Hospitals in crisis

• As admission rate jumps over 400% in two weeks
• It’s a new virus and it’s brutal—Divala

Malawi’s healthcare system is groaning as coronavirus admission rate jumps by more than 400 percent within two weeks in what epidemiologists say is the “rebirth of Covid-19”.

The situation in hospitals is worrying experts, with 138 Covid-19 patients admitted nationwide as of on Wednesday, up from 25 on New Year’s Day; straining an already fragile healthcare architecture.

Currently, Queen Elizabeth Central Hospital has 60 admissions from 12 on New Year’s Day; Kamuzu Central Hospital has 37 patients from 10 on January 1; Mzuzu Central Hospital has seven from two while Zomba Central Hospital has four from one.

The rest of the patients are in district hospitals; especially Karonga, Nkhotakota, Balaka, Chikwawa, Dowa, Mchinji and Rumphi at a time risks to caregivers have also risen.

The Ministry of Health estimates that 754 health workers have tested positive since the onset of the pandemic in Malawi and six have died.

Out of the six, according to the ministry’s Principal Secretary Charles Mwansambo, three have succumbed during the resurgence. He also estimates that active cases among health workers could be about 25.

Mwansambo could not hide his worry about the rate at which Covid-19 is spreading, saying the public health system is overwhelmed such that they are encouraging private hospitals to spare some rooms for Covid-19 patients.

He said: “Honestly, the new wave is quite heavy on us. It is not just about patients, but also health workers. The increase in number of patients is a threat to our health workers. They live in a community where they can also get infected and having them quarantined for some days is depleting our numbers in the hospitals. The system is getting overwhelmed.”

On Tuesday, University of Malawi College of Medicine epidemiologist Dr Titus Divala said the new Covid-19 is not a second wave, but a new epidemic altogether.

He stated: “I think what we are experiencing is way more than a second wave, it is a fresh epidemic altogether. What we are seeing now should properly be called the rebirth of Covid-19, it’s just like a new virus is amidst us and it is brutal.”

Divala explained that in the first wave, the country had a long period before seeing large numbers of hospitalisations.

“But this time, we have seen hospitalisations jumping from 19 to 70 in just seven days. It took very long to start seeing large numbers of deaths in the last wave, and the highest we recorded in a single day was nine deaths on August 1 2020,” he said.

On the day he issued the statement, which is also the day the two Cabinet ministers Sidik Mia and Lingson Belekenyama died, the Ministry of Health recorded 19 deaths in 24 hours. On Wednesday, 21 deaths were recorded, the highest in a single day so far.

Therefore, Divala said: “I think calling this a second wave is a serious understatement. This is a new epidemic; an epidemic within epidemic.”

January is proving to be the most tragic month as in just 13 days, about 67 people have died of Covid-19.

On average the country has been recording about five deaths every day since January 1, 2021 due to Covid-19.

This brings the death toll to 275 since April last year when the first positive cases of Covid-19 were reported in the country.

January alone, so far, has recorded 3 409 positive cases which represents almost 30 percent of total positive cases registered since April last year (9 991).

In his national address on Tuesday, President Lazarus Chakwera, noting the sharp increase in Covid-19 cases and attendant deaths, described the situation as a tragedy.

Presidential Task Force on Covid-19 co-chairperson John Phuka said task force forewarned the citizenry last year.

He said: “In December, ahead of the festive season, we proposed a set of measures aimed at minimising the spread of Covid-19, but some [people] sought a court injunction. We would not be in this situation today if we did what was supposed to be done.”

Phuka conceded that Malawian returnees from South Africa have aggravated the situation.

In a separate interview, University of Malawi’s College of Medicine epidemiology professor Adamson Muula called on government to review the Public Health Act, arguing it is too old to respond to current health issues.

He said this was also the submission of the Society of Medical Doctors to the High Court in a constitutional case where some individuals and organisations were arguing the legality of lockdown.

“The Act was enacted 1948 and is mostly irrelevant to present scenarios. We need the law reviewed to provide guidelines on how to deal with pandemics such as Covid-19,” observed Muula.

Muula believes that government is currently grappling with enforcing the measures for lack of a strong legal framework.

In the case–constitutional reference number 1 of 2020—the medical doctors, which consulted widely, observed that the Act refers to some diseases such as smallpox that are long eradicated and no longer an issue of public concern.

Since the start of Covid-19, the most affected age range is 35-36 years. The oldest case is 98 while the youngest is a two-week-old baby.

Blantyre and Lilongwe are hit the hardest, followed by Mzimba, Zomba, Nkhotakota and Karonga.