On Sunday, a 38-year-old man from Sahidnagar in Dhanusha was taken to the Janakpur-based Provincial Hospital after he reported having Covid-19-like symptoms—high fever, common cold and difficulty in breathing.

Doctors at the hospital started his treatment in the emergency unit for heart and lung ailments and also collected his swab samples for PCR test.

The patient needed immediate ventilator support, according to the doctors at the hospital, but all three ventilators were in use at the time.

“The patient was then referred to Dharan-based BP Koirala Institute of Health Sciences following requests from his family members,” said Nagendra Yadav, medical superintendent at the Provincial Hospital.

The man died on the way to the hospital.

“Following his death, the man’s PCR report came back positive,” said Yadav. His family members now blame the hospital for his death, as it could not manage a ventilator on time.

The man had crossed into India a few days ago to buy chemical fertilisers, according to family members.

Currently, there are only seven ventilators in Province 2’s government hospitals—three in Janakpur Provincial Hospital and four in Narayani Hospital in Birgunj. Although the provincial government in April had reached the decision to purchase 50 ventilators for government hospitals, the decision is yet to be implemented.

On April 19, a Cabinet meeting had permitted Rs 680 million budget for the purchase of 50 ventilators and other essential medical equipment required to fight Covid-19.

The Ministry of Social Development had to purchase 50 ventilators, two PCR machines, PPEs, sanitisers, masks, gloves and other medical items from the allocated budget. The government had planned to distribute five ventilators each to six districts of Province 2 and send 10 ventilators each to Janakpur and Birgunj.

On Sunday night, Chief Minister of Province 2 Lal Babu Raut called for an immediate meeting in Janakpur following the death of the 38-year-old man. He asked Dinesh Thakur, acting secretary of the Ministry of Social Development, to furnish an explanation to the delay in the purchase of ventilators. A secretary of the province who was present at the meeting but was not authorised to speak to the media said Thakur did not have an answer.

“People have started to die due to lack of ventilators. The government had allocated the necessary budget to purchase ventilators but they were not bought on time. This is shameful,” the secretary quoted Raut as saying in the meeting. According to him, the officials of the Ministry of Social Development and Provincial Health Supply Division blamed each other for the delay in the procurement process.

Dr Pramod Yadav, chief at the supply division, said his office had invited a tender for the purchase of ventilators on June 19 and started the process for the purchase on June 29.

“But Ram Prasad Ghimire, the secretary of the Ministry of Social Development, got transferred and we couldn't complete the procurement process as decided by mid-July,” he said. “If the process starts now, we can make the purchase within 15 days.”

Meanwhile, Dr Ramkewal Sah, a member of the expert group formed for Covid-19 prevention and control in Province 2, said, “All eight districts of Province 2 share an open border with India. The rate of coronavirus infection in Bihar in India is growing at an alarming rate. The effect of the rise in cases there can be seen in Province 2.”

According to him, it has become increasingly necessary to reimpose complete lockdown in the province.

“Prohibitory orders do not work well here. The province needs to go under lockdown again,” he said.

Prohibitory orders have been imposed in Rajbiraj and Birgunj from July 23 and July 25 respectively following a resurgence of coronavirus cases in these cities.

Sah also stressed the need for hospitals in the province to be well-equipped with ventilators to minimise the loss of lives due to Covid-19.

“Around 50 ventilators should be kept on standby. Number of symptomatic cases are surging and the death rate has increased in the province. The only fully equipped hospital is in Dharan,” he said. “It is necessary to manage human resources and medical equipment to start ventilator services in the hospitals of Province 2 as well.”

According to data of the Ministry of Social Development in the province, 18 Covid-19-related deaths and around 650 new infections have been reported in several districts of Province 2 in the past few weeks. The data showed 643 new cases were confirmed in the last two weeks only. The ministry said the majority of cases confirmed in the past few weeks were symptomatic.

The data available at the ministry shows that a total of 4,768 positive cases were reported in all eight districts of the province as of August 1; among them, around 3,100 patients have returned home after treatment.