Drugs, death and doom ... The emerging fear in Covid wards

One of the general wards converted into an isolation wing at the Lumumba Sub-County Hospital in Kisumu. It’s a challenging time to be a healthcare worker due to poor facilities. PHOTO | ONDARI OGEGA


What you need to know:

  • In just a week, eight healthcare workers at the Kenyatta National Hospital’s accidents and emergency department turned positive for Covid-19.
  • Healthcare workers could be using substandard face masks, which are exposing them to infection.

About a month ago, doctors could give significant attention to each Covid-19 patient. Well, not any more.

With too many patients, doctors and nurses can no longer cope with the situation. They are also getting infected by the day, with some turning to alcohol to ‘forget their problems’.

On Sunday, a 32-year-old nurse who had tested positive in Kisii and even gave birth successfully a fortnight ago while on oxygen support, succumbed to the virus.

Kisii County Public Health Director Dr Richard Onkware said the nurse from Homa Bay County died at 4pm after battling the virus for two weeks.

Her newborn, however, tested negative. “Unfortunately, we lost her. One of her lungs collapsed,” said Dr Onkware.

For three weeks, the Nation followed the progress of seven doctors and 11 nurses in five public hospitals in Nairobi, Mombasa and Kisumu.

In just a week, eight healthcare workers at the Kenyatta National Hospital’s accidents and emergency department turned positive for Covid-19. Another 11 turned positive at the pediatric department. The nightmare is becoming real in the wards.

“I thought I had overcome the anxiety when a 13-year-old boy died here and we only knew after the postmortem that he was positive. Soon after, my colleagues turned positive,” a nurse at the paediatric ward told the Nation.

A few days before the eight healthcare workers got infected, one of the most experienced nurses at the facility’s Infectious Disease Unit (IDU) turned positive. The nurse was one of the Kenyans sent to West Africa in 2015 to battle Ebola.

Healthcare workers could be using substandard face masks, which are exposing them to infection. “After working in hospitals for more than a decade, it is interesting that I may not be able to tell how a quality mask looks like,” said M11.

The new cases came days after nurses complained about the poor quality surgical masks at KNH. Later, the management told them that the masks were not substandard but the manufacturer had put them “in the wrong package”. Contacted about the infections, KNH management directed the Nation to the Ministry of Health “on all matters Covid-19”. Similar cases have been reported elsewhere in the country.

Dr Kevin Osuri, a Kenya Medical Practitioners, Pharmacist and Dentists Union official, Nyanza branch, told the Nation that the few masks available for frontline healthcare workers are “in our view, substandard”.

Respiratory distress

“Anyone who has a disease that has affected the lungs, such as Covid-19, can spread it easily. When they speak, sneeze or cough, they release large and small droplets in the air,” says Dr Jeremiah Chakaya, a respiratory infections expert. A worker with a substandard mask can easily get infected as a result.

Dr Joshua Santarpia, who studies biological aerosols at the University of Nebraska Medical Center in the United States, found out that when a person stands by the bed of a patient, it does not matter whether the patient is speaking or not.

The researcher observed that the particles the patient emits, as they breathe out, will be inhaled by a nurse or a doctor a metre and a half away, such as at the foot of their bed. Should these particles contain Covid-19 (Sars-CoV-2), the healthcare provider will be infected. It is these fatal mistakes that leave the healthcare workers exposed, and depressed.

While the World Health Organisation’s (WHO) technical guidance on how the virus is transmitted directs that healthcare workers be protected when they do medical procedures, which might be anticipated to produce smaller respiratory droplets that could then be inhaled, the supply of full protective gear: masks, gloves, goggles, gowns and hand sanitizer is poor.

Alfred Obengo, the president of the National Nurses Association of Kenya, told the Nation that counties’ procurement departments and officials have turned PPEs into a cash cow, and never consult the nurses on what would be the best options. In the process, they are exposing the workers to infection. “They are not technical people, they would order non-medical masks at a price of the medical cost,” Mr Obengo said.

The Nation has not established the allegations Mr Obengo made but samples from Nakuru Level 5 Hospital in May, and Pumwani in June, showed that oftentimes, healthcare workers are forced to use surgical masks and not the recommended N95 masks.

And yet, they deal directly with patients during insertion of tubes, an act which is performed to many who are in respiratory distress due to Covid-19.

The N95 draws their name from their ability to filter out 95 per cent of nearly all of bacteria, viruses, fungi and other microbes even in their tiniest form, as tiny as 0.3 microns wide.

The mask is made up of a thick mesh of plastic fibres which trap the disease causing germs either on the inside (for the person who is sick and does not want to release this to the environment).

With crucial protective gear, such as masks, in short supply, many hospital managements have now accepted surgical masks as “an acceptable alternative” to the protective N95 respirators. However, surgeon Elly Nyaim says surgical masks are considerably less protective than N95 masks and respirators.