As the number of people infected with the coronavirus is increasing day by day, hospitals of the county are now faced with intense pressure.
As the number of patients getting admitted has increased, some hospitals in the Kathmandu valley and other major cities have already started announcing that they will not be able to admit them. However, the government seems least prepared.
Number exceeds capacity
Covid-19 Focal Person of the Tribhuvan University Teaching Hospital Dr Santa Kumar Das also says that the pressure has increased so much that the hospital cannot bear it.
The hospital is currently treating 230 infected people, with many of them in critical condition. They are all being treated with high-flow oxygen. The line of people waiting for their turn in the emergency room is just as long.
According to him, the hospital is facing a lack of sufficient oxygen supply and human resources. “We need some eight to ten people daily just to manage the oxygen supply.”
The hospital has already called applications for an additional 25 medical officers and 150 nurses to treat the patients. But, very few have applied, he complains. In the past once, when the hospital called applications for 15 staff nurses, 1,700 people had applied, says Das.
While 80 per cent of infected people are in home isolation, the other 20 per cent, who are in various hospitals, need oxygen support, informs the Epidemiology and Disease Control Division Director Dr Krishna Prasad Paudel.
The country has a capacity of about 22,000 beds. However, there are only a few beds with high-flow oxygen facility. Paudel insists that the number of beds with high-flow oxygen needs to be increased immediately, adding there is a significant shortage of human resources. “It is difficult to cope with the pressure with the available capacity.”
As the pressure of the infected has also increased in Patan Hospital, it has started using normal beds to treat Covid-19 patients, informs the Hospital Director Dr Ravi Shakya. He says that out of 650 beds available in the hospital, more than 300 beds have been set aside for the people infected with the coronavirus. “The situation is complicated; we cannot say that the situation will not go out of hands,” he adds.
As the rate of infection increases, Paudel insists that testing and contract tracing should be expedited to make treatment more effective. He says that if the infected people are found on time, the situation can be brought into control. “When we detect Covid-19 patients on time, we can isolate and treat them as well as can prevent the situation from deteriorating further.”
Doctors say that government and private hospitals, medical colleges, primary health centres, community buildings and ward clinics should be put to use. They argue that the management will be efficient if people with normal symptoms who need normal oxygen support can be kept in such places. Also, they say there should be proper management of high-flow oxygen and human resources immediately.
Regarding the shortage of skilled workers at hospitals, they say there should be a better coordinating role between provincial governments. Poudel explains, “At present, the condition of all the hospitals even within one province is not the same. Health workers from hospitals with low or no Covid-19 cases should be deployed at the hospitals overwhelmed with the cases. It must be done immediately.”
He further says that since the central government has also given the same directive, and the provincial governments should adhere to it and expedite the work. According to him, given there is the availability of required amounts of additional oxygen and human resources, treatment can be done even on the premises of the hospitals. If the government can make all the government and private hospitals equipped for the treatment of the infected, people will not reach a time when they will have to die untimely, says Dr Ravi Shakya.
If the government can mobilise the medical college students, the problem hospitals are facing regarding the lack of workers can be managed to some extent, he adds.
However, the Ministry of Health and Population’s chief expert, Dr Roshan Pokharel, claims that the situation is under control with hospitals’ existing staff.
“Patients are having problems only when they are searching for high-flow oxygen, ICU, and ventilator on their own without consulting a doctor,” he further claims.
He claims that the government is already making arrangements to increase beds for Covid-19 patients in hospitals, confiscating high-flow oxygen cylinders kept in homes and industries for non-medical purposes as well as buying those available in the market. “The government is trying to manage as much as possible. But, the workforce size cannot be increased immediately, but those available will be mobilised systematically,” he claims.