Published on 12:00 AM, June 20, 2020

DMCH struggles to meet rising ICU demand

Only 14 ICU beds for Covid-19 patients or those with symptoms

Dhaka Medical College Hospital is struggling with inadequate ICU facility as a large number of critical Covid-19 patients are thronging the country's largest public hospital.

Against the demand for at least a hundred, it has only 14 ICU beds dedicated for Covid-19 patients or those showing the symptoms.The hospital has around 35 other ICU beds for general patients.

DMCH doctors said most of the Covid-19 patients and those suspected to have coronavirus come here in critical condition with severe shortness of breath and low oxygen level. Many of them need ICU supports.

"There are only 14 ICU beds for Covid-19 treatment. There is a long queue for ICU beds," said Alauddin Al-Azad, deputy director of DMCH, adding that they were trying to increase the number of ICU beds but it will take time.

On June 12, a retired government official, Engineer Shafiq Islam, 67, was admitted to DMCH's Covid-19 unit at Ward-602 with shortness of breath.

His nephew Aminul Islam said doctors immediately advised that the patient needs an intensive care unit, but any ICU bed for corona patients at DMCH could not be found empty.

After frantic efforts, they could finally manage an ICU bed on Sunday evening. Hospital sources said they were lucky to get it in just two days.

DMCH is currently treating around 625 Covid-19 patients with the capacity for 750.

Prof Dr Mujibur Rahman, head of medicine department, said the old burn unit started admitting Covid-19 and suspected coronavirus patients on May 2. At present, it has 100 patients of surgery, gynaecology and paediatrics, who are coronavirus positive or have Covid-19 symptoms.

Besides, over 500 coronavirus or suspected patients have been admitted at DMCH's new 10-storey building as of Tuesday.

If beds are filled here, the hospital's newly arrived Covid-19 or suspected patients would move to Railway Hospital, which has a 100-bed coronavirus unit, DMCH authorities said.

With the surge in the flow of patients, the number of deaths at DMCH is also apparently on the rise, according to hospital sources.

Over the last two weeks, 12 to 15 Covid-19 patients and those with coronavirus symptoms have died here every day, the sources said, adding that 11 Covid-19 patients died on Monday.

Prof Mujibur said they have treated about 3,000 coronavirus positive and suspected Covid-19 patients so far and the recovery rate is 80 to 85 percent.

"The death rate is not high considering the number of critical patients coming to Dhaka Medical College Hospital from all over the country. Earlier, there was ten percent death in medicine wards. The current situation is not depressing."

Asked about reported negligence in treating Covid-19 patients, Alauddin Al-Azad said, "Although there were some problems in the beginning, the system has improved a lot."

He hopes the doctors will do better in the future.

The authorities said the hospital's doctors are doing their best to handle this critical situation. Every night, a virtual meeting is held on how to manage and discharge patients and admit new arrivals.

INCREASED DEMAND FOR OXYGEN

Doctors at DMCH said many patients come with oxygen level below 40 percent. It is difficult to raise it above 80 percent with the central oxygen supply, and in that case, they need ICU supports.

Prof Dr Mujibur Rahman said the demand for oxygen gas has increased at hospitals, giving an example of a ward.

"Out of 80 Covid-19 patients admitted here, 60 need oxygen support," he said on June 8.

All these severe patients need oxygen supply with high-flow nasal cannula (HFNC) with which oxygen can be given with a flow-rate of 60 litres per minute. At present, DMCH has only two such equipment.

The hospital's deputy director said they have asked for 20 more HFNCs -- two for children and 18 for adults.

"We hope to get the supply in next week as those are being brought from New Zealand," he said, adding that these would work as an alternative for ICU to treat patients with severe shortness of breath.