Nephrologists from different countries have described their work experience in the International Society of Nephrologists (ISN) during the ongoing coronavirus pandemic.
Dr Tania Mahbub, Nephrology Consultant of United Hospital in Dhaka described her experience as an ISN Fellow from Bangladesh.
Dr Tania said, since it is a novel disease, the modus operandi of Covid-19 management has needed some change over time in Bangladesh in line with the country's needs and national guidelines of Covid-19 management. Early in March 2020, when a handful of coronavirus positive cases were detected, we focused mainly on prevention, educational programs for health workers regarding the management of the new disease and updated training on personal protection.
For all patients coming to the hospital, including patients on dialysis, there is triage for preliminary screening. When patients present Covid-19 like symptoms, they are managed in separate zones. Also, telemedicine service has been developed to prevent disease spread from the OPD.
Throughout this period, there has been emphasis on maintaining regular dialysis as volume overload may erroneously mimic Covid-19 infection. Special precaution was taken for the dialysis unit as a potential portal of infection. Patients are taught about preventive measures, symptoms of Covid-19, and advised to seek help through telemedicine rather than coming directly to the Dialysis Unit.
Initially, there were designated Covid-19 hospitals in the country. When community transmission occurred on a large scale, the Health Authority decided to treat both Covid-19 and non-coronavirus patients in all hospitals.
"We divided our hospital into Covid-19, non-Covid-19, and suspected Covid-19 zones. Eventually, we started RT-PCR in our hospital. Currently, we are providing renal consultation, dialysis of COVID patients in the Critical Care Area, and have built a negative pressure isolation chamber for Covid-19 positive dialysis patients. In my experience, treating Covid-19 and non-coronavirus patients in the same center is still challenging," said Dr Tania.
Sadly, many patients hide their actual history and pose a greater threat to physicians. Bangladesh has unfortunately observed a high rate of physician deaths due to Covid-19 within a very short period.
"I always emphasise wearing a proper N95 or equivalent mask/respirator to my fellow colleagues whenever they come into contact with any patient," Dr Tania added.