The Ministry of Health has come out to dispute a story that run in Sunday Monitor about Covid-19 deaths at Mulago hospital.
In a Press statement released yesterday, titled Mulago National Referral Hospital Response To The Allegations By Sunday Monitor Article on Covid-19 Response, Byarugaba Baterana, the hospital executive director refutes that the deaths were due to a faulty oxygen plant. Here below is the verbatim:
Our attention has been drawn to an article titled “Dying with Dignity” published by the Sunday Monitor on November 29th, 2020, which makes a number of allegations on the COVID-19 response in the country including among others that two patient died from a Faulty oxygen plant at Mulago, Fake masks for Doctors and unfounded doubts on the country’s capacity to respond to the pandemic.
Therefore, Mulago referral hospital would like to respond to the various allegations contained in the article as follows:
Background
Mulago National Referral Hospital opened a COVID-19 Treatment Unit (CTU) early in March following the confirmation of the first COVID-19 patient in March this year. The centre provides the following services:
- Clinical and supportive treatment for confirmed COVID-19 patients
- Psycho-social support to COVID-19 patients
- Clinical and supportive treatment for presumptive patients (these are patients with COVID-19 like symptoms pending laboratory tests)
- Post COVID-19 follow up care (this clinic runs on Thursdays)
- There is a help desk which attends to the concerns of the relatives as well as the public
The centre is currently running at a capacity of 500 beds but may be expanded depending on the need. Of these Intensive Care Units (27), High Dependence Unit (200) and the rest general care
As of 30th November 2020, Mulago National Referral hospital had a cumulative admission of 2,456 patients with a total discharge of 2,137 and the current admission stands at 160 (of these 97 severe in HDU, 5 critical cases in ICU and 60 in general ward). The total fatalities currently stand at 150. Self-requested transfers out of Mulago to other units are five (5) in total.
The cumulative admission into high dependence unit and ICU is 605. It is important to note that almost all patients are referred to Mulago Hospital from other hospitals in critical condition, some arriving from other hospitals with late stage of the disease. Most of the patients are referred in critical conditions (with multi-organ failure).
We would like to inform the public that Mulago national referral Hospital is doing whatever it takes to ensure that services required for COVID-19 treatment are made available.
Other services
Mulago National Referral Hospital continues to provide surgical, medical, paediatric, and diagnostic services. The hospital being the highest level of care, continues to provide specialized services; for instance recently, we separated Siamese twins in a multi-disciplinary surgical operation that lasted 24 hours, the babies are currently recovering and doing well. The hospital has also recently successfully handled casualties and traumatic injuries from the riots. All other services are running normally in various departments.
We wish to clarify on the allegations made on the aforementioned article carried in the Sunday Monitor of 29th November 2020.
DEATH OF TWO PATIENTS
The article alleges that two patients died from Mulago Hospital’s Intensive Care Unit in August this year due to lack of oxygen.
However, this is not true and we would like to categorially state as follows;
The patients who include a 70-year-old referral from Rubaga Hospital ICU, a 27-year-old case from Hoima Regional Referral Hospital and 46-year-old case all died from severe COVID-19 with multi-organ dysfunction. It is therefore not true that the patients died due to lack of oxygen. During this period, the Mulago Hospital ICU had other patients who posted better outcomes.
Letters to My Younger Self: What Uganda’s CEOs and Professionals Wish They Knew at the StartCOVID-19 causes mild to moderately severe disease which in majority of cases, can be self-limiting. About 20% of cases progress to very severe disease leading to multi organs in the body failing to function. Depending on the severity of the organ dysfunction, the outcome is usually bad with most patients who progress to this stage succumbing to the disease. As at March to April 2020, COVID-19 was the 3rd leading cause of death in the USA after heart diseases and cancer.
It is important to note that admission into the Intensive Care Unit (ICU) is meant to offer life support for critically ill patients. Life support includes the use of machines such as ventilators and other high end medication as the patients’ body fights the disease thus the death rate tends to be high. Italy’s death rates during this pandemic were at 51% and a good number discharged from ICU still remained incapacitated in one way or the other
ICU care and use of ventilators is last resort because it means that your body has failed to function and it’s a machine doing this for the patient.
Given the current stage of the pandemic, where there is wide spread community infections, the patients are presenting to the hospital rather late as they delay at home trying to treat this as common flu that has similar symptoms with COVID-19.
We therefore appeal to the general public to test for COVID-19 whenever they present with flu-like symptoms, fever, headache, high temperature, chest pain and difficulty in breathing.
OXYGEN PLANT
Currently, Mulago National Referral Hospital has four (4) new fully functioning Oxygen Plants which are supplying Oxygen to where it is required in optimal amounts and purity levels.
The newly installed 4 oxygen plants at the Hospital makes it the largest Oxygen plant in the country that is able to generate 2,083 litres of Oxygen per minute.
In 24 hours, the Mulago plant can generate about 2,999, 520 litres of Oxygen which in normal circumstances can serve about 900 patients. The four are part of the seven plants procured by the Ministry of Health to meet oxygen needs in the country.
The article makes a comparison of the cost price of the new plants with the old ones installed 10 years ago which is misleading. The cost drivers for the current plants include;
- Higher specifications due to demand for high flow and high purity Oxygen necessary for treating COVID-19 patients
- High production capacity of 125 cubic metres per plant as compared to old ones which are of lower production of 20 cubic metres
- The global demand of oxygen plants
- Global travel restrictions amid COVID-19 and the urgency of oxygen plants made airlifting of the plant as the only available quick option
- The brand of equipment is also high end and durable
Furthermore, the allegation that Oxygen supplied to patients dropped from 90% to 20% is not true. We would like to clarify that Oxygen is delivered to the user wards through pipes when its purity is ranging between 93% and 100%.
The currently installed plants are automated and cannot generate Oxygen when its purity levels go beyond 90%. All patients in need of Oxygen are connected to a supply of medical grade Oxygen which is always above 90%. This is contrary to what the authors allege that patients are supplied with ‘hot air’.
FACE MASKS
The allegations on fake medical masks is not true.
The Hospital would like to state that all medical face masks used by health workers country wide meet both local and international standards.
Indeed no health worker at ICU at Mulago has contracted COVID-19. This is attributed to the training and strict adherence to Personal Protective Equipment (PPE) which is highly protective including the alleged face masks.
