Empty ICU bed hardest to find

The Daily Star  April 08, 2021

In the capital yesterday, finding an empty ICU bed was akin to finding a needle in a haystack.

Nazrul Islam, 75, died early in the morning after waiting a week for an ICU bed.

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Nazrul, battling pneumonia and severe breathing difficulties, has been admitted at the post-coronary care unit at Dhaka Medical College Hospital since April 1. He was being administered concentrated oxygen via a high-flow nasal cannula in the unit, but that was not enough. Nazrul needed critical care.

He has been in line for an ICU bed since April 1. But at no point during the last week were the 20 Covid ICU beds empty for Nazrul.

According to statistics from Directorate General of Health Services (DGHS), the number of empty ICU beds at DMCH has swung between zero and one since April 1, with the only exception being on April 2, when 6 beds were empty.

“We were going to the ICU every single day, imploring them for a bed. The doctors at DMCH were the ones who suggested it. We had a relative stationed in front of the ICU almost all day every day,” said Nazrul’s son Jamal Uddin, a journalist by profession.

Finally, Nazrul succumbed to the struggle at 2:00am in the morning. “We could not even transfer my father to any other ICU because he could not be taken off oxygen even for a minute. How would we put him inside an ambulance?”

Nazrul was not the only one dying while waiting for an ICU bed. Six hours after his death, 55-year-old Rokeya Begum breathed her last in the high dependency unit. She had also been waiting for an ICU bed since March 30.

“We tried so hard, and got her a seat in the high dependency unit, but in the end, it didn’t matter because she needed an ICU bed,” said Jahangir Hossain, a relative of the deceased.

Deputy Director of DMCH Dr Alauddin Al Azad said the current situation is absolutely critical.

“Finding an empty ICU bed in DMCH is basically like finding a golden deer. A lot of critical patients who need ICU support are just waiting for their chance at life. We are not turning away any patients however — if we cannot provide an ICU [bed], we are giving them [patients] oxygen via a high-flow nasal cannula,” he said, adding that he is trying to add 14 more beds.

Visiting the Kurmitola General Hospital yesterday morning, one of the first sights was that of a skeletal, frail old woman in a pink nightgown being transferred into an ambulance.

She was frothing at the mouth, sitting in a vegetative state in a wheelchair with her head lolling over to one side. She was hooked to an oxygen cylinder but was wearing her oxygen mask upside down, meaning the oxygen was escaping through the sides of the mask. As her relatives took off the oxygen mask to transfer her to the stretcher, the frothing intensified.

“There are no ICU beds empty here. She was admitted here, but she needs immediate ICU support. We are taking her to Rampura,” said a relative.

They were so distressed with the situation that these correspondents could not get further details about the patient.

Kurmitola has 10 ICU beds and all are occupied. Medical staff inside the hospital told saidthe current waiting list is 29 patients — meaning the whole ICU unit has to empty out three times over for them to be able to accommodate the backlog that accumulated till yesterday. With each passing day, the waiting list could only be expected to increase.

The total number of empty ICU beds at Kurmitola has stood at a grand total of zero since April 1, according to statistics from the DGHS.

Faced with this reality, Asaduzzaman sat under a tree and was busy on his phone, desperately trying to manage an ICU bed for his brother, who was inside the Kurmitola hospital.

“More than 48 percent of his lungs are shot. I need an ICU bed desperately but this hospital’s ICU unit has been full for days. How is this possible that I will only get an ICU bed when someone dies?” he asked.

As he and his relatives called one hospital after another, they were met with rejection everywhere. He took out a large wad of cash, handed it to a relative and instructed him to go to hospitals across the city and try and book a seat.

Hours into the ordeal, he finally got a seat at Hi-Care General Hospital Ltd.

Mir Omar Faruk, the manager of the hospital, said, “This patient has been trying to get a seat here for the last three days. He only managed, because he has a relative here.”

The hospital has 10 ICU beds.

“Patients don’t die every day so we are almost always full. We do not have space to increase [the capacity of] the ICU,” said Faruk.

At Kuwait-Maitree Hospital, sources described how 10 ICU beds lie empty because of a shortage of nurses.

“We used to have over 200 nurses, but that number has been curtailed to 150. Around 25 of those nurses are either Covid-affected or pregnant. So, even though we have 10 empty beds, we cannot admit patients into them,” said the source who requested anonymity because of a government circular banning healthcare professionals from speaking to the media.

Meanwhile the hospital’s 16 “open” seats were all filled up and have been for the past week, except for a blip the day before yesterday, when 3 beds were empty.

As a critical care doctor from Kurmitola wrote on his Facebook wall, “So many patients in the wards require critical care, and are suffering. Where are they going being unable to find ICU beds? How are they? Can we hear the cries of their families?”

Did the woman in the pink nightgown find an ICU bed after leaving Kurmitola? Did she survive? These questions lie unanswered.