Oxygen supply could save many from dying of Covid-19: Chattogram doctors

Doctors in the port city of Chattogram have said the city's healthcare system is near collapse due to an inadequate supply of live-saving equipment.

The frontline medical personnel said they have lost many people – including university teachers, physicians and bankers – just due to a shortage of high-pressure oxygen supply.

"The critical patients are dying just due to a shortage of oxygen supply. We could have saved many patients if there had been a proper flow of the life-saving gas," said a doctor in a novel coronavirus unit in Chattogram Medical College Hospital.

"We do not have adequate equipment. We cannot pump pressurised oxygen using the sub-standard nasal cannula," the doctor said.

Chattogram has the second-highest amount of novel coronavirus patients and the situation is deteriorating fast. Physicians said the capacity of the existing medical system is failing to accommodate the rising number of cases.

As of Wednesday, at least 3,394 were diagnosed with Covid-19 in the port city – with 77 deaths.

The port city has four Covid-19 dedicated hospitals: Chattogram General Hospital, the Bangladesh Institute of Tropical and Infectious Diseases (BITID), Chattogram Medical College Hospital, and Field Hospital.

The three public hospitals and one private hospital can accommodate a total 360 patients and they are struggling with the rising number of cases. Doctors recommend most of the patients take their medication at home unless they have breathing issues.          

Chattogram was declared a risky area from the beginning of the outbreak. More than 200 people have tested positive for the virus, on average, since May 25. The infection rate is around 45 to 50 percent against the total number of tests.     

Public Health Rights Protection Committee Chattogram chapter Member Secretary Dr Sushanta Barua believes there was a serious lack in preparation to fight the pandemic which resulted in the current healthcare system breakdown.

"Chattogram was declared risky for the virus outbreak in February. However the lax preparation since then failed to expand medical care capacity. Now, many people are dying without receiving any medical care," he said.

For Covid-19 patients, there is a severe bed crisis at Chattogram's hospitals. Though the government acquired several private hospitals for Covid-19 patients, health directorate officials could not specify when the hospitals would start admitting novel coronavirus patients.           

Chattogram Civil Surgeon Dr Sheikh Fazle Rabbi said they are trying to open those private medical facilities for Covid-19 patients as soon as possible.

Severe shortage of oxygen  

Chattogram General Hospital novel coronavirus treatment committee focal person Dr Mostafa Jamal said the hospital does not have any high-flow nasal cannulas – a respiratory support device used in the treatment of acute respiratory failure.

"The hospital got two of them as a donation, but the equipment has yet to be installed," he added.      

The physician said there are also facing a crisis for a minimum of lifesaving equipment including pulse oximeters and oxygen masks.

Chattogram Medical College Hospital's medicine department Professor Dr Aniruddha Ghosh said most of the Covid-19 patients do not require treatment at hospital.

"However, 15-18 percent of patients need oxygen support. For them, oxygen cylinders cannot provide the adequate pressure they require. Therefore, a Covid-19 treatment facility should have a central oxygen supply system," he explained.        

BITID and Chattogram General Hospital have 100 oxygen cylinders and the hospitals wrote to the health directorate asking for more. However, they have yet to receive an allocation.

Meanwhile, Chattogram Medical College Hospital has a central oxygen supply which is being used for the intensive care unit for general patients.

Deputy Director of the hospital Dr Aftabul Islam said they have some old cylinders which are inadequate for Covid-19 patients. He said the hospital also wrote to the health directorate for more oxygen cylinders.

Meantime, BITID Director Dr MA Hasan Chowdhury said they do not have oxygen supply equipment though their cylinder stock is good.   

Dr Biddut Barua, chief executive officer of Field Hospital, said they are unable to admit any patient with critical respiratory issues as the hospital is suffering from a shortage of medical equipment.   

Chattogram Civil Surgeon Dr Sheikh Fazle Rabbi said there is a shortage of numerous respiratory measuring and supportive equipment including: pulse oximeters, oxygen masks, high-flow nasal canulas, arterial blood gas analyzers, oxygen concentrators, bilevel positive airway pressure, and continuous positive airway pressure.

"We have written to the higher authorities several times asking for this equipment," he added.