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Health - July 27, 2021

When and how the cry for ICU will stop?

MaMassive spread of Covid Delta variant

Golam Mostafa Jibon:As the number of patients with Coronavirus increases continuously, there is an outcry for ICUs (intensive care units) in hospitals in and outside the capital.
In some hospitals, patients take last breath, while waiting for ICU beds for several days. Many delta patients die in ambulances due to the rapid deterioration of their health condition and the need for more oxygen.
Health Minister Zahid Malek also expressed concern that it would be difficult to get hospital beds in the future, if the infection continues to increase. The Corona epidemic has manifested itself in the country due to the terrible transmission of the Delta variant. Most of the infected patients are suffering from 40 to 50 percent lung infections. Those, who need ICU (Intensive Care Unit) to ensure the necessary treatment, are facing immense sufferings.
Meanwhile, country’s all the ICU beds have become filled up with the covid patients. Even, the so-called ICU beds are no longer empty.
But the government officials claimed that, out of listed 1321 beds, there are 1076 patients in the hospitals. From this side, 80 percent of ICU beds including complete and incomplete have been filled up with the corona patients. There is also doubt about the calculation of such beds. The number of ICU bed has been increased thus that the bed has not yet been created; but it has been announced, but not in reality. The beds are in list, but not in reality, reliable sources said.
The government’s list mentions that there are 1321 equivalent ICU beds across the country of which 245 are vacant. But only a week ago, some 1259 beds were shown and 1165 beds were shown at the beginning of this month. Doctors themselves have doubts about how hundreds of ICU beds have been set up in such a short time.
Of the 16 government hospitals in the capital, 10 have no ICU beds and 8 of the 28 private hospitals have no vacancies. The crisis of general beds has also created for the Corona patients. As the number of patients increases, the lack of normal beds will become severe. Many officials of Health Department said, the number of ICUs in the country mentioned in the list is not the real picture. Officially, ICU-like beds are referred to as ICUs. But in fact, self-contained ICU is much less.
Mugda Medical College Hospital, one of the Covid dedicated hospitals in the capital, has more ICUs than any other hospital. The 500-bed hospital has not had an ICU bed for the past seven days. ICU beds are not available due to high pressure of patient from outside the capital. In addition to the patients being treated at the hospital, relatives of critically sick patients from different parts of the country are also waiting for the ICU beds to be vacated. An ICU bed is only available, if a patient undergoing treatment in the ICU dies or is transferred to a general ward. The bed is getting full as soon as it is empty. Some patients need ICU support on an emergency basis, but they are not getting it easily.
On condition of anonymity, a doctor engaged in Covid treatment said that, due to the Delta type, the whole country has now become a hotspot. The lungs of such patients become infected quickly and most of the infected patients face difficulty to recover, if they are not treated in time. Some of the infected patients are coming to the hospital after damaging more than 80 percent of the lungs. Then, there is nothing to do. Besides, delta sufferers seem to have more oxygen support than other types. Due to the increasing rate of corona infection across the country, it is not possible to provide ICU support due to limitations in district level hospitals. Many patients die in ambulances like last year without getting treatment there. Ensuring medical services to patients outside Dhaka has become a big challenge.
Regarding the current situation of corona infection in the country, Health Minister Zahid Malek said, “Corona infection has started increasing again in the country after Eid. If this situation continues, there will be severe bed crisis in the hospitals of the country shortly.” He feared that there would be no place in the hospital, if the infection increased. At present, 80 percent of the patients coming to the city hospital are from rural areas. The infection has increased 5 to 6 times due to coming and going of Eid holidaymakers.
According to the Department of Health, there are currently 1,321 ICU beds for Covid-19 patients in the country. Of these, 393 are in 16 government hospitals in the capital.
There are 505 ICU beds in 28 private hospitals. There are 961 ICU beds in Dhaka district including Dhaka city. There are 107 ICU beds in all districts and upazilas of Chattogram division, 22 in Mymensingh division, 58 in Rajshahi division, 44 in Rangpur division, 74 in Khulna division, 33 in Barisal division and 22 in Sylhet division. Of them, there are currently no ICU beds in Sylhet.
According to the list, there are vacancy of 11 ICU beds in Barisal, 16 in Khulna, 20 in Rangpur, 14 in Rajshahi, 22 in Chattogram, 6 in Mymensingh and 154 in Dhaka. But, in reality, there is no vacancy of ICU bed, sources sadi.
In the first week of June, corona infection rates were low across the country, but in the border areas, Delta-type infections were on the rise. This type later spread despite the strict restrictions. The Delta type has several times high infectious capacity than the Corona alpha and beta types. Despite restrictions in border and local areas, corona infection has spread at an alarming rate across the country. The whole country has now become a hotspot for corona.
Public health expert Dr Lenin Chowdhury, also director of the Health and Hope Hospital in the capital said, “The Corona Delta type caused more infections than alpha and beta. In some cases, it can also evade antibodies. Besides, it can quickly overwhelm the infected patient. As a result, the patient’s health deteriorates within two to three days of infection. The patient needs more oxygen than before. In many cases, 60 to 70 percent of the lungs are damaged before the patient realizes anything. If the patient is admitted to the hospital in critical condition, then there is not much opportunity for treatment.”
The public health experts have expressed fear of a deadly corona outbreak since strict restrictions were relaxed before Eid-ul-Azha. About 10 million people left Dhaka before the Eid holiday taking the opportunity of relax. More than half of them will remain in rural areas until August 5 as most of the government and non-government offices, garments, factories and other offices have remained closed due to strict restrictions. Only banks and stock market related institutions and emergency services are open, so some workers have just returned. The pressure of extra people outside Dhaka has caused of increasing the transmission.
As a result, the pressure of infection has increased in the district headquarters hospitals. The concern is that the district hospitals are plagued by various crises. Many hospitals do not have ICU. Some hospitals have ICU beds, but it is difficult to find them empty. There is also a shortage of high oxygen levels. In some hospitals, patients are now being treated on the floor. There is no initiative to fill the manpower shortage including doctors, the expert said.

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