Covid-19 treatment goes haywire

Upscale private hospitals remain out of the purview of serving Covid-19 patients even as the rush of sick people has almost overwhelmed dedicated public facilities.
The private players are willing to serve as multidisciplinary hospitals for non-COVID patients claiming that their existing infrastructure is not fit for treating highly-infectious diseases.
A total of 298 people have died while 20,065 persons got infected since March 8 when Bangladesh detected its first case.
Talking to the FE, representatives of the Square, United and Evercare (Apollo) hospitals, however, said the treatment of cancer, dialysis and other patients would be hampered if those hospitals work as dedicated Covid-19 hospitals.
They insisted the private healthcare facilities are not refusing the patients with critical conditions, though allegations are rife many people died or denied admission to these hospitals.
The hospital authorities said they have started treatment for Covid-19 patients on a limited scale.
As per the government's directives, private hospitals are allowed to conduct Covid-19 tests only for admitted patients.
Meanwhile, a number of doctors in the Covid-19 dedicated hospitals said all the seats are occupied and the government will need to involve more hospitals in the treatment of respiratory illness.
They said critical Covid-19 patients need centralised oxygen supply system, advanced ICU (Intensive Care Unit) facility, which exist in a handful of hospitals.
Yousuf Siddiq, chief administrative officer of Square Hospital, said a number of patients who need kidney dialysis, bypass surgery or are pregnant women would be deprived of their treatment if the hospital deals with COVID patients.
He, however, said the existing patients, who were taking treatment for a long period in the hospital, are getting treatment even if their virus tests return positive.
"We have got permission to carry out coronavirus tests only for admitted patients as per the instruction of Director General of Health Services," he said.
Responding to the queries on the patients with fever, he said they have separate arrangements to conduct test to those.
He said many healthcare providers of the hospital are already Covid-19 positive due to exposure to the virus.
"If their health condition permits, we send Covid-19 positive patients to the dedicated hospitals. Patients with critical health condition are not refused for treatment in the hospital," he said.
The recent uproar over the death of an additional secretary of the Food Ministry, a chronic kidney disease patient, does not support this claim.
Dr Arif Mahmud, head of medical services of Evercare Hospital Dhaka, said they want to work as multidisciplinary hospital, but will come forward if the situation deteriorates.
Although it is not dedicated to the COVID treatment, both corona and general patients are receiving treatment as per the meeting decision of DGHS on March 10, 2020.
Dr Shagufa Anwar, director of communication and business development at United Hospital, said they have opened up five beds initially in a separate arrangement for Covid-19 patients.
"Although the existing single roof infrastructure with central air-conditioning facility of the hospital is not fit for the infectious diseases, we are trying our best," she said.
The United will have to think about safety of other patients who go there for dialysis, radiotherapy and bypass surgery, she added.
Dr Enamur Rahman, state minister for disaster management and relief, said the government will have to give permission to the private hospitals for Covid-19 treatment.
So far, some six to seven private hospitals have obtained the permission, said Dr Rahman, who is also president of the Bangladesh Private Medical College Association and chairman of the Enam Medical College and Hospital.
Dr Rahman said since the disease is highly infectious, the private hospitals have to take precautions as they are providing treatment to non-COVID patients too.
He said the number of non-COVID patients is higher than that of the corona positive patients.
Health secretary Asadul Islam said the private hospitals have obtained licences to provide health care services and they should do this accordingly.
"There is no restriction on the hospitals to come forward in this situation. They have to maintain protocol of the health ministry to provide treatment to the Covid-19 patients," he said.
The government has strengthened monitoring so that no hospital refuses to treat patients, he said.
Additional secretary of the Health ministry Habibur Rahman Khan acknowledged some of the private hospitals are still shaky about offering treatment to corona patients, fearing their physicians and nurses may not be willing to work.
He said offering treatment to COVID patients is not a matter of government order, rather it is their responsibility to come forward in this situation.
Dr Fahmida Khatun, executive director of the Center for Policy Dialogue said an oversight mechanism needs to be there in the country's health system covering the private hospitals.
Charges at private hospitals are very high and these are escaping their responsibilities in this pandemic situation, she added.
Owners of those private hospitals are influential enough to influence the government's policy, she added.
There are some 13 government hospitals in Dhaka that are providing treatment to the Covid-19 patients, said a heath portal information officer of the DGHS.
The portal has so far no information of the involvement of private hospitals in Covid-19 treatment, the official said.

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