Government hospitals outside the capital and the port city of Chattogram have little preparations for the treatment of Covid-19 when deaths from and infection of the disease are spreading across the country after the country has started experiencing the pandemic’s second wave since March this year.
Still, according to government data, nearly two-thirds of the government hospitals in the districts have no intensive care unit while over one-third of these hospitals have no central oxygen supply system, two key facilities for treating critical Covid patients.
Despite the prime minister’s directives in last October and the High Court’s repeated orders to install the critical care facilities in the districts, the Directorate General of Health Services is yet to do the job.
Though the health agency is assuring the nation of an adequate supply of oxygen and other facilities for Covid patients the situation on the ground is different.
Outside the capital and Chattogram, the country has only 239 ICU beds in government hospitals in 25 districts, with an average of less than 10 beds in a district.
Among the 64 districts, 39 have no ICU bed for Covid patients, the DGHS data shows.
The districts without Covid ICU bed include Barguna, Bhola, Jhalakathi, Patuakhali, Pirojpur, Bandarban, Brahmanbaria, Feni, Khagrachari, Lakshmipur, Noakhali, Madaripur, Munshiganj, Narsingdi, Rajbari, Shariatpur, Tangail, Bagerhat, Chuadanga, Jashore, Jhenaidah, Kushtia, Magura, Narail, Netrakona, Sherpur, Chapainawabganj, Jaipurhat, Naogaon, Natore, Pabna, Sirajganj, Kurigram, Nilphamari, Panchagarh, Thakurgaon, Habiganj, Moulvibazar and Sunamganj.
Another key component in ensuring a continuous oxygen supply to a Covid patient is a central oxygen supply system in a hospital.
But the DGHS records show that the government hospitals in 23 districts have no central oxygen supply system.
The districts are Jhalakathi, Patuakhali, Khagrachari, Rangamati, Madaripur, Manikganj, Narayanganj, Rajbari, Kishoreganj, Shariatpur, Tangail, Khulna, Netrokona, Jaipurhat, Naogaon, Natore, Pabna, Sirajganj, Kurigram, Nilphamari, Panchagarh, Moulvibazar and Sunamganj.
Hospitals in the capital and Chattogram are already under an overwhelming pressure of Covid patients.
These two regions account for over 90 per cent of the Covid patients and deaths.
Many critical patients in the capital are shuttling between hospitals for hospitalisation with ICU support.
The capital counts 13 government Covid hospitals with 242 ICU beds.
On Thursday only 22 of the beds were vacant, according to the DGHS data.
In Chattogram, the government has four Covid hospitals with 33 ICU beds with about half of them remaining vacant.
Experts fear that Covid would spread outside the two regions but, they resent, the preparations in the districts are scanty.
Bangabandhu Sheikh Mujib Medical University medicine professor Mujibur Rahman said that the virus still concentrated in Dhaka and Chattogram but it would spread to other parts of the country in coming days, particularly when the country would celebrate Eid-ul-Fitr a few days later.
‘We should not be complacent that the coronavirus is not spreading to other parts of the country,’ he said, adding, ‘The districts lack ICUs and even general beds for Covid patients.’
‘The numbers of cases and deaths are increasing but the number of ICUs is not,’ said Mujibur, an editorial board member of the National Guidelines on Clinical Management of Covid-19.
Since July 2018 the High Court has pushed the DGHS authorities to set up ICU and coronary care units in all the general hospitals across the country.
On February 1 this year the court extended the deadline for the 20th time for two more months to install the facilities.
In October last year prime minister Sheikh Hasina ordered the authorities concerned to set up central oxygen supply system in the government hospitals across the country.
Noted virologist Nazrul Islam said that it was a serious lapse that the districts were not yet prepared after more than a year had passed since the coronavirus outbreak in the country.
Nazrul, a former vice-chancellor of Bangabandhu Sheikh Mujib Medical University and a member of the National Technical Advisory Committee on Covid-19, questioned the sincerity of the health ministry and the DGHS.
‘It’s a question of sincerity of the health ministry and the DGHS that despite the orders from the High Court and the prime minister the facilities are yet to be established,’ he said.
DGHS director for hospitals Farid Uddin Miah admitted that the districts were not equipped with ICUs and central oxygen supply systems.
He said that they were implementing a project to install ICUs and central oxygen supply systems in every district.
He, however, could not give any timeline about when the project would be completed.
Farid said that the treatment facilities were enhanced manifold compared to last year when the country saw the coronavirus outbreak.
He said that the focus was now mainly on Dhaka and Chattogram as the majority of the cases and deaths were occurring in these two regions.
The districts without ICUs and central oxygen supply, he said, have adequate oxygen cylinders and high-flow nasal cannulas.
‘We refer patients from these districts to nearby districts with ICU facilities if they require the services,’ he said.
Neither the health minister nor the health secretary could be reached for comment.
As of Thursday, Bangladesh recorded 10,781 Covid deaths and 7.36 lakh cases.
The situation has deteriorated since March this year, with the test positivity rate rising above 20 per cent from 2-5 per cent recorded in January and February this year.
The daily deaths have been around 100 for days although the figure had dropped to 5–10 in January and February.
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