Covid-19: On the waitlist for a ventilator

Just 30 ICU beds were available for Covid-19 patients in city’s hospitals on Thursday

KARACHI: With each passing second, Adeel's* family was brought closer to facing the dreadful reality of his impending death, as they rushed from one hospital to another all day in search of an intensive care unit (ICU) bed and a ventilator.

A landlord, Adeel, 37, had to be shifted from Larkana to Karachi when his condition worsened after being infected with the coronavirus. His family hoped that he would get the much-needed medical assistance in the more developed port city.

But their hopes died as he breathed his last in an ambulance just outside the Indus Hospital on Wednesday evening, after multiple refusals of admission to overflowing healthcare facilities, both public and private.

"Everywhere we went, we were told there was no space, that the hospital was filled to capacity, that we needed to wait for a vacancy," Dr Naveed Ahmed, a friend of the deceased who had tried to help in finding a ventilator, told The Express Tribune.

"All hospitals - Aga Khan University Hospital (AKUH), Liaquat National Hospital, South City Hospital, Dr Ziauddin Hospital, among others - refused to admit a critically ill patient in need of immediate medical help," he narrated, reliving the ordeal. "The family was ready to pay any amount of money, but money wasn't enough to save his life."

Out of space

Adeel's tragic reality reflects the fears of the medical community, dreading what appears to be inching closer by the day.

It has been reported, and confirmed to The Express Tribune by the Sindh health department, that the Covid-19 wards at public and private hospitals in Karachi - Pakistan's most populous city - have run out of space for critically ill patients and are left with little choice but turn them away.

Unable to provide ICU beds and ventilators to all patients, most seeking help are now "diverted" or "referred" to other hospitals, according to hospital managements.

But chances of finding space elsewhere, too, are bleak.

Consequently, the waiting lists for Covid-19 patients at private, semi-private and public hospitals, including Dr Ruth Pfau Civil Hospital (CHK), Jinnah Postgraduate Medical Centre (JPMC), the Dow University of Health Sciences (DUHS), the Sindh Institute of Urology and Transplantation and the Indus Hospital, are getting longer by the day.

Data released by the health department shows that just 30 ICU beds were available in intensive care units across the city on Thursday - with those at Shaheed Mohtarma Benazir Bhutto Trauma Centre, JPMC and the Indus Hospital only vacated after the death of the previous occupant. The beds were immediately reoccupied.

At the time of filing this report, ICU beds were also available at the newly-established facility at Services Hospital, though a senior doctor at CHK said that critically ill Covid-19 patients were already being shifted there.

Indus Hospital director Dr Abdul Bari said the situation had spiralled out of control after Eidul Fitr, when cases spiked. According to him, all 28 beds for critically ill coronavirus patients at the facility were occupied, with 18 patients awaiting vacancy on the hospital premises.

Similarly, Dr Ziauddin Hospital spokesperson Amer Shehzad confirmed that while the emergency ward had not been closed at the facility, there was no space.

"As a result, we are unable to accommodate all patients," he said, adding that they hadn't expected the surge in patients. "Those waiting inside the hospital are being given priority in case a bed is vacated."

On the same lines, AKUH spokesperson Masooma, too, confirmed that Covid-19 patients visiting the hospital were being "diverted", adding, however, that emergency ward beds were available for patients suffering from other illnesses.

"With the influx of Covid-19 patients, most have to be put on waiting list [if not referred to another hospital]," she explained.

Meanwhile, DUHS spokesperson Naeem Tahir said that the hospital administration "does not say no to anyone," but the facility had run out of space.

Bleak outlook

A health department official, speaking on condition of anonymity, reckoned that, "in the coming days all [Covid-19] patients will have to be put on the waiting list."

This was echoed by Pakistan Medical Association Karachi's general secretary, Dr Abdul Ghafoor Shoro. "The situation will be more critical in the coming weeks," he said. "Our condition is similar to Italy's if not worse. We are committing suicide."

*Name changed to protect identity 

Published in The Express Tribune, June 5^th, 2020.