Lack of ICU beds remains a worry in Sylhet division

While it may sound reassuring to hear that Sylhet division has 589 beds dedicated to treating Covid-19 patients in isolation centres. However, that enthusiasm might start to fade in the face of some details -- out of these 589, only two are ICU beds.

Both of these are located at the "Corona Isolation Centre" in Sylhet city's Saheed Shamsuddin Ahmed Hospital.

Though nine more ICU beds and four ventilators are being installed at this dedicated Covid-19 treatment facility, medical experts say this will not be enough if the contagion continues to spread.

According to the divisional health office in Sylhet, there are a total of 103 ICU facilities in Sylhet, which includes 15 functional beds at Sylhet MAG Osmani Medical College Hospital, while the rest are at private medical colleges and hospitals in the district.

However, there is no ICU facility available across Sunamganj, Moulvibazar and Habiganj districts; not even at the Sheikh Hasina Medical College Hospital in Habiganj.

According to the fourth version of 'National Guidelines on Clinical Management of Coronavirus Disease 2019 (Covid-19)', critically ill patients should be treated in intensive care units (ICU).

Professor AFM Nazmul Islam, former head of the department of medicine at Osmani Medical College, said, "A patient's vital functions are respiration, circulation, blood pressure and oxygenation, all of which are functions of the lungs and heart. Those who cannot maintain vital functions need to be taken to intensive care. Around five percent of the total Covid-19 infected get to a critical stage where this care is required."

"Considering the population density of the country, if we estimate one lakh infected cases, at least five thousand of them will be critical, and at least one to two thousand of them will need ICU facility. It's time to plan beforehand as cases keep rising every day," he said.

So far, only seven people have tested Covid-19 positive in the division, including a deceased doctor and an elderly. Moreover, one was detained in Sunamganj after fleeing from Dhaka after testing positive.

Among them, three are being treated at Sylhet Saheed Shamsuddin Ahmed Hospital, two in Sunamganj Sadar Hospital and one in Habiganj Sadar Hospital.

Contacted, Civil Surgeons of Sunamganj, Moulvibazar and Habiganj all said that they have sent requisition for ICU facilities to the Directorate General of Health Services but received no further instruction.

They also said they have no option but to refer positive patients in critical condition to Sylhet or Dhaka.

Dr Anisur Rahman, assistant director (disease control) of Sylhet divisional health office, said, "We are considering using private hospitals' ICU facility if needed, but this privilege is not available for the other districts where no such facility is available."

Besides the lack of ICU beds, the region is also suffering from a lack of expertise. "We are in acute shortage of anesthesiologists in Sylhet. Without trained experts, there will be no meaning of installing ICU," he said.