Three coronavirus prone areas outside Dhaka lack preparations for critical coronavirus patients.
The Institute of Epidemiology, Disease Control and Research (IEDCR) recently announced that it identified five clusters of coronavirus infections including two in Dhaka.
Suspected coronavirus cases or patients from Dhaka’s clusters - Tolarbag in Mirpur and Basabo - can access emergency or critical care facilities setup at Kuwait Bangladesh Government Friendship Hospital and other hospitals prepared for treatment of Covid-19 patients.
But there are no Intensive Care Unit [ICU] facilities for critical patients who are identified at the other three cluster areas - Madaripur, Narayanganj and Gaibandha.
As of Wednesday, Bangladesh has confirmed 218 positive cases of Covid-19 with 20 deaths since the infection was first reported on March 8. Among them, the highest number are from Dhaka city at 123.
In conversation with Dhaka Tribune on Wednesday, civil surgeons of the three coronavirus prone districts outside the capital confirmed they lack preparations for treating Covid-19 patients.
Narayanganj Civil Surgeon Mohammad Imtiaz said none of the patients from Narayanganj are being treated at local government hospitals due to lack of facilities.
He also confirmed that there is no ICU in any of the government hospitals for treating critical patients in, where 46 infections have been detected so far.
“We have sent our patients to Dhaka for treatment,” Imtiazsaid.
Narayanganj came under complete lockdown on April 7.
Madaripur Civil surgeon Shafiqul Islam said they sent seven patients to Dhaka as they were in critical condition. A total of 11 cases were detected there.
"We do not have any ICU for treating patients, neither any other critical facility. We have referred our patients to Kuwait Maitree Friendship Government Hospital for critical treatment,” Shafiqul said.
On March 20, Bangladesh saw its first lockdown in Shibchar Municipality and three unions of Shibchar upazila in the district.
According to Google Maps, it may takes six to eight hours for transporting a patient to Dhaka from Madaripur.
Meanwhile, Gaibandha, where five cases were detected, does not have any ICU also.
Gaibandha Civil Surgeon ABM Abu Hanif said they have setup 35 beds at different hospitals for treating Covid-19 patients.
Important challenges ahead
Eminent healthcare expert Professor Rashid E Mahbub warned that Bangladesh may face critical shortage of ventilators, manpower, and ICU facilities, if it does not prepare to curb coronavirus, immediately.
Mahbub, also the former Bangladesh Medical Association president and chairman of Bangladesh Health Rights Movement, while speaking to Dhaka Tribune, said the first priority should be testing, quarantine and isolation of suspected cases and coronavirus infected patients.
“We are isolating suspects in many districts, but the hospital beds, where they are being isolated, are used for both corona and non-corona patients. This may take huge toll on the crisis,” he said.
The professor also pointed out that the hospitals, which the government has dedicated for treatment of Covid-19 patients, are not still fully prepared yet.
The expert opined that no hospitals in Dhaka are taking patients with respiratory problems suspecting them as coronavirus patients, which is not a wise decision at all.
“This is being done because of lower number of testing,” he said.
“If we have 1,000 patients in total, of them, 200 will need ICU facilities. But given the current situation, the number of ICU across Bangladesh are quite low and the country is not prepared for a massive outbreak,” Mahbub, also a former vice-chancellor of Bangabandhu Sheikh Mujib Medical University said.
All the medical colleges in Bangladesh should have ICU facilities, but there are other issues involved too, according to the expert.
“You will need ventilators, technologists and manpower to operate, and necessary supply of oxygen for treating critical patients. If we could have prepared us earlier, the situation could have been better,” he pointed out.
Private hospitals must be included
Director General (DG) of Directorate General of Health Services [DGHS] Dr Abul Kalam Azad on Tuesday said there are 112 ICU beds in the country for Covid-19 treatment and they are trying to increase the number.
But Professor Mahbub thinks only managing ICUs will not be enough.
The private hospitals could have been engaged in the process of testing and treating Covid-19 patients as they do have more capacity than government hospitals, but the government did not include the private sector in the process.
“I think the government should sit with private hospitals to sort this out and discuss what assistance they can provide to ensure a better Covid-19 management in days to come,” Mahbub further said.
