Only strong-willed patients can survive in hospital: Recovered Covid-19 patient

On March 23, a woman from Hazaribagh, with severe breathing problems, was admitted to Bangladesh Kuwait Moitree Hospital after she tested positive for Covid-19.

It took her an hour to get a bed and two more hours to get an oxygen supply.

"The patients are locked up in the wards like prisoners at the hospital," she told this correspondent requesting anonymity. "The doctors and nurses do not stick around the wards. The patients see nurses only if they need injections." 

"Food is not served at the bed. Instead, the hospital announces through loudspeakers that food has been served and we should collect it ourselves. We collected our food and medicine from near the gate. Each of the food boxes is marked with the patient's names," she explained.

"Those with breathing problems or elderly patients have a hard time getting to the gate to collect their food," she continued.

"Those without tremendous mental strength will not be able to recover at that hospital," she said adding, the hospital treats patients like untouchables – just like society does."

She had tremendous will power and returned home after nine days at the hospital.

While sharing her experience, she noted that the toilet at the hospital did not have pots or mugs. She had to clean the toilet herself while experiencing her breathing problems. 

"I was suffering from diarrhoea. I used bottled water at the toilet."

The quality of food at the hospital initially was also very poor. Covid-19 patients should be given a high protein diet to develop immunity, but they were not served such diets. 

They gave the patients bread and bananas in the morning; then coarse rice, lentil, and fish or meat during lunch and dinner. While it is recommended that Covid-19 patients drink warm water, they had no such facility, and were served bottled water.

The nurses administered injections twice a day. Sometimes, they checked on us but we barely saw the doctors. During my stay, a doctor came to me two or three of the days. Doctors came in rounds but they usually did not come close to the patients," she noted.

She had stayed at a ward on the third floor. She pointed out that the hospital was infested with mosquitoes and she was afraid to leave from the mosquito net, fearing dengue infection.

As she had breathing problems, she had to use a nebuliser – along with azithromycin antibiotics and injections – for treatment. 

When contacted, Md Alimuzzaman, administration officer at Kuwait Bangladesh Friendship Government Hospital, said, "Initially, the quality of the food was not good as we had a lack of budget, however, at present, more budget has been allocated and the quality has improved."

Regarding the mosquito infestation, he said the city corporation applies mosquito repellent every day. 

"We have made our best efforts to upgrade the overall condition of the hospital to provide good quality medical services," he added.

No infectious disease expert

Although the Kuwait Bangladesh Moitree Hospital has been converted into a hospital for Covid-19 patients, it does not have an infectious disease expert. The hospital has 73 physicians – two are assistant professors and 10 consultants. There is no professor or associate professor at the hospital.

The hospital has a total of 200 beds including 40 dialysis beds.  

Only three physicians run the 26-bed Intensive Care Unit. This unit does not have a central oxygen supply system.

The hospital was built at the standard of district headquarter hospitals but has not been upgraded to fight novel coronavirus, doctors observed.

Several doctors and nurses told The Business Standard that they had to attend to patients without N95 masks and that is why they avoid them.

Treatment

According to physicians, as there is no particular drug to fight the novel coronavirus they are treating patients with symptomatic drugs. 

Medicine specialist of the hospital Dr Rashidun Nabi Hasan told this correspondent they were administering drugs for fever and cough and using the nebuliser on patients when needed.

"When a patient needs oxygen, we give him oxygen. If oxygen does not work, he is put on a ventilator," he said.

As other nations are experimentally using established drugs like azithromycin and hydroxychloroquine the doctors at this hospital are using these on critical patients with worse symptoms.

They have not used Avigan, a drug that was developed by Japan and manufactured locally by two pharmaceutical companies. 

"Avigan is still at the trial stage and we are not using it," he said.

Professor Sayedur Rahman, Chairman of pharmacology and assistant coordinator of the novel coronavirus-related taskforce at the Bangabandhu Sheikh Mujib Medical University (BSMMU) told the Business Standard, "Till now Bangladesh is following a treatment guideline where we use: painkillers, antihistamine, azithromycin, and hydroxychloroquine. There is no other drug. Some other supplementary drugs are used if the patients have other ailments and we administer shock management, plus provide oxygen and a ventilator. If someone develops an infection, they are given antibiotics."

"Avigan is not a registered drug in the country. Two pharmaceutical companies were permitted to make this drug on condition that they cannot sell it. This drug is not available across the country, as far as I know," he added.

Why the recovery rate is low

Compared to the number of deaths, the number of recoveries is quite low. Until yesterday, the number of deaths was 84 while the number of recoveries was 66.

Specialists are concerned that the number of deaths was higher than of recoveries.

Former Vice-Chancellor of the BSMMU and virology expert Professor Nazrul Islam told The Business Standard we should not be worried about how many patients are infected with the novel coronavirus. 

"The concern is the ratio of recovery versus death. Our patients are mostly dying because hospital management is not good. If the management was good, the number of deaths would drop. If we get more patients, we will have more problems with the management."

A doctor of medicine of Kuwait Moitree Hospital said their patients were taking longer to recover. 

"Usually problems related to the virus are addressed within seven to 10 days but we see those admitted to the hospital are taking 15 days to 30 days to recover. That is why the recovery rate is slow."

However, the Institute of Epidemiology Disease Control And Research director Professor Mirzadi Sabrina Flora said, "If a patient has recovered, he has to have two separate tests where the result must be negative. As there is a delay in getting two test results, it seems our death rate is higher. We cannot conclude anything about the death rate at this point."