Nepal Health Ministry says situation unmanageable as hospitals run out of bedsThe country's health system cracks as coronavirus cases surge, crossing the 5,000 mark.
“We give up.”
That’s what could be summed up from what the Ministry of Health said on Friday through a statement.
“As the number of infections has been increasing, the health system is not able to cope and a situation has already arisen in which hospital beds cannot be made available,” the ministry said in the statement.
And going by the scene at Sukraraj Tropical and Infectious Disease Hospital in Teku, Kathmandu, Friday evening, this is indeed the case.
At 5pm on Friday, at least 17 people infected with the coronavirus were waiting to be admitted to the general wards and intensive care units of the hospital. Some patients were being administered oxygen on the hospital premises—they were either on chairs or wheelchairs.
All 23 intensive care unit beds and 12 ventilators at the hospital were occupied by the critically ill.
The hospital has converted its gastroenteritis ward, used during the monsoon for the treatment of patients infected with diarrhoeal diseases, into a Covid-19 treatment facility. All 33 beds of the gastro ward as well as four other beds available at the hospital have also been occupied by patients infected with the coronavirus.
“We have been sending home patients whose conditions are not very serious,” Dr Sagar Rajbhandari, director of the hospital, told the Post. “Our staff try to manage beds in other hospitals for the critically ill but that is not easy in the present situation.”
On Friday, 5,657 people tested positive throughout the country in the polymerase chain reaction tests and an additional 70 tested positive in the antigen tests. It is the highest number since October 21 last year and only the third time that the number of cases in 24 hours crossed the 5,000 mark.
The positivity rate on Friday was around 37 percent.
In the last 24 hours, 33 deaths from Covid-19 were recorded throughout the country, again the second highest on a single day. On Thursday, 35 people lost their lives to Covid-19-related complications. The number of active cases stands at 38,813. So far, 323,187 people have tested positive since the country first reported its first Covid-19 case in the third week of January last year.
The death toll has reached 3,279.
It is not just Sukraraj Tropical and Infectious Disease Hospital where Covid-19 patients are not getting beds.
Most health care facilities designated for treating Covid-19 have already been overwhelmed.
Around 400 people come to the fever clinic at Patan Hospital in Lalitpur every day and the case positive rate among these is 50 to 60 percent, according to Dr Ravi Shakya, director at the hospital.
The hospital has allocated 180 beds for the treatment of people infected with the coronavirus. None of the 21 intensive care unit beds and 17 ventilators are vacant.
Only a few general beds are available for those infected with the coronavirus.
“Our hospital’s phone rings every minute. Desperate relatives of patients call for intensive care unit beds and ventilators,” said Shakya. “We have no other option than to say sorry to them.”
The use of oxygen has increased fourfold compared to normal at the hospital. But without ensuring the supply of oxygen, just expanding the number of beds for infected patients is meaningless, according to him.
The situation is similar elsewhere too.
The Health Ministry on Friday said besides the three districts of the Valley, coronavirus infections were spreading “dangerously” in 19 other districts–Morang, Sunsari, Jhapa, Parsa, Bara, Dhanusha, Chitwan, Makawanpur, Kavrepalanchok, Kaski, Dang, Banke, Rupandehi, Palpa, Bardiya, Kapilvastu, Surkhet, Kailali and Kanchanpur.
“We request all of you to be sensible,” the ministry said in the statement addressed to the general public.
All nine intensive care unit beds at the Karnali Provincial Hospital in Surkhet have been occupied by seriously ill patients. Around half a dozen patients, whose condition is critical, have been placed on ventilator support.
The hospital has witnessed 16 deaths since the start of the second wave some three weeks ago.
Some of those who died at home also tested positive, according to Dr Rabin Khadka, director at the hospital.
“Infected patients have been seeking care only after their conditions worsen,” Khadka told the Post over the phone from Surkhet. “We have been providing high flow oxygen therapy to 35 patients. Most of the patients seeking care at the hospital either need intensive care or high flow oxygen therapy.”
Of the 49 total intensive care unit beds in the entire Karnali Province, 27 have been occupied by seriously ailing patients. There are only 17 ventilators in the province. Of them, seven are occupied at present, according to the data provided by the Ministry of Health.
“Even if we have intensive care unit beds and ventilators in sufficient numbers, we are not in a position to use them due to a lack of trained human resources,” said Khadka. “It is not possible to hire human resources, who can operate intensive care unit beds and ventilators.”
In Gandaki, the Provincial Health Directorate under the Social Development Ministry has opened vacancies for seven anesthesiologists and 12 consultant general physicians, as Covid-19 cases have continued to rise.
“We all know that it is not possible to hire consultant doctors in the current situation,” Dr Ram Bahadur KC, chief of the division, told the Post. “If new cases continue to spike in coming days, health facilities of the province will be overwhelmed.”
Karnali Province, meanwhile, has stopped performing tests on those returning from India, as their numbers are simply too high and it is not possible to test them with the existing human and financial resources, according to doctors.
“We have stopped testing as the infection spilled into communities,” Khadka said.
In Kaski, prohibitory orders have been in place for a week since Wednesday.
“Even if the lockdown has been enforced in many places, people have not stopped attending marriage ceremonies, parties and coming out of the homes,” said KC, the chief of Provincial Health Directorate under the Social Development Ministry of the Gandaki Province.
Nepal started to report a spike of Covid-19 cases about three weeks after India reported a massive surge in coronavirus infections. On February 1, India had reported 11,427 coronavirus cases. But in 60 days, the figure crossed the 70,000 mark on April 1. From thereon, within 20 days, the number of cases passed 300,000. India, for the past few days, is clocking over 350,000 new infections.
The Nepal government, however, paid little attention to the management of the porous border. Nepalis working as migrant workers in India were let in without testing or without putting them in quarantine or isolation. It was only on Friday, the Covid-19 Crisis Management Centre decided to “tighten” border points.
A meeting of the Covid-19 Crisis Management Centre decided to shut 22 of the 35 border points, allowing only 13 to operate.
The decision follows the Health Ministry statement in which it has asked the members of the public to take care of themselves.
“The public is requested to be sensible,” reads the statement. “Observing health protocols–wearing masks, maintaining physical distance and frequent handwashing with soap–is the best way to prevent infections.”