Kenya: Medics - Six-Year-Old Boy May Have Exposed Many to COVID-19

The six-year-old boy who died at Kenyatta National Hospital (KNH) may have exposed dozens of people to the coronavirus.

Some of the health workers who attended to the boy use public transport.

Healthcare workers who spoke to the Sunday Nation said the paediatric department at the hospital is considered low risk for Covid-19 and they were therefore not given any protective gear.

It is feared that more than 50 health workers may have come into contact with the child and exposed their families to the virus.

The boy also interacted with the registrars at the hospital who did not have personal protective equipment.

Registrars are postgraduate students from the University of Nairobi. They are usually around 400 at the hospital at any given time.

"Very few of us have vehicles. We use matatus to get come to work and when going back home. We may have exposed our family members, friends and fellow passengers to the virus. It is scary," one of the students said.

LITTLE TRAINING

The registrars added that they have not been trained on handling Covid-19 cases but are still being included in the rota to see patients.

The child was first taken to the paediatric emergency unit where nurses and medical officers checked his temperature, breathing and other health vitals.

The process usually takes about an hour. From the emergency unit, the child was taken to the paediatric ward where a healthcare worker noticed that he already had signs of pneumonia, a disease that is a feature in nearly all severe Covid-19 cases.

The boy spent two days in the ward, where medical procedures that emit the virus in the air such as intubation were performed by doctors who were not properly protected.

On the third day, a team from the intensive care unit went to the ward. After being reviewed, the boy was taken to the ICU.

While at the ward, nurses told the Sunday Nation, two registrars took samples from the child for coronavirus testing fearing they may have contracted the disease.

VARSITIES CLOSED

The results came back positive on Wednesday, the day the child died. Dr Alfred Odhiambo Otieno, a senior doctor at KNH, told the Sunday Nation that he and 12 colleagues have formed a group to buy personal protective gear.

He said the group has already raised Sh1.3 million. Doctors and registrars interviewed said they do not understand why the hospital put the students on the rota when universities have been closed.

That in essence means what they are doing cannot be counted as class work and goes unpaid. Registrars from Moi University, Eldoret, are not working.

The KNH administration declined to comment on the issue but insisted that the workers have been trained on infection control.

The administration directed the Sunday Nation to the Ministry of Health.

The interaction between the child, the nurses and doctors who provided care also raises questions about the government's seriousness in taking care of health workers, the most critical people in managing the pandemic.

SELF-ISOLATION

Health Director-General Patrick Amoth told journalists on Saturday that the ward where the boy was treated would be disinfected.

"More than 20 of the registrars have been told to self-quarantine," Dr Amoth said.

Health Cabinet Secretary Mutahi Kagwe said health workers would be provided with transport. "We are trying our best to protect them from infections... We could do better but we are trying," he said after his daily briefings on the pandemic.

The minister downplayed the fears about registrars and young doctors' abilities to handle the infection.

"Do not underestimate the effectiveness of these young workers. They can take care of themselves and the patients," he said.

Kenya Medical Practitioners Pharmacists and Dentists Union chairman Samwel Oroko asked the government to provide jobs to doctors who are still unemployed.

In countries like Italy, as many as 12 per cent of the coronavirus fatalities are healthcare workers. Research has shown that the virus is airborne in healthcare settings.

SAFETY KITS

The World Health Organisation (WHO) says protection against airborne transmission is important, especially for health workers when they do medical procedures that can to produce smaller respiratory droplets.

This includes insertion of tubes as performed on the child by some of the registrars and medical officers. The mere act of breathing by the patients can infect the workers.

According to Dr Josh Santarpia - an expert in biological aerosols at the University of Nebraska Medical Centre in the United States - when a healthcare worker stands by the bed of a patient, it does not matter whether that sick person is speaking or not.

The particles the patient emits will be breathed in by someone who could be as far away as five feet, at the foot of the bed.

Should these particles be pathogenic - containing the virus causing Covid -19 or even SARS-CoV-2 - the healthcare provider will be infected, Dr Santarpia says in his work.

National Academies of Sciences, Engineering and Medicine - which is often called upon to advise the White House Office of Science and Technology Policy - wrote this week:

"Currently available research supports the possibility that SARS-CoV-2 could be spread via bioaerosols generated directly by patients' exhalation."

Bioaerosols are the fine particles let out when someone breathes out rather than larger droplets produced through coughs and sneezes. Bioaerols can be suspended in the air.

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