Covid management collapsing outside capital

Covid management at different districts of the country outside the capital is deteriorating at an alarming rate due to lack of adequate preparations and machinery.

As the severity of the infection increases, the patients' pressure at different covid-dedicated hospitals in various districts increases simultaneously. Many hospitals have to deal with patients more than their capacity. As a result of the bed and ICU crisis, patients are being released before recovering fully.

As these hospitals in different districts have fewer facilities than the capital, the doctors are struggling to treat the patients.

Kazi Abanti Rani, an English teacher at Cumilla Victoria Government College, was infected by corona 10 days ago. About 35% of her lungs became infected, creating severe breathing problems. But the teacher did not get a bed at Cumilla Medical College, only specialised Covid hospital in the district.

Due to the pressure of covid patients in greater Cumilla and Noakhali, this hospital is now being forced to serve more patients than its capacity.

Hospital sources said there are 16 ICU beds in the hospital, none of which is empty. Besides, there are 134 beds in the corona unit where 149 patients are receiving treatment. As a result, doctors and nurses are struggling to provide treatment. In the last one week, the hospital authorities have been forced to send back patients having mild infections without admitting them.

Comilla Medical College Hospital Director Md Mohiuddin said, "We are serving more patients than the number of seats. However, I am very concerned about the rate at which the number of victims is increasing. I do not understand how long the service can be provided in this way."

Not only Cumilla, the situation is the same in many districts of the country.

The situation in the divisional city of Chattogram is also deteriorating day by day. Divisional health officer Dr Hasan Shahriar Kabir said, "We have taken initiatives to reopen the closed isolation centres to overcome the situation. We are making all preparations, so that people are not deprived of medical services."

The Bogura Civil Surgeon's Office said the infection rate in the district is more than 25% this month which was 2% at this time last year. Due to lack of awareness, the number of patients infected with coronavirus is constantly increasing in Bogura.

Mostafizur Rahman Tuhin, deputy civil surgeon of the district, said that the number of infections in Bogura this time is several times more than last year.

The 250-bed Mohammad Ali Hospital is the only specialised hospital in the district. However, there is no central oxygen supply system there and patients are given oxygen through cylinders.

Doctors concerned said Covid patients are suffering due to lack of PCR lab, rapid antigen, hyflonazole canola and ventilator in Pabna. Medical services are being severely disrupted due to the breakdown of the medical system in the district. 

Doctors said that they are not being able to provide treatment due to lack of quality and skilled manpower in running the hospital.

Pabna General Hospital Assistant Director Dr Ayub Hossain said skilled manpower including full-time trained nurses is needed to run the ICU, which we do not have enough. However, work on the central oxygen line is underway. Once introduced, it will play an important role in corona treatment.

The condition of Netrokona Modern Sadar Hospital is worse. Even though it is 'modern' in name, there is no central oxygen system in this 100-bed district headquarters hospital. There is no ICU bed or ventilator also, besides the shortage of specialist doctors.

According to relevant sources, the hospital is the only government hospital in the district headquarters. Apart from the district headquarters, patients of 9 upazilas depend on this hospital for emergency and advanced treatment. Although the hospital has already been upgraded to 100 beds, it is still being operated with previous limited manpower.

At the beginning of the pandemic last year, the corona ward was started with 36 beds in the hospital which has only three pulse oximeters and 11 oxygen concentrators.

The director of the hospital, Dr ASM Mahbubur Rahman, said it would take more time to introduce the central oxygen system. On the other hand, turning on two ventilators also requires at least three anesthetists and at least one medical specialist.

Civil Surgeon Dr Selim Mia said, "We have all the preparations for the treatment of corona patients with mild symptoms. However, the complex patient has to be sent to Mymensingh Medical College Hospital for better treatment. Demand letter has been sent to the departmental director for all types of equipment."

But patient pressure at Mymensingh Medical College Hospital also increased four to five times last week due to the increase in infections. The officer in charge of the hospital Dr Mohiuddin Khan Moon said the hospitall's Covid dedicated unit has 10 ICU beds, all of which are full now.

Moulvibazar is at the top of the list of 29 districts with the highest possible rate of corona infection in the country during the second wave.

The rate of infection in the first wave was 5% but now it is fluctuating from 25% to 30%. Meanwhile, there is no corona test lab in this district. Samples are sent to Dhaka or Sylhet.

Civil Surgeon Chowdhury Jalaluddin Murshed said, "We will arrange corona test for the time being by using the genexpert machine of our local hospital."

Ahmed Fayjan Zaman, resident medical officer at the district's 250-bed hospital, said there were a total of five ICU beds in the hospital. Although at the peak of the probable infection rate, corona patients in the hospital are fewer.

According to the relevant sources, there is not enough system in Rajshahi for identification and treatment of corona patients.

At present, corona is being tested in the PCR lab of Rajshahi Medical College only. Since corona samples from Rajshahi, Natore, Chapainawabganj and Naogaon districts are tested only in Rajshahi, the pressure has also increased.

Rajshahi Medical College PCR Lab in-charge virologist Sabera Gulnahar said, "We are not being able to test all the samples, even though we have arranged four shifts in our lab every day. Besides, there is a lack of manpower. We are struggling to cope with the situation."

Meanwhile, more than a hundred people have been identified with coronavirus in Sylhet almost every day for the last one week. Patients are crowding the Shaheed Dr Shamsuddin Hospital which has only 100 seats.

There are only 21 ICUs in Sylhet division. Of these, 17 are in Shaheed Shamsuddin Hospital and five in Moulvibazar Hospital. Sunamganj and Habiganj government hospitals do not have ICU systems. Although there are 17 ICUs in Shaheed Shamsuddin Hospital, two beds are ineffective.

Concerned people say that many patients have to be returned every day. Many are not getting ICUs even if they needed. Among them, the able-bodied are going to private hospitals while the rest are in misery.

A visit at Shamsuddin Hospital revealed that all the 14 ICU beds in the hospital were full of patients. The hospital's Resident Medical Officer Sushant Kumar Mohapatra admitted that there were no empty beds in the hospital. "No patient is being admitted to ICU unless corona infection is severe. Many times it is not possible to provide an ICU bed to the victims," he said.

Sylhet Civil Surgeon Dr Premananda Mandal said that apart from Shamsuddin Ahmed Hospital, isolation centers have also been set up at Shah Paran Hospital and Dakshin Surma Upazila Health Complex. However, patients are less interested in being admitted to these hospitals. Besides, a 200-bed isolation center is being set up at Osmani Medical College Hospital.

However, the corona situation in some districts of the country is still much better. Satkhira is one of them. There are six corona patients in Satkhira Medical College Hospital while 36 patients are admitted with symptoms.

Corona unit chief of Satkhira Medical College Hospital Dr Manas Kumar Mandal said the hospital has 100 beds for the treatment of corona patients. There are eight ICUs. Although the number of corona patients has increased in the last two weeks, it is not mention worthy.

Institute of Epidemiology, Disease Control and Research Adviser Dr Mohammad Mushtuq Husain said to prevent the spread of coronavirus infection across the country, interdistrict movement should be restricted for several months and the identified patients should be isolated and treated at a field hospital.

"Our medical capacity has increased, but the infection is growing several times faster than that. So, no matter how much medical ability you have. If you can't control the spread of infection, it will not work," he observed.

District correspondents of The Business Standard contributed to this report.