Coronavirus: Insufficient ICU beds, inadequate service

There are supposedly 349 dedicated ICU beds in the country with proper ventilation facilities for treating Covid-19 patients currently, as per Dr Nasima Sultana, the additional director general of Directorate General of Health Services (DGHS)

The number is insufficient and does not meet guidelines issued by the World Health Organization (WHO) last month as the number of total infected in the country reached 8,790 as of May 2.

An ICU is a specialized ward for treating seriously ill patients who need constant monitoring. ICU beds include ventilators to help patients minimize breathing difficulties.

The WHO, quoting a study in China, said 15%–20% of Covid-19 cases require hospitalization, with around 15% of cases presenting severe symptoms, and 5% requiring intensive care.

A total of 1632 people are in isolation (hospitalized) as of May 2, some 18.57% of the total infected.

The government has arranged 9,638 isolation beds in more than 90 hospitals and clinics across the country including 3,944 in Dhaka city alone, according to DGHS sources.

DGHS data shows that public and private hospitals currently have 1245 ICU beds in total.

In the seven divisions except for Dhaka, only the leading hospitals in the seven divisional cities have dedicated ICU facilities.

Despite accounting for the most positive Covid-19 cases (72) among all the districts of Sylhet division, Habiganj has no ICU facility. Rather, a serious Covid-19 patient has to be taken to Sylhet Shaheed Shamsuddin Ahmed Hospital (SSAH) in Sylhet Sadar where 11 ICUs have been prepared for treating all patients from the whole division.

Habiganj Civil Surgeon Dr AKM Mostafizur Rahman told Dhaka Tribune he is aware of the situation, adding that ICU beds might be needed there in the future.

Moyeen Uddin, the first doctor in the country who died from Covid-19, did not get necessary ICU facility and proper treatment due to insufficient logistic support at SSAH, claimed his colleagues.

The WHO document emphasized that critical interventions, such as ICU beds and mechanical ventilators, must be made available to healthcare professionals and others supporting the response in terms of services and infrastructure, whose training makes them indispensable.

Mahanagar General Hospital at Nayabazar in Dhaka, was ordered to have five ICU beds with ventilators ready for treating Covid-19 patients, but the authorities are reportedly yet to install these.

There were no ICU facilities in the hospital and the ongoing installation process for the unit would take at least 10 days, informed Ashraful Hasan, a resident physician of the hospital.

DGHS ADG Nasima Sultana acknowledged the ICU crisis and said the situation of the country is in line with the global situation adding that “Bangladesh is not an exception.

“Preparation of ICUs is in full swing. These cannot be installed overnight even if the authorities wished so, as we have to wait for the import of all equipment,” Nasima added.

A DGHS letter sent to the Ministry of Health and Family Welfare on April 18 stated that 50 ICU beds are required to start ICU services in the 17 hospitals dedicated for Covid-19 treatment.

While ventilators have been installed in most of the hospitals, infrastructural development, oxygen supply, and other necessary equipment are still required for the ICUs to be operational, according to the letter.

Notably, the Central Medical Store Depot (CMSD), the state-run organization which supplies necessary equipment to the government hospitals, invited tender in the previous month on different dates for buying ventilators, beds for dialysis, ICU, HDU and general units, and haemodialysis equipment.

In line with international standards, a 100-bed hospital should have at least five ICU beds.

Hospitals in Bangladesh only have 1,245 ICU beds (508 government owned, 737 private) in total against a population of over 160 million people.

Furthermore, when it comes to the number of general beds, the country has only 141,903, which translates to only eight (8.7) beds for every 10,000 Bangladeshis.

None of the quarantined infected

The authorities concerned have quarantined 1,90,443 people till Saturday who may have come into contact with the coronavirus infected people. Of them, only 9,668 were under institutional quarantine and while the rest were quarantined at home.

As many as 1,21,349 have completed the required 14-day isolation including the 1,17,267 quarantined at home. The authorities did not find any of them eligible for testing Covid-19 testing as none of them showed any symptoms of the disease.

The DGHS ADG confirmed the matter.

Doctors facing the brunt

Doctors in Bangladesh make up 6.5% of total Covid-19 cases as the number of infected from this community has increased to 540, mostly from Dhaka, as of May 2.

Only 18 of them have recovered so far. 

Several media reports have questioned the quality of Personal Protective Equipment (PPE), masks, and other protective gear provided to healthcare professionals across the country.