ICU bed crisis at hospitals

Noman Mosharef :
Bangladesh is facing severe shortage of Intensive Care Unit (ICU) beds at public and private hospitals. The relatives of the coronavirus positive patients are waling and ran over the hospital for an ICU bed. The doctors felt helpless on the situation and felt guilty for the limitation. The deaths of the patients are being common and daily scenario for them with the shortage of ICU.   
The doctors themselves are not getting ICU beds. Sylhet MAG Osmani Medical College Hospital, Assistant Professor of Medicine, Moin Uddin did not get ICU at his workplace. He was later brought to Dhaka for advanced treatment and died on April 15 at Kurmitola General Hospital.
One person working in an educational institution has died for the same reason. He is the head of the Private  
University of Development Alternative's (UDA) head of Account Md Moniruzzaman was admitted to Dhaka Medical College (DMC) Hospital with breathing problem. Samples tested positive for coronavirus. On the evening of June 2, doctors advised him to be taken to the ICU if his condition deteriorated. But there is no ICU bed in the hospital. He died shortly after being taken by ambulance to a private hospital.
There are more heartbreaking incidents. Khandaker Sahidul Islam was admitted to DMCH on May 21 with shortness of breath. He was later diagnosed with coronavirus. He died on the night of May 31 after 10 days of treatment. His brother Khandaker Monirul Islam Sohail said, "Doctors repeatedly asked him to be taken to the ICU. I have tried since last May 25, I have sworn to many people. Towards the end the doctors themselves rushed for the ICU, yet were not found. They were very sincere, that's the only positive thing I saw. Everything else is wrong. My brother died due to lack of ICU.

The doctors wrote: "Many attempts have been made, but the ICU has not been arranged."
According to the World Health Organization, 80 percent of coronavirus patients have mild symptoms. They do not have to go to the hospital. Of the remaining 20 percent, 15 percent have severe symptoms and have to go to the hospital. And the condition of the remaining 5 percent is complicated. They need an ICU bed as well as a ventilator.
However, experts say that ICUs are usually needed in the elderly and those suffering from other complex diseases. However, more than one patient has to wait to get an ICU bed in each Covid-19 Dedicated Hospital. The picture of patients dying without ICU is almost daily.
A total of 399 dedicated ICUs beds, 218 are in Dhaka city alone, while the number is only 47 for the rest of the Dhaka Division, and seven for Mymensingh Division, as per data compiled by Directorate General of Health Services (DGHS).
There are 34 dedicated ICU beds in Chittagong division, 28 dedicated ICU beds in Rajshahi divisions, 18 in Khulna division, 13 in Rangpur division, 16 in Sylhet division, and 18 in Barisal division.
Among the covid- 19dedicated hospitals in the capital, Bangladesh Kuwait Maitri Government Hospital has 26, Kurmitola General Hospital has 27, Mugda General Hospital has 10, Dhaka Medical College Hospital has 48, Sheikh Russell Gastroliver Institute and Hospital has 16, Regent Hospital's Uttara and Mirpur branch has 3, Sazida Foundation has 4, Holly Family Red Crescent Medical College Hospital has 10, work is underway to set up 5 ICU units at Mahanagar General Hospital and Mirpur Maternal and Child Health Hospital. Anwar Khan Modern Medical College Hospital in Dhanmondi has pulled out of the Covid Dedicated Hospital contract. Besides, there are 14 ICUs in the private Impulse Hospital in Tejgaon Industrial Area for the treatment of police personnel.
Kuwait Bangladesh Maitri Government Hospital, Assistant Professor of Anesthesia. Chandan Kumar Banik said "It goes without saying that the ICU bed here is not empty. Multiple patients wait for each bed. If someone recovers and goes to the cabin or dies, the one who is in a critical condition is brought to the ICU. '
Mugda General Hospital Intensive Care Unit Medical Officer  Asadul Majid Noman claims that there is a lot of pressure for every ICU here. At least five people are waiting for each bed. They want to know if the bed has been empty for a while.
Dr. Asadul Majid Noman said, 'I don't know what we are going through all the touching experiences. One patient's death certificate was brought to another before it was finished. His condition was so critical that he died before he could be treated in the ICU.
Former Vice Chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU) Professor Nazrul Islam of Bangabandhu Sheikh Mujib Medical University and Member of the 'National Technical Advisory Committee' told The New Nation, "There are lack of necessary number of ICU beds in the coronavirus dedicated hospitals in our country. Many more ICU beds have to be arranged as the numbers of infection have been detected every day."
Expressing disappointment over lack of every facility in those Covid-19 dedicated hospitals, the public health expert said there are lacks of many logistic supports like adequate supply of oxygen and ventilator machines.
He also said there are lack of trained manpower including nurses who can capable to operate ventilator machine and other equipment in ICU.
Professor Nazrul Islam said, the government has appointed new nurses but we need trained up nurses who have ability to work in ICU to care Covid-19 patients.
However, it is not possible to increase the ICU bed overnight. This is the reality mentioned by Habibur Rahman, Additional Secretary of the Ministry of Health and Head of the Media Cell for Corona Affairs. "Everything is available now," he said. Besides, the process of bringing whatever can be done from abroad is going on. '
The Additional Secretary of the Ministry of Health said, "We are trying to ensure that all the ICU beds are fully utilized." Even so, at least 400 people will get the service. '
Expert advice: 'Since there is a shortage of ICUs, patients need to be looked after before they become complicated. Oxygen supply to hospitals needs to be increased.
Former director of the Department of Health, Professor Dr. Benzir Ahmed called for the emphasis on the prevention of bacterial infections.
He said, "The fewer the patient, the lower the risk. At the same time, if simple management can be done before complex management like ICU, then the patient will be less towards complications. '