The number of coronavirus patients is on a steady rise, but not all hospitals have started treatment of COVID-19 cases. The government has issued directives to all hospitals, both government and private to start treatment of coronavirus cases, but these directives have not been implemented fully as yet. So with the increase in patients, pressure is mounting on the hospitals which had already been specified for the treatment of COVID-19 cases.
There are no vacant ICU beds in these hospitals. Five months ago work had started on installing 5-bed ICU facilities in Mahangar Hospital and the Mirpur Maternity Hospital, both hospitals in the capital city selected for coronavirus treatment. These were scheduled to be ready two weeks ago, but till Wednesday these facilities were not functioning.
Till Wednesday, 55,140 coronavirus cases were conformed in the country. Of them, 11,590 have recovered. According to the World Health Organisation (WHO), 40 percent of the patients have mild symptoms and 15 percent have acute symptoms. The remaining 5 percent face complications. All the patients with acute symptoms and complications require hospitalisation, while many with medium symptoms also need to be hospitalised.
According to the health directorate, till 1 June there were 13,964 beds specified for coronavirus patients in hospitals all over the country. These included 399 ICU beds and 106 for kidney dialysis. There are 7250 hospital beds in the capital city, of which 137 are ICU beds and 101 for kidney dialysis.
A total of 17,998 coronavirus cases were confirmed in the capital city. The government had specified 13 hospitals in the city only for coronavirus treatment, but one of the private hospitals has retracted its agreement with the government. Another one only treats members of the police force who have contracted the virus.
Coronavirus patients are also being treated at a unit in Dhaka Medical College Hospital and the temporary isolation centre set up at Bashundhara International Conference Centre.
Physicians of three hospitals specified for coronavirus have said that with the increasing number of COVID-19 patients, pressure is mounting on the hospitals. With no vacancies in the ICUs, many patients are being turned away. And many complicated cases are placed in general wards. Under such pressure, the hospitals are unable to admit patients with mild or medium symptoms.
According to the regular bulletin of the health directorate, many serious patients have died on the way to hospital. There are several groups on Facebook exchanging experiences of coronavirus treatment. Many of these groups have appealed for assistance to set up ICU facilities for coronavirus patients.
On Monday, a 74-year-old tested COVID-19 positive and was admitted to a ward in Mugda Hospital. A heart patient, he needed ICU treatment, but there were no vacant ICU beds in the hospital. His family contacted several hospitals to no avail. Speaking to Prothom Alo, one of his relatives said that after trying for several hours, finally they transferred him to an ICU at Holy Family Hospital.
The health ministry on 24 May issued directives to ensure the treatment of coronavirus cases. The directives stated that all government and private hospitals with 50 beds or more, must arrange separate treatment for Covid and non-Covid patients. Not all hospitals and clinics have complied, despite 11 days having passed since the directives were issued.
The Executive Committee of the National Economic Council (ECNEC) on Tuesday approved two projects to develop ICUs and oxygen support systems in the government hospitals around the country. These two projects will be implemented with assistance from the World Bank Asian Development Bank (ADB). However, it will take considerable time for these projects to be completed.
Convenor of the health ministry’s media cell and additional secretary of the health services division, Habibur Rahman Khan, told Prothom Alo that all hospitals have been asked to start treatment of coronavirus patients. The hospitals have asked for some time to prepare. Some private hospitals have already begun treatment and others will start shortly.
Not all hospitals start COVID-19 treatment
The health ministry on 24 May issued directives to ensure the treatment of coronavirus cases. The directives stated that all government and private hospitals with 50 beds or more, must arrange separate treatment for Covid and non-Covid patients. Not all hospitals and clinics have complied, despite 11 days having passed since the directives were issued.
Speaking to Prothom Alo, state minister for disaster management and relief, and former secretary general of Bangladesh Private Medical College Association, Enamur Rahman, said that all hospitals had been instructed to treat coronavirus patients, but this would take some time. It will be possible for all hospitals to start treating these patients by the end of June.
Two officials of two private hospitals in the capital city, on condition of anonymity, said the bed arrangements for coronavirus patients were different from other patients. Non-Covid patients would have to be kept on a different floor. The hospitals would require separate entrances for Covid and non-Covid patients too. All this required time.
However, a few private hospitals have begun treatment of coronavirus patents in a limited scale after receiving the government’s directives.
Universal Medical College Hospital in the capital city has started up a 25-bed coronavirus isolation unit. Managing director of the hospital, Ashish Kumar Chakraborty, speaking to Prothom Alo, said that they now have a corona unit with 7 ICUs.
Mounting pressure on specified hospitals
On Wednesday there were 45 patients admitted to the private Sajida Foundation hospital. This hospital has four ICUs, all occupied. The hospital’s manager, Obaidullah, told Prothom Alo that the government should strictly monitor whether all hospitals were actually treating coronavirus cases.
Convenor of the government’s National Technical Advisory Committee for the coronavirus, Mohammad Shahidulla, said that the decision for all hospitals to treat COVID-19 is good, but the hospitals are not complying with this decision fully. All hospitals should come forward out of moral obligation to treat coronavirus cases.
Of the government hospitals specified for coronavirus treatment, there were patients round the clock at the ICU beds of Kuwait-Bangladesh Friendship Hospital, Kurmitola Hospital and Mugda Hospital. The general beds were also filled. It was the same at Dhaka Medical College Hospital.
ICU not started
There were 51 coronavirus patients under treatment at Mahanagar General Hospital and 50 at the Mirpur Maternity Hospital on Wednesday. Neither of these hospitals have ICU treatment, though work began 5months ago on installing ICU facilities.
Director of Mahanagar Hospital Prakash Chandra Roy, speaking to Prothom Alo, said certain equipment and skilled workforce has been sent to the hospital and the ICU will begin functioning from next week. The director of the Mirpur Maternity Hospital, Shamsul Karim, also said they would start up the ICU from the coming week.
No patients with complications are being admitted to the Railway General Hospital as it has no ICU facilities. Superintendent of the hospital, Syed Firoz Alamgir, told Prothom Alo that patients with complications are referred to other hospitals as this hospital has no ICU or ventilation facilities.
Convenor of the government’s National Technical Advisory Committee for the coronavirus, Mohammad Shahidulla, while speaking to Prothom Alo said that the decision for all hospitals to treat COVID-19 is good, but the hospitals are not complying with this decision fully. There are certain challenges to implementing this decision, but several hospitals are simply unwilling to do so. All hospitals should come forward out of moral obligation to treat coronavirus cases.
Mohammad Shahidulla said the coronavirus outbreak has highlighted the crisis of ICUs in the country. In many cases the patients with complications need oxygen more than ICU. The hospitals should be supplied with high-flow nozzle canola equipment. The sooner this is arranged, the sooner treatment of patients with complicated symptoms can be ensured.
* This report has been rewritten in English by Ayesha Kabir