Coronavirus makes the case to completely devolve health

As the coronavirus ravages the country, now that it is unlocked, the responsible institution — the national government — is now throwing the gauntlet at hapless county governments to shoulder.

Now it’s the turn of county governments to shoulder blame, to be told they’re accessories to murder for not having 300 isolation beds within a month to host possible Covid-19 victims, but without testing capacity and capability.

The unlocking of hotspots and releasing possibly infected people into counties is akin to releasing murder convicts into a community. But does it matter?

From the day the first case hit the country in March, the government has progressed with experimentation, trial by error and no certainty on the end game.

POETIC VERSE

Times have been when Cabinet Secretary for Health Mutahi Kagwe’s updates became outlets for piety and poetic verse, not instructional sessions on where to go for testing.

We went through a frenzied period of public mobilisation and sensitisation on sanitation. We’ve been constantly fed on a diet of the tested, affected, quarantined, dead, healed; and exhortations to stay safe by washing hands, sanitising, no handshakes, maintaining social distance, wearing face masks and staying at home. We became weary because all the razzmatazz proved mere vanity.

The fear of coronavirus has been replaced by a carefree attitude. The daily media blitz frenzy is dead. Changing location and anchors isn’t helping. I don’t envy Mr Kagwe.

He’s left his juniors to do the courting. He must know that the centrepiece — testing that never was — especially mass testing, wasn’t a prophecy. It was a delusion that he should never have let himself be misled into by the own-proclaimed Afya House “cartels”.

No matter. We’re still churning out numbers, not to warn of the call of death, but to make Covid-19 the new normal.

PIT OF FAILURE

I pity counties who’ve been thrown into this pit of failure, but must now — as they say in courts — carry the burden of the suspect’s evidence.

The truth of the matter is that we’ve failed to prevent infection so much so that now we must prepare for a deluge of the sick into poorly equipped county health facilities.

Why, you may ask, is the urgency in buying beds? Because the government can no longer pretend to be preventing the disease through testing and isolating the sick. It has given up on pretending. It knows there are going to be unaccountable sick that must be hospitalised.

But is admission to hospital the new Covid-19 cure?

Of course not. Were it so, the government would be investing in equipment other than beds — equipment for testing, ventilators and ICU. It could unbundle Covid-19 emergency funds from being centralised at the Ministry of Health to counties.

Counties know what they need — testing capacity and capability — but not preparing to host unmanageable sick. Testing is the problem and solution government has evaded.

There are no public walk-in and out testing facilities anywhere, not even at Kemri. Private testing is expensive. All Lake Victoria region counties depend on one Kemri facility in Kisumu, North Rift counties on Eldoret Referral Hospital and Eastern region share facilities with Nairobi.

So, counties wait for weeks to receive test results, by which time self-isolation patients have vanished to infect many more. These secondary contacts’ results are no more useful for contact tracing. No wonder counties have scaled down all mitigation measures for being broke.

DILEMMA

The deluge had by Thursday crossed 11,000-plus cases out of only over 250,000 tests and rising. But how do counties know levels of prevalence and act, if we’re never told from which counties the tested come from?

Lack of samples by county has left them in an insufferable dilemma, not knowing what to mitigate against.

Why haven’t we invested in testing kits? Two reasons. One, because there are vested interests to procure only that with immediate benefits to the procurer. Two, fear of exposing the extent of vast infections.

County governments have turned into fatalism. Their coffers are empty. Council of Governors is waiting for the worst to happen to ask the President to lock down offending counties. But how do you identify the offender?

We’ve been exposed. Our health system is poor. It’s poor for want of space, healthcare workers, specialists, equipment, medicines — and what else? Coronavirus makes the case to completely devolve the health function. No more half measures. So, someone must bell the cat.

Mr Kabatesi is a communications and governance consultant; [email protected]                          Mutuma Mathiu’s column will resume next week.