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How Kenya is losing track of Covid deaths

A Covid-19 burial team lowers into a grave a casket containing a body of a Covid-19 victim.

The Ministry of Health could be massively under-reporting coronavirus deaths due to an unchecked home-based care system, delay in releasing test results, harsh county-imposed restrictions on handling Covid-19-related deaths and high mortuary costs.

Kenya, whose overall Covid-19 deaths tally was at 4,350 on Monday, recorded only 10 deaths that day, from a sample size of 5,693 with a positivity rate of 11.9 per cent as per the official ministry report.

Dr Josephine Kibaru Mbae, the former director of Health Services at the Nairobi Metropolitan Services, however, explained that many people are dying at home after contracting Covid-19.

She said: “The people we treat in hospitals are just the tip of the iceberg. We should be liaising more with local administration, like area chiefs, to establish the actual number of deaths.”

Some of the reports of deaths the ministry gets are done much later.

“The deaths during home-based care may be reported to chiefs and community heath volunteers, but they are not captured in MoH records,” she explained.

A businesswoman in Kakamega County said expenses have seen them fail to report a death from Covid-19 .

“My relative died of Covid-19-related complications last week and since we have spent all the money we had on his treatment, we opted to preserve the body traditionally, then bury it,” she said.

She further disclosed that she had been introduced to private hospital mortuaries that do not notify the government of Covid-19 deaths in exchange for high fees.

Kakamega County General Hospital administrator Titus Mumia noted there could be such private hospitals that do not report when they lose a patient to coronavirus.

“For us in government hospitals we must account for all Covid-19 testing kits and so we must report, though the data is sometimes generated two days later,” he said.

A mortuary attendant at Mukumu Mission Hospital agrees that the cost of handling Covid-19 bodies is scaring away many people.

“Governor Wycliffe Oparanya recently announced that bodies must be picked up on Fridays between 6am and 10am, after which they must be buried within 72 hours. Some people cannot raise monies to settle everything to comply with that order within that short period and so they look for alternative means to deal with their situation,” the attendant explained.

In Kilifi, County Health Executive Charles Dadu told the Nation that a majority of suspected Covid-19 deaths happening in homes are not recorded. In Nairobi and Machakos, the situation is no different. Doctors explained that the Covid-19 death statistics are not accurate because the country is under-testing for coronavirus.

“The home-based care system is massively flawed. The government does not follow up the way they should and the truth is many people are dying in their homes and they go unrecorded; but for us as hospitals, we send daily reports,” a doctor in Machakos said.

A delay in releasing results of Covid-19 tests is also responsible for the inaccurate numbers.  “There are patients who succumb to coronavirus before their test results are out, hence they are not usually recorded as Covid-19 deaths,” an isolation ward doctor in Nairobi disclosed.

According to the Ministry of Health, its task force, where all deaths are reported and recorded, is doing its best to deliver.

“We have situations whereby someone one day woke up feeling unwell then collapsed and died. When they do the autopsy later, they discover the person was suffering from coronavirus and it is the hospitals that are supposed to notify us,” an official at the ministry told the Nation on Tuesday.