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Fighting coronavirus: Time to bring private hospitals into the loop

  • Published at 01:33 am April 8th, 2020
File photo of a ICU unit at a Hospital Dhaka Tribune

They have the facilities, with 75% of beds vacant

As the number of Covid-19 cases continues to climb in Bangladesh, the government, while mobilizing resources to tackle the pandemic, is still neglecting a large part of the health sector – the private hospitals.

It has been a month since Covid-19 was first detected in Bangladesh. The government has been dealing with the crisis without bringing the private hospitals into the fold, whereas neighbouring countries India and Pakistan have already brought them into their national response plans, anticipating the threat of community transmission.

Private hospital operators say they have the necessary facilities for Covid-19 response – if the government equips them with the testing kits.

“Usually, private healthcare operators provide 64% treatment in Bangladesh, but in the current situation, they are only advising patients to go to government hospitals if they have Covid-19 symptoms,” said ABM Haroon, senior vice president of Bangladesh Private Clinic and Diagnostic Owners’ Association. 

“We are equipped to provide emergency support for Covid-19 response if the government wants us to, and formulates a policy in this regard,” he told Dhaka Tribune on Tuesday. 

Haroon, also the managing director of Samorita Hospital, further said private hospitals had covered 65% of the dengue patients last year and were ready to do the same for Covid-19.

“If the government provides us with the testing kits and logistics, we are ready,” he stressed.

Dr AM Shamim, managing director of LabAid Group, echoed his remarks.

“We have many beds empty in private hospitals, which can be used to treat Covid-19 patients,” he told Dhaka Tribune on Monday.

“If the government provides us with the testing kits and the personal protection equipment (PPE), the private sector can join in the national Covid-19 management plan,” he added. 

When contacted on Tuesday, Dr Meerjady Sabrina Flora, the director of Institute of Epidemiology, Disease Control and Research (IEDCR), said the government was always ready to include the private sector when fighting any crisis.

“When the novel coronavirus infection was first reported in other countries, we sent letters to all private hospitals, asking them to prepare isolation beds, and many complied with it. But no decision has been made yet on whether they will be included in testing and treatment,” she said

“The government already has a plan to set up makeshift hospitals, but this huge task cannot be done alone. The director general of health services has already held several meetings with the private sector. We can certainly discuss their involvement, if they are interested,” she further said.

Breaking out in China’s Wuhan city in December last year, Covid-19 – a severely acute respiratory illness caused by a new coronavirus strain named Sars-CoV-2 – had quickly spread throughout the world, becoming a pandemic in less than three months.

Health authorities in Bangladesh reported the first Covid-19 cases on March 8. As of Tuesday, 164 people tested positive for the extremely contagious disease, of whom 17 died.

75% beds empty at private hospitals

Private hospitals have been seeing a sharp decline in the number of patients coming in for treatment, Dhaka Tribune has found.

Hospital officials said the number plunged to more than half in comparison to the figures on a normal day.

They said most patients, except those who are suffering from severe illnesses, are not willing to come to the hospitals due to the shortage of transport amid the government-enforced shutdown, as well as fearing Covid-19 transmission.

On the other hand, doctors and nurses in private hospitals are also unwilling to tend to patients, particularly those with respiratory problems, because of the lack of PPE and masks, which is needed to prevent contact with potential Covid-19 patients, the officials further added.

>> 90,600 beds in private hospitals, 53,000 in government ones

>> 75% of beds vacant at private hospitals

>> Nearly 1,200 ICUs in Bangladesh, most of them in private hospitals

>> Only 45 ICUs prepared for Covid-19 patients

>> More ICUs with ventilators need to be set up immediately

LabAid’s Dr Shamim said almost three-fourth of more than 90,000 beds in private hospitals across Bangladesh were empty.

“These empty beds can be used for Covid-19 patients,” he added. “The disease is still under control in Bangladesh, but we need to be prepared right now to face its impact in the coming days.”

The Directorate General of Health Services (DGHS) stated that it was able to earmark 5,143 beds to be used for Covid-19 treatment in isolation, as of Thursday evening.

The government is currently testing samples of suspected patients at 14 laboratories: nine in Dhaka and five in other districts.

It has prepared 11 hospitals in Dhaka to treat Covid-19 patients, but most suspected cases are being handled by Kuwait Bangladesh Friendship Government Hospital only, as the other hospitals are still not ready to treat the coronavirus patients.

‘Use the available resources’

Three ministers recently announced they would use stadiums, launches and empty train bogies to quarantine people suspected to have the infection.

“Setting up new facilities in a short period of time is not easy. It is a huge task involving fund, space and manpower, but we already have all the necessary facilities in place at private hospitals, which is somehow being consistently ignored,” Dr Shamim said.

Instead of investing in quarantine centres, if the government uses the logistics available at private hospitals and train the manpower employed there for this gigantic task, it can bring fruitful results, he commented.

“We have the set-up, trained personnel and other equipment. There are 120,000 doctors, nurses and technicians involved in the private sector who can be utilized in combating this crisis,” he suggested.

10,000 ventilators needed

According to the DGHS, there are nearly 1,200 ICUs with ventilators in hospitals around the country, with about 500 in government hospitals and the rest in private hospitals.

But only 45 of them have been prepared for Covid-19 patients.

“We need at least 10,000 ventilators to keep us prepared. We have spoken to banks who are ready to offer loans with 5-6% interests. If the government asks the banks to provide low-interest loans to private hospitals, we can procure and set up 1,000 ventilators within a month to meet the demand,” Dr Shamim said.

He said as China was now providing ventilators to other countries as their demand has come down, Bangladesh could request China to provide ventilators too.

“If we can finalize the Letter of Credit (LoC) in seven days, we can be prepared significantly within a short time,” Dr Shamim said.

‘Introduce zonal system’

The LabAid Group managing director also proposed introducing a zonal system for treating Covid-19 patients.

Under this system, a private hospital can first test the suspected patients. Those who test positive for Covid-19 can be sent to the zonal hospital in that particular area, while the non-Covid-19 patients can go to other private hospitals for treatment, he said.

“For example, there is a 370-bed maternity hospital in Azimpur which had only 62 patients on Monday. We can set up that hospital as a zonal hospital for Dhanmondi for Covid-19 treatment,” he explained.

Also, there can be a 24-hour hotline team at the DGHS where healthcare providers in the private sector can share ideas on Covid-19 management, he added.

“We have managed the dengue crisis with the government. We can do the same with Covid-19 too, if the authorities allow us,” Dr Shamim concluded.

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