Infections rise, fear of second wave grows

Except for educational institutions, all spheres of activities are going on as usual. 

Businesses, restaurants and offices are open. Public transports need not follow any seating rules to limit the number of passengers. And to get rid of boredom, people are again arranging social gatherings to meet friends and families. 

Amid all this, the coronavirus curve has been rising once again and public hospitals are filling up with Covid patients, mirroring the May-June situation when the country saw the first peak of the infection. 

A greater concern is that those who are admitted to hospitals now are showing severe to critical symptoms, while doctors with their hands-on experience are quick to identify mild and moderate cases and mostly prescribe remote medicines for them. 

In the latest country-wise report, the World Health Organisation (WHO) said Covid-19 cases increased by 10.1% in the week that ended on 16 November when compared to the previous week. And the number of weekly deaths went up by 0.8% during this period.

The weekly rate of infections was faster in Chattogram, Rangpur and Rajshahi than in Dhaka, according to the WHO report. That means the coronavirus is now transmitting at a faster pace outside the capital and many patients are rushed to Dhaka for specialised care.

Dr Asadul Mazid Noman, an anaesthesiologist at the Covid-19 the intensive care unit (ICU) of Dhaka Medical College Hospital, said more critical patients are coming to the ICU from Gazipur, Mymensingh and Savar districts.

"The increasing flow of patients gives an impression that we are heading into the second wave of infection." 

Mahmud Alam, 46, an employee of a private company in Chattogram, was brought to Dhaka on 14 November by an ICU ambulance for advanced treatment. He had come out positive three days earlier. 

A diabetic patient, Mahmud's condition turned critical within a day and he was put on life support. 

Currently, he is undergoing treatment at a private hospital in Dhaka. Meanwhile, his two children and wife have tested positive for the coronavirus.  

Another Covid-19 patient, Tanima Islam, 22, contracted the virus from her father who had fallen sick while on a visit to Barishal. Her father was suspected to have got the infection from a relative whom he met in Barishal. 

Doctors at several public hospitals in the capital told The Business Standard that in the last two weeks, hospitals had been dealing with twice as many patients as they did a month ago. 

Intensive care units are under huge pressure. In many cases, critical patients have died before an ICU seat could be made available for them.   

Sami Al Hasan, a doctor who finished his shift on Saturday at Kurmitola General Hospital, said about 80% of patients at wards required oxygen support, in contrast to what he saw last month. 

In an ideal situation with social distancing in place, the Covid-dedicated hospital can accommodate 200 patients at wards but this week it had more than that. 

If the virus transmission goes on unabated, the Kurmitola Hospital would soon become overwhelmed with patients, Sami observed. 

The highest number of patients was about 300 in the June-July period.  

The Kurmitola Hospital maintains a log book of patients from the wards who need intensive care. 

Every day, 8-10 patients are added to the list to wait for a vacancy in the 10-bed ICU, said Dr Md Harun Ur Rashid, registrar of the ICU at the Kurmitola Hospital. 

The pressure of patients has been mounting since last month after a gap of about two months, he said.

Most of the government's Covid-dedicated hospitals in Dhaka had their ICU beds fully occupied on Wednesday, according to the Directorate General of Health Services.

The 250-bed Sheikh Russel National Gastroliver Institute & Hospital had nine beds vacant but general people do not have access to the healthcare facility.

AKM Akhtaruzzaman, chairman of the intensive care medicine department at Bangabandhu Sheikh Mujib Medical University, said the queue for an ICU bed had been getting longer over the last one and a half weeks, whereas last month half of the 21-bed ICU unit remained unoccupied at times.

"Patients are coming to the hospital with severe conditions, in some cases with oxygen saturation levels dropping to 60% [the ideal is 95% and above]."

At Dhaka Medical College Hospital, the number of patients doubled in a month, said Robed Amin, a doctor at the medicine department. 

The lax enforcement of health guidelines, unrestrained outdoor activities and social gatherings are responsible for the rising infection, as suggested by health experts.   

Against such a backdrop, there is no strategy from the government to beat back the coronavirus, apart from the "no mask, no service" policy that seems to be a futile attempt when people of all strata and professions take part in all activities without masks on.