Crossover Kenya’s Harleen Jabbal had a chat with Dr Shamsa Ahmed- head of COVID-19 Unit at M.P. Shah Hospital on the ongoing COVID-19 situation in Kenya, here’s the interview:
HJ: What is COVID-19? Has there been a change in the virus and the symptoms since we first heard of it in Kenya as of 13th March 2020?
SA: COVID-19 is part of the CORONA virus family responsible for respiratory tract infections. This means the flu and pneumonias. This particular strain was discovered in Wuhan, China in 2019, hence the name. Initially symptoms were restricted to headache, fever, muscle pain and sore throat, but now we have found that loss of taste and smell can be an early sign of infection. Some patients have presented with abdominal symptoms such as diarrhea and urine infections. History of travel is no longer a prerequisite for diagnosis since we moved to community-based transmission.
HJ: As a hospital, are you still allowing patients to show up if they have other issues other than COVID-19? How are you handling these?
SA: The hospital is fully functional for all children and adult outpatient and inpatient medical needs including laboratory, pharmacy, maternity and surgery. Patient safety is our utmost priority.
We have a competent and thorough screening mechanism as patients walk through the facility, to ensure quick service delivery by identifying patients with symptoms of COVID-19 and effectively providing them with medical services while protecting anyone else accessing the facility. There are multiple areas for hand hygiene/sanitizing, well demarcated zones for social distancing and appropriate infection prevention measures.
There are completely separate medical services for NON COVID patients, suspected COVID-19 and confirmed COVID-19 patients. Suspected COVID-19 patients are tested promptly and if they test negative they are managed as per their primary ailment.
There is no discrimination against COVID-19 positive patients. We provide them with state-of-the-art medical care, to manage not only the COVID-19 infection, but also any underlying conditions as well as the provision of strong psychosocial support during their admission.
HJ: Usually there is a combination of medical insurance and NHIF and personal funds in the clearance of hospital bills, in regards to COVID-19, how is this combination working out? What should a patient who is COVID-19 positive keep in mind?
SA: The larger costs of managing a stable suspected COVID-19 or COVID-19 positive case, beyond general medical care, is the amount of protective personal equipment that is required by all staff that come into contact with the patient.
I would encourage everyone with a private medical insurance to engage their individual companies on medical coverage related to COVID-19, as this varies depending on the policy. The trend has been for insurance to cover admissions related to COVID-19 based on workplace exposure. Non civil servant NHIF holders who are up to date with their payments will still get the usual relief in terms of bed charges and diagnostic imaging.
HJ: You have recently started a COVID-19 testing by appointments, how is it working out?
SA: We have had very good response to our outpatient COVID -19 testing so far.
This is a paid service in partnership with Lancet laboratories. We have developed protocols to assist any client depending on the outcome of the results and provide them with an information packet as what to do next. We are also in touch with the Ministry of Health and the County Services. Our M.P. Shah hotline is accessible 24hrs a day for anyone who needs any further assistance.
As home isolation for stable positive patients is being rolled out by the government, we at M.P. Shah Hospital have developed an isolation package that allows for telemedicine follow up with our specialist consultants. The aim of this is to guide one through the isolation process at home, provide psychosocial support and be available for any medical queries including follow up testing at the end of the isolation period.
HJ: If patients are currently stranded in clearing their bills if they are suffering from other ailments and not COVID-19 what kind of advice or support are you offering?
SA: Whether you have a private insurance or not, it is very important to ensure that your NHIF cover is active. This assists greatly with bed charges, surgical procedures and diagnostic imaging fees. The hospital credit control team provides logistical support on an individual basis for patients who are unable to clear their bills.
HJ: How would you compare Kenya’s response to other East African countries or say India at this moment to COVID-19? There must be some positives that we have compared to other developed countries like the UK.
SA: I wouldn’t make comparisons because one size doesn’t fit all and there is never a solution to a problem that will make everyone happy. In an unprecedented time, I believe the initial response by Kenyan government and Ministry of Health was warranted and effective. It allowed us time to learn from other countries, beef up our infrastructure and develop public health policies to mitigate the effects of the pandemic.
We have seen a setting up of critical care centers in multiple public facilities in remote areas. Hopefully beyond the pandemic these structures will remain active and functional. There was excellent public education with regards to disease transmission, hand hygiene, cough etiquette, social distancing and a focus on mental health.
I am in awe of all the frontline workers in Kenya who continue to bravely provide medical services despite the continued risk to themselves in what may be deemed as a resource limited setting.
HJ: What is your hospital policy in keeping your staff protected?
SA: Our staff welfare has remained our key priority during this time. In order to protect them during service provision, we have implemented various hospital policies at every level of patient interaction and care; from admission through to discharge. The necessary protective personal equipment is provided in all departments and the staff undergo continuous training and education on the COVID-9 virus to ensure they remain vigilant. Mental Health is also a key priority and the hospital has cushioned the employees by providing them with all the necessary support that they require during this pandemic like free counselling and mental health webinars for all staff.
About Dr Shamsa Ahmed: