu currently has 245 active cases of Covid-19, even though by Tuesday the Ministry of Health had still not yet updated its numbers and had only 102 patients in its records.

According to the Kisumu Director of Public Health, Fredrick Oluoch, 211 patients are on home-based care while 34 are receiving treatment at the JOOTRH isolation facility.

"Majority of the Covid-19 cases come from Manyatta Slum and Kibos in Kisumu Central," said Mr Oluoch in an interview.

The Indian variant of the deadly virus was first reported at Kibos two weeks ago.

The Kisumu governor says the situation is already getting out of hand, and overstretching the capacity of the largest referral hospital in Western Kenya.

Disregarding safety protocols

The governor pointed out that the situation has forced the county to extend the treatment of Covid-19 patients to the neighboring Siaya County.

“Very soon all these facilities will be full and then people who will need medical attention will be on the streets crying for help,” he said at JOOTRH.

The governor noted that many residents are disregarding the ban on night funeral vigils and flocking celebrations.

“We have also banned catering services at funeral venues while underlining the need for hand washing and sanitization,” he said.

He spoke as the Lake Region Economic Bloc (LREB) called for collective action by the 14 county governments in the region to curb the spread of the Covid-19 in the lake region amid a spike in the numbers recently.

The regional body spoke as counties said they were doing everything possible to equip their facilities in preparation for a new surge in infections.

LREB made the observations amid latest reports that indicated that Kisumu had taken the lead, overtaking Nairobi in new Covid-19 infections.

It was followed closely by Kericho, Siaya, Busia, Kisii, Nyamira, Nandi amd Bungoma all in the Lake region.

Also on the list of counties with new infections were Kakamega, Homa Bay, Vihiga, Trans-Nzoia and Bomet, also members of LREB.

Despite the worrying trends, residents of the region continue to carry on with business as usual, with many disregarding Covid-19 safety protocols.

In Kericho county, 113 patients have died due to COVID-19 complications, 214 are currently under home based care and another 39 are admitted in hospital, according to Dr Shadrack Mutai, the County Executive in charge of Health.

In the last one year, 56 patients in Bomet county have succumbed to COVID-19 complications in Bomet County in the last one year according Dr Joseph Sitonik, the County Executive Committee (CEC) member in charge of Medical Services and Public Health.

The county has recorded 749 positive cases, out of which 655 have been placed on home based care in the last one year. Currently, there are three patients in Intensive Care Unit (ICU) and another 32 in home based care.

2,950 have been tested for COVID-19 in the county in the last one year. Dr Sitonik said a total of 8,359 people have received COVID-19 vaccination with an average of 53 residents taking the jab daily in designated health facilities in the region.

Busia County has reported 28 new infections in the last one week and two patients are admitted at the Alupe isolation facility.

 Dr Isaac Omeri, the chief officer for Health Services said cases of reported infections have lately gone down but residents were still not observing precautionary measures.

Covid hotspots

“We are doing everything possible to equip our facilities in preparation for a new surge in infections but so far the numbers have gone down,” said Dr Omeri.

According to the LREB Covid-19 advisory committee, the international borders in Migori and Busia are unable to handle the traffic, resulting in persistent long queues of lorries and crowding.

"Our border posts are perpetual COVID hotspots and continue to hamper mitigation efforts in LREB," said Prof Rogo.

Additionally, he said, counties do not have the resources to vaccinate a significant portion of the population in good time.

"We cannot manage hundreds of critically ill patients. We lack medical oxygen and skilled personnel. The few ventilators are useless without oxygen," he noted.

LREB chairman- Kakamega Governor Wycliffe Oparanya yesterday said counties in the bloc were working on a coordinated response to handle emergencies and closely to monitor the infections.

Mr Oparanya said the counties were focusing on improving on their capacities to handle the large number of patients who could end being infected with Covid-19.

In the plan, a committee comprising County Health executives from the region had been formed to coordinate the monitoring and response strategy.

“We are doing everything to ensure we improve our capacity to deal with the pandemic by setting up more ICU beds in our health facilities and ensuring we have facilities for supply of oxygen in hospitals,” said Mr Oparanya in an interview.

Kakamega County has reported five new cases of Covid-19 infection out of 58 samples tested in the last 24 hours.

County executive for Health Services r Collins Matemba said 10 patients were admitted at the County General Hospital, four of them male and six females.

Two patients were admitted in the Intensive care Unit and two other at the Mumias Sub County Hospital.

“We are still facing in challenges in ensuring people observe the guidelines on social distancing in public places, wearing of masks and washing of hands using soap and water,” said county health executive Dr Collins Matemba.

The County has increased the bed capacity in the ICU facilities from six to 26 and is supplying oxygen to sub county hospitals from a plant at the County General Hospital.

Home based care 

In Vihiga County, health officials have raised an alarm after total confirmed cases hit 312.

The county still has 21 active cases, all of which are under home based care thus reducing strain on the ill-prepared health facilities.

Governor Wilber Ottichilo is today, expected to officially launch the newly installed oxygen plant and five bed ICU at the county referral hospital in Mbale to boost the fight against the pandemic.

Health Executive Dr Amos Kutwa said most of the confirmed positive cases are imported from neighboring counties.

The official noted that health personnel are not spared either after 36 of their colleagues contracted the virus, with one of them succumbing.

Vihiga Sub County has the highest infections at 162, followed by Hamisi (46), Sabatia (45), Luanda (35) and Emuhaya (24).

"The county has vaccinated a total of 11,334 persons to date, with peopled aged above 58 years leading at 4,283 followed by teachers at 2,755 and health care workers at 1367," said Dr Kutwa.

While Siaya County has lost 31 patients to Covid-19, Governor Cornel Rasanga’s administration is impressed by the low fatality ratio in the devolved unit.

According to the Mr Dismas Wakla County Executive Committee member for Health and Sanitation, the low deaths recorded points to good care given to patients.

The county as at May 17, 2021, recorded a total of 1, 051 positive cases out of 13, 941 samples collected across the six sub-counties in the region.

While the daily positivity rate stands at 23.5 per cent, seven cases are currently at the Siaya County Referral Hospital Covid-19 treatment center while 38 are in home isolation.

Community transmission 

Mr Wakla stated that the high positivity rate in the county is consistent with established community transmission, as opposed to earlier when most cases were clusters following importation of cases.

The Health CEC, however, stated that schools remain a point of concern as well as funerals and called for local strategies to be put up in line with national, to scale up vaccination exercise once the antigens are available.

Also a challenge is the matatu sector with public service vehicles carrying beyond the required capacity.

The cumulative number of those vaccinated so far are 10, 714.

In Homa Bay, medical workers appealed to the devolved unit to heighten surveillance within its boundaries after health officials who were screening travelers at entry points to Homa Bay were withdrawn from strategic points.

 Kenya National Union of Nurses (Knun) Executive Secretary Omondi Nyonje termed withdrawal of health workers at the centres as a lapse in the fight against Covid-19.

According to the LREB Covid-19 Advisory Committee, the rising cases in the region are driven by the lifting the lockdown, reopening of schools, arrival of the Indian Variant and continued disregard of the public health guidelines meant to prevent spread of coronavirus.

It said there's challenge of inadequate testing and genomic determination in the laboratories.

"Our insistence and reliance on PCR done at the overstretched KEMRI labs in Kisumu is misadvised. Rapid testing is the only affordable option for the region and country.  We are not serious when we invoke contact tracing activities without enhancing our rapid testing capacity," said committee chairman Khama Rogo.

The regional body gives a Covid-19 advisory after three weeks to the 14 county governments.

In the latest LREB Covid-19 situation report, Prof Rogo noted the Lake region counties have dominated the top 10-20 county list of Covid-19 cases.

"Our totals of positive cases are now more than Nairobi and Mombasa combined,” he said.

Governor Nyong’o blamed Kisumu residents for failing to adhere to Covid-19 containment measures which he said, has led to a surge of the infectious viral disease.

Reporting by Elizabeth Ojina, Victor Raballa, Benson Amadala, Rushdie Oudia, Vitalis Kimutai, Derick Luvega and George Odiwuor.