Daily death counts break the previous record, Covid patients occupy newly arranged hospital beds within hours, critical patients gasp for oxygen and medical personnel struggle on the frontline with a severe doctor crisis – this is exactly what happen when an India-bordering division wakes up unprepared in the middle of delta variant rampage.
In the past 24 hours until Tuesday morning, Khulna division registered 46 deaths, and the highest 1,865 new cases. The southwestern region on Monday reported the highest 51 deaths as the death tally of the division has been the highest for the last eleven days.
"Khulna has emerged as Covid-19 hotspot as the government failed to act on time," said Prof Nazrul Islam, a member of the national technical advisory committee on Covid-19 management.
Prof Nazrul, also a renowned virologist, said hospitals in the India-bordering regions were supposed to ramp up the capacities, ready more intensive care unit (ICU) beds and train the required manpower when the country detected the Indian strain of the virus in the second week of May.
Khulna division started witnessing the Covid patient rush in the first week of June. On 6 June, Khulna Medical College Hospital (KMCH) had 125 patients against its 100-bed capacity. In the first wave, the number of admissions to the hospital did not cross 100.
After ramping up the capacity multiple times, the medical facility now has 200 beds as the hospital admission exceeds the beds. Only 77 beds at the hospital are connected to the central oxygen supply as the remaining rely on oxygen cylinders. There are 20 ICU beds at KMCH – currently all occupied.
"Now Khulna must ensure adequate oxygen supply. Otherwise, the situation may worsen further," Prof Nazrul added a note of caution.
The division's overall death rate stands at 2.4%, higher than the national fatality rate from Covid-19. Khulna's overall positivity is more than 36% as the division reported the maiden Covid case on 19 March last year.
On 20 June, Khulna General Hospital joined KMCH to treat the coronavirus patients. But since the medical facility does not have any ICU bed, it cannot treat the critical patient.
Apart from the two public hospitals, private Gazi Hospital had its all 150 beds including nine ICUs occupied on Tuesday.
On 4 July, the 45-bed Specialised Abu Naser Hospital with ten ICUs was opened for coronavirus patients.
Ten districts of Khulna have only 67 ICU beds as four districts do not have any ICU. The entire division has 115 nasal cannulas, and 175 oxygen concentrators.
The health directorate claims there is no oxygen shortage in the division though it registered deaths at district hospitals due to a crunch in oxygen supply.
Health experts said many of the deaths could have been averted if Khulna was better prepared in June.
67.5% physician posts still vacant
According to the health directorate, there are 1,327 posts for the doctor at upazila level of the division. But currently only 431 doctors are serving the patients as 67.5% of the posts are vacant.
Khulna hospitals said they are struggling with the overwhelming patient rush due to the severe doctor crisis.
The 250-bed Jashore General Hospital on Tuesday had 150 patients admitted against the capacity of 110 beds. Only one doctor at the hospital had been treating the patients on rotation.
On Tuesday, the health ministry transferred 175 doctors from upazila and other medical facilities to Khulna district hospitals.
Inadequate testing facilities
Many districts in the southern division such as Bagerhat, Chuadanga, Magura and Meherpur do not have RT-PCR labs for Covid-19 test. Due to inadequate test facilities, doctors said many Covid cases remain out of detection and the patients come to the hospital at the final stage of the infection.
"Late admission and comorbidity factors of the patients are contributing to the burgeoning deaths tally," Dr Mehedi Newaz, vice-principal of Khulna Medical College, told The Business Standard.
"People's reluctance to Covid test and a lax approach to virus safety also help the Indian variant or Delta variant spread rapidly," Dr ASM Alamgir, principal scientific officer of the Institute of Epidemiology Disease Control and Research (IEDCR) told TBS.
"There is no manpower or oxygen crisis in Khulna now. We are gradually expanding our capacity, and hope the situation will improve soon," claimed Dr Rasheda Sultana, director of Khulna divisional office of the health directorate.