We had a year to develop infrastructure and logistical support to combat coronavirus, but we failed to utilise the time properly.
Dr Mahfuzur Rahman, convener of Public Health Rights Protection Committee, Chattogram
Most of the upazila health complexes in Chattogram have no high-flow nasal cannula (HFNC) facility, although all 14 of them have isolation wards to treat Covid-19 patients. Even many of the medical centres have no central oxygen system.
According to experts, central oxygen system and HFNC are highly required to treat moderate to severe Covid-19 patients.
"We face difficulties with such patients who need HFNC support," said a medical officer of Raozan Upazila Health Complex, which lacks the required facilities. "So, we have to refer them to city hospitals," he added.
"General patients also have to suffer due to the crisis," said the medical officer, preferring anonymity. "Although we give support to patients with cylinder oxygen, that does not guarantee uninterrupted supply," he further said.
Chattogram Civil Surgeon Office sources said only three out of 14 upazila health complexes have HFNC. Of those, Boalkhali Upazila Health Complex has one, and Chandanaish and Satkania health complexes have two each, said Deputy Civil Surgeon Dr Asif Khan.
Only eight such facilities have central oxygen system, while the rest six have neither HFNC nor central oxygen system.
According to the Civil Surgeon Office, around 47,861 Covid-19 cases have so far been detected in Chattogram and of those, 9,437 are from upazilas, which is 19.71 percent of total cases.
"We had a year to develop infrastructure and logistical support to combat coronavirus but we failed to utilise the time properly," said Dr Mahfuzur Rahman, convener of Public Health Rights Protection Committee, Chattogram.
"The city hospitals are struggling to accommodate increasing number of patients. The pressure could have been minimised to some extent, if the required facilities in health complexes had been ensured."
Echoing the same, public health expert Prof Dr Shakeel Ahmed said it is unfortunate that central oxygen system could not be installed in all upazila health complexes in Chattogram in a year.
"When the number of positive cases started to decrease, we all became relaxed and lost our concentration on improving infrastructure and logistical facilities to tackle the pandemic," said Dr Shakeel, also head of Bangladesh Institute of Tropical and Infectious Diseases (BITID) laboratory.
"If a patient gets HFNC initially when oxygen saturation goes low, most of them do not need ICU support," he said.
Contacted, Chattogram Civil Surgeon Dr Sheikh Fazle Rabbi said skilled manpower should operate high-flow nasal cannula under guidance of anaesthetists. No upazila health complex has such staff.
About central oxygen system, he said most health complexes have the facility, and initiative will be taken to ensure it for the rest.