The government is planning to use all public and private medical college hospitals for the treatment of Covid-19 patients, in order to cope with the increasing number of people testing positive for the infection.
Each of the hospitals will be segregated into three zones: A primary zone for receiving patients, a Covid-19 zone, and a non-Covid-19 zone. The aim of the reorganization is to ensure that people are not turned away from hospitals if they do not have a Covid-19 test result.
Bangladesh recorded its highest single day increase in Covid-19 cases with 1,034 new positive cases and 11 deaths from the infection on Monday. 15,691 people have tested positive for Covid-19 in the country so far, with the death toll at 239.
Panic over Covid-19, which is caused by the extremely contagious SARS-CoV-2 coronavirus, has led some hospitals to refuse treatment to people who do not have Covid-19 test results. An additional secretary of the government is among those who died after being refused treatment for a significant period of time.
The government has issued a notice saying no hospital can reject a patient without the permission of the Directorate General of Health Services (DGHS).
The DGHS has plans to include 110 public and private medical college hospitals in Covid-19 treatment efforts, as the institutes have various treatment facilities and the necessary space.
“We are planning to segregate a hospital into three parts: A primary zone for receiving patients, a Covid-19 zone, and a non-Covid-19 zone. If a patient is suspected to have Covid-19, he or she will be sent into isolation and samples will be taken for testing. If the test comes back positive then the patient will be sent to the Covid-19 zone of the hospital, and if it comes back negative he will be sent to the non-Covid-19 zone of the same hospital,” said Dr MA Foyez, a member of the treatment protocol planning team for Covid-19 under DGHS.
“This method is being followed in many developed countries, including the USA, to ensure better management of patients. We think hospital management is likely to be easier if we try it in Bangladesh,” added Dr Foyez, who is also a former director general of DGHS.
Dr Ridwanur Rahman, another member of the treatment protocol planning team, told Dhaka Tribune the purpose of the zones is yet to be finalized.
“Such a system may help to ensure treatment for both Covid-19 and non-Covid-19 patients. The plan is not finalized yet and we will sit for discussions with experts,” said Dr Rahman, also head of research at Universal Medical College Research Centre and former head of medicine at Shahid Suhrawardy Medical College Hospital.
Health experts and virologists say keeping Covid-19 and non-Covid-19 patients in the same hospital may increase the risk of transmission of the virus if proper safety precautions are not taken.
Veteran virologist Nazrul Islam said: “If one hospital is segregated into three zones, including Covid-19 and non-Covid-19 sections, this may increase the risk of transmission as coronavirus is extremely contagious.
“If all the zones are designed with the same facilities and preventive equipment, then it can be comparatively safe. However, it will be hard to maintain protection for the non-Covid-19 zone in a country like Bangladesh,” added Nazrul, a former vice chancellor of BSMMU.
“All zones should have preventive equipment, like PPE and masks, and there should be separate changing rooms in each zone, as well as disposal and autoclaving facilities. If there is even a single fault, everyone at the hospital will be infected,” he told the Dhaka Tribune.
Dr Mozammel Haque, former regional adviser of the World Health Organization, said: “Zoning a hospital will increase risks for medical professionals, as Bangladesh is unable to maintain the separation properly. Medical professionals of different zones may end up meeting for various reasons. Covid-19 and non-Covid-19 hospitals should be kept separate. Only dedicated Covid-19 hospitals should serve coronavirus patients, as it is an extremely contagious disease.
“Non-Covid-19 hospitals will serve general patients, but they should have an emergency, outdoor, and flu corner. They should also have an isolation centre, where suspected Covid-19 patients will be referred from the emergency, outdoor, and flu corners. If isolated patients test positive, they should be sent to dedicated Covid-19 hospitals,” he added.
10,000 test per day from 3rd week of May
The government is preparing to test 10,000 samples per day at 50 laboratories across the country from the third week of May, in order to identify coronavirus patients.
“Real-Time PCR (polymerase chain reaction) machines are being installed at thirteen government medical college hospitals, in order to setup new testing labs by the third week of May and increase the number of per day tests,” said Ali Noor, secretary of the Medical Education and Family Welfare Division.
“We have 36 public medical college hospitals. All of the medical college hospitals are gradually being equipped to test for coronavirus,” he told Dhaka Tribune.
Earlier, Health Minister Zahid Maleque had said it would be possible to increase the number of tests to 8,000-10,000 per day very soon.
In the beginning there was only one testing lab, but now there are 37 where more than 7,000 samples are being tested daily.
“As many as 7,208 samples were tested in the last 24 hours at 37 labs across the country,” said Nasima Sultana, additional director general (ADG) of the Directorate General of Health Services (DGHS).
It was the highest number of tests in a single day for the country since Bangladesh started tests in February.
“In comparison to the population size in Bangladesh, 10,000 tests a day is still not enough,” said veteran virologist Nazrul Islam.
“We should go for mass testing, but Bangladesh is not yet capable to do this,” he added.