Safely reopening and operating a primary healthcare facility after closure due to SARS-CoV-2 infection in a healthcare worker - Nairobi, Kenya, 2020

Abstract

The first COVID-19 case in a healthcare worker in Kenya was reported on March 30, 2020, in Nairobi, leading to a 41-day closure of the health facility where he had worked. We assessed infection prevention and control (IPC) activities and implemented recommendations to re-open and operate the facility. We conducted a risk assessment of the facility in April 2020 using a modified World Health Organization, six-element IPC facility risk assessment tool. IPC recommendations were made, and a follow-up assessment of their implementation was conducted in July 2020. Breaches in IPC measures included poor ventilation in most service delivery areas; lack of physical distancing between patients; inadequate COVID-19 information, education, and communication materials; lack of standard operating procedures on cleaning and disinfecting high-touch areas; insufficient IPC training; inadequate hand hygiene facilities; insufficient personal protective equipment supplies; and an inactive IPC committee. Strengthening IPC measures is critical to prevent healthcare facility closures.

Keywords: COVID-19; SARS-CoV-2; healthcare worker; infection prevention and control; primary healthcare facility.

Fig. 1.

Triage area, respiratory and non-respiratory waiting bays with marked physical distancing at the Nairobi primary healthcare facility. A. Risk assessment team at the healthcare facility, B. Physical distancing markers at the non-respiratory patient waiting bay, C. Hand hygiene stations for clients with posted information, education, communication material, D. Open waiting bay for respiratory patients, E. Triage area, F. Improved ventilation at the waiting bays following assessment and removal of expired commodities.