A baseline review of the ability of hospitals in Kenya to provide emergency and critical care services for COVID-19 patients
Wachira B, Mwai M.
Afr J Emerg Med. 2021;[Epub ahead of print]
Patients who are assessed by a Health Care Worker and meet all the criteria below will be considered for home-based isolation and care:
As the COVID‐19 pandemic continues to unfold here in Kenya, more and more patients are requiring oxygen. To increase the capacity of healthcare facilities to provide oxygen to more patients, we have installed Oxygen Gas Manifolds in the emergency departments at the county referral hospitals in Machakos, Kiambu (COVID-19 isolation centre) and Kajiado counties and at the Alupe Sub-County Hospital COVID-19 isolation centre in Busia county. These are the hardest hit counties at the moment and we continue to seek additional support to support more facilities.
The findings of this well done randomized controlled trial indicate that in patients with COVID-19 pneumonia, that dexamethasone improves 28d mortality compared to placebo in patients requiring invasive mechanical ventilation (IMV) (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29). There was no benefit to patients not requiring oxygenation support and even a signal for harm. It is important to remember this is a preprint, preliminary report, which is better than a press release. At this time, in patients requiring any oxygen therapy, HFNC, NIV, IMV, or ECMO I would recommend dexamethasone until further evidence disproves this benefit.