Having spent a week in home isolation, coronavirus-positive Rima Pandey’s oxygen level dropped to below 70 on May 15. Worried, Pandey’s family started to make calls to book a bed at a hospital in Kathmandu. With most hospitals full, the family of the 63-year-old went through the list of beds at various hospitals provided by the Ministry of Health and Population in its daily Covid-19 tally update.
“We called Bhaktapur Hospital asking if we could take our mother to the hospital. They told us that they had no available beds even though the list stated it had,” says Raunak Pandey, Rima’s son. “We even tried using our influence, but we couldn’t find a bed anywhere.”
Desperate for a hospital bed, the Pandey family airlifted Rima to Biratnagar where she is undergoing treatment.
Rima is one of many who have had to fly out of Kathmandu due to the lack of beds at hospitals in the valley. Some have even been airlifted to hospitals in Pokhara and Jhapa due to it.
But, the Ministry of Health and Population says every day that there are beds available in Kathmandu. According to the ministry, there are 19 Covid-19 specific hospitals in Kathmandu. They had 750 normal beds, 221 ICU beds and 69 ventilators available for the patients as of Monday, May 17.
Looking at the notice, many families, like the Pandeys, call hospitals looking for beds. But, most of them get the same answer that the hospital is full.
Differences and difficulties
While the ministry says hospitals have beds, the hospital officials say that they do not. One hospital official even goes on to say that the information provided by the ministry was wrong.
For example, according to the ministry’s data as of Monday, Bhaktapur Hospital has 83 normal beds, six ICU beds and eight ventilators. There were currently 48 patients being treated in their normal ward, six in the ICU and one was kept on the ventilator. Looking at the data provided by the ministry, there should have been 35 vacant beds and seven ventilators.
But, officials at Bhaktapur Hospitals say that the information is incomplete as they do not have separate beds for ventilator and that the ventilator machines are used for patients who are critical in the ICU itself.
“They’ve said we have eight ventilators, but we only have six out of which three are being used for patients in the ICU. I don’t know where the ministry got its data from, but it’s worrying not only for us but also for families of people suffering from Covid-19,” says Dr Sumitra Gautam, adding even though they have additional ventilators, they do not have enough beds in the hospital’s ICU to bring it to use.
The state of Civil Service Hospital is also similar. According to the data released by the Health Ministry, the hospital has 70 normal beds, 24 ICU beds and three ventilators which housed 68, 14 and one patients respectively as of Monday. But, the hospital’s information officer Dr Suman Babu Marahatta says that the information provided by the Health Ministry is wrong and they have no room for more Covid-19 patients.
“We only have 21 beds in the HDU, 15 in the ICU and three ventilators. All of them are currently occupied,” says Dr Marahatta.
Causes of the differences and concerns
According to hospitals, the Health Ministry collects its data every day around 11 am but publishes it online only after 5 pm. That is one of the problems the hospitals see as the occupancy of the hospitals can change drastically in the six hours’ time it takes for the data to become public.
For example, on Monday, around 11 am, there were a few beds empty at Bir Hospital. But, by the time the data was put to the public, those beds had already been occupied.
Another problem for the confusion is that the Health Ministry treats ICUs and ventilators separately even though at most hospitals, a ventilator is installed at a bed in the ICU itself.
At the APF Hospital, the government’s data said on Monday afternoon that it had 20 beds in the ICU and had the capacity to put nine people on ventilator support. But, the hospital said that the nine ventilators were included in the 20 ICU beds (11 without ventilators and nine with ventilators).
Dr Pravin Nepal from the hospital says the problem has occurred due to the ministry’s inability to collect and disseminate the data properly.
“People who are responsible for data collection and distribution should be a bit more aware of the situation at hospitals. You can’t be giving out incorrect information at such a delicate time. People need to understand things in detail before distributing information,” says Dr Nepal.
The same problem has plagued Bir Hospital too. The ministry’s information stated that it had 10 ICU beds and 10 ventilators. But, According to Dr Achyut Karki, the hospital had 10 ICU beds, all of which have ventilators.
“We don’t have 10 separate ventilators,” he says. “When the ICU is full, so are the ventilators.”
The director at Sukraraj Tropical and Infectious Disease Hospital, Teku, Dr Sagar Rajbhandari says the lack of coordination between hospital personnel and government officials is the reason for the confusion.
He says that it is wrong for the government to put out wrong information about empty beds at hospitals even though they are adjusting patients on corridors and some even on the floor.
“The data are confusing people who are desperate for hospitals to look after their loved ones. The ministry itself needs to first understand the situation before putting out data. Now is not the time to confuse people,” he says, adding that the hospital is getting hundreds of phone calls every day asking if they have ICU beds.
“They tell us we’re lying. But, we aren’t. People can come to check for themselves how we’re treating patients,” says Dr Rajbhandari.