More Covid beds now vacant

Whereas securing hospital spaces for Covid-19 patients had become a tug-of-war across the country, more spaces are now being freed up with the cut back on the number of infections, admissions, and deaths.

Last month, the public raised an outcry over claims that Covid-19 patients were being turned away from health facilities that cited overcrowding.

This raised concerns over government ability to meet critical health needs of its citizens as the Covid-19 cases soared in the second wave of the pandemic.

For those who opted for private hospitals, the costs soon became prohibitive, prompting hundreds of complaints to the State House Anti-Corruption Unit.

There were also anger over some medical facilities denying emergency medical care and detaining patients or their bodies over their relatives’ failure to make down or full payment. 

Although some Intensive Care Units (ICUs) still remain full, there has been a reduction in patient numbers in the High Dependency Units (HDUs) and general admission spaces.

A quick survey by Saturday Monitor indicates that bed spaces for Covid-19 patients are more available now, creating room for new admissions.

At Kibuli Muslim Hospital in Kampala, Mr Sinani Siraj Mbulambago, the hospital administrator, yesterday said of the 15 beds dedicated to Covid-19 patients, only five were occupied.

Previously, especially last month, the hospital was stressed with high numbers seeking admission.

At the Mulago National Referral Hospital, its Covid-19 treatment unit has 70 beds available.

As the new wave hit and number of cases increased, Mulago expanded its bed capacity to 200.

Dr Rosemary Byanyima, the deputy executive director of Mulago hospital, said the reduction in the number of admissions has led to reduction in consumption of medical vitals such as oxygen.

At least 2,600 litres of the medical gas per minute are consumed by Covid-19 patients, unlike previously where the patients used 3,000 litres per minute.

“The numbers have reduced, even the mortality has reduced.  In the last week of June and around mid-June, we would admit 40 patients, discharge some 20 and lose 12,” Dr Byanyima told Saturday Monitor.

“We have 70 beds, we keep expanding as the need arises. When the numbers started going high, Namboole stadium was reopened to decongest Mulago. Currently, we have 14 patients in ICU and our capacity is 27, and 108 patients are in HDU,” Dr Byanyima added.

She said many of the deaths during the peak would be the long-stay patients with a lot of complication and those who fail to heal, as well as those who have stayed for a short time but presented to hospital when already in severe state. 

The Health ministry also says Covid-19 admissions in isolation centres have reduced from 120 daily to 80 patients, whereas infections have reduced from more than 1,000 to 600 that were recorded on a daily basis. 

As of Wednesday, the death rate had reduced from 50 to 21 daily.

“There are more spaces in hospitals to admit more patients because they are no longer overwhelmed. The lockdown measure is working,” Health minister Jane Ruth Aceng said on Thursday.

She also said there was now stability in the supply of oxygen due to reduction in admission.

“The number of people dying daily has reduced. Of course, 21 are still many, but at least there is a decline in the numbers and we hope at the end of the 42-day lockdown, the Corvid graph will have flatten,” Dr Aceng said.

Dr Michael Mwanga, the Soroti Regional Referral Hospital director, attributed the reduction in hospital admission to the lockdown measure.

Dr Mwanga said about three weeks ago, there were nearly 100 Covid-19 patients admitted, thus straining the hospital capacity of 70 beds.

By press time, the hospital was nursing 74 Covid-19 patients, indicating that patients are still more than the bed capacity. 

Dr Mwanga said the hospital will be expanded by more 48 beds next week.

“Our tents are getting ready within the next one week. We have already received beds and mattresses from the Ministry of Health,” Dr Mwanga said.

Dr Richard Lukandwa, the medical director of Medipal International Hospital, says: “We have 15 ICU and HDU beds, but we have 11 occupied. We have 10 patients in the general ward of 50 beds. The numbers have gone down, the lockdown has worked. At the peak, we had about 60 patients.”

Dr Lukandwa has called for vaccination of the population to stop more waves.

But Dr Emmanuel Tugeinayo, the director of Mbale Regional Referral Hospital, says there is need to investigate whether the lockdown is the one responsible for the reduction in number of admissions, and deaths.

“It’s not easy to attribute it to any single measure, so one needs to investigate whether the lockdown has caused the drop, but when there is lockdown, there are also challenges in accessibility to medical services,” Dr Tugeinayo said.

In other hospitals including Entebbe Grade B, there were 20 HDU beds available, although the ICU remains full.

However, Dr Moses Muwanga, the hospital director, says this number could have changed given that there are ongoing admissions.

At Mbarara Regional Referral Hospital, at least nine beds are free. The hospital director, Dr Celestine Barigye, says two of the patients have mild cases, 10 moderate and 30 severe, while four are critical.

“We prepared an emergency ward with 20 beds and all have oxygen and can take all the mild and moderate cases. We also prepared private wings with 20 beds. This can take moderate and severe cases. We also prepared a Covid-19 treatment unit, which has 15 beds, each with a ventilator and can take both critical and severe cases that are tending towards critical,” he said.

“In addition, we have constructed a Covid-19 Unit of 42 beds to be commissioned in two weeks. All these are going to be ICU beds… our target is 100 beds to enable us handle all the cases,” Dr Barigye said.

Dr Monica Musenero, the minister in-charge of Science, Technology and Innovation, who also doubles as a senior presidential advisor on epidemics, said the reduction in hospital admission and positivity rate are good indicators.

“Our goal is to have as few people as possible falling sick, detect more cases early, and prevent transmission. The important thing is how many cases are severe and seeking care? At Mulago [hospital], they will tell you there is a reduction in that number,” Dr Musenero said.

However, Dr Charles Olaro, the director of curative services at the Health ministry, warns that it is too early to celebrate the apparent reduction in infections and hospital admissions.

Current Covid bed capacity

What some stakeholders say...

The numbers have reduced, even the mortality has reduced.  In the last week of June and around mid-June, we would admit 40 patients, discharge some 20 and lose 12. We have 70 beds, we keep expanding as the need arises. Currently, we have 14 patients in ICU and our capacity is 27, and 108 patients are in HDU,”  Dr Rosemary Byanyima, Mulago hospital deputy executive director.

There are more spaces in hospitals to admit more patients because they are no longer overwhelmed. The lockdown measure is working. The number of people dying daily has reduced. Of course, 21 are still many, but at least there is a decline in the numbers and we hope at the end of the 42-day lockdown, the Corvid graph will have flatten,”  Dr Jane Ruth Aceng, minister of Health.

We have 15 ICU and HDU beds, but we have 11 occupied. We have 10 patients in the general ward of 50 beds. The numbers have gone down, the lockdown has worked. At the peak, we had about 60 patients. Government should work towards having more of the population immunised,”  Dr Richard Lukandwa, medical director of Medipal International Hospital.

The reduction in hospital admission and positivity rate are good indicators. Our goal is to have as few people as possible falling sick, detect more cases early, and prevent transmission. The important thing is how many cases are severe and seeking care? At Mulago, they will tell you there is a reduction in that number.”  Dr Monica Musenero, minister in-charge of Science, Technology and Innovation.

There is need to investigate whether the lockdown is the one responsible for the reduction in number of admissions, and deaths. It’s not easy to attribute it to any single measure, so one needs to investigate whether the lockdown has caused the drop, but when there is lockdown, there are also challenges in accessibility to medical services.”  Dr Emmanuel Tugeinayo, director of Mbale hospital.