HYDERABAD: Increase in Covid-19 patients after detection of UK variant of coronavirus in Hyderabad, which is more contagious and spreads faster, has put strain on resources and service delivery of Liaquat University Hospital (LUH), which already remains overburdened with arrival of patients from other districts.
The UK variant is contagious and spreads fast, hence the increase in number of patients in Hyderabad,” said Liaquat University of Medical and Health Sciences (LUMHS) vice chancellor Prof Dr Bikha Ram on Monday.
The university’s Diagnostic and Research Laboratory confirmed the existence of the virus a few days back during genetic sequencing of samples of some patients, who were now reported dead.
Positivity ratio in Hyderabad remained between 24pc and 19pc between April 24 and 30 and doctors attribute it to the UK variant. It dropped to 15pc to 16pc in last two days after the administration opted for smart lockdowns in virus-hit localities and modified business timings for main bazaars in Hyderabad, Latifabad and Qasimabad. Deputy commissioner on Monday placed 19 more localities under smart lockdown till May 9.
“There are also South African and Brazilian strains in Sindh which are not vaccine responsive while UK variant responds to the vaccine,” he said.
According to LUMHS’s professor of medicine Dr Imran Ali Sheikh, who had been overseeing Coivd-19 ward at LUH until two days back, said the UK variant’s genetic material was different from wild coronavirus.
Ten Covid-19 patients died from April 30 till May 3 afternoon in LUH’s City and Jamshoro branches. LUH administration plans setting up 35-bed high dependency unit (HDU) in Jamshoro where Covid-19 patients were handled through non-invasive methods called BiPAP (positive air way pressure) and CPAP (continuous positive air way pressure). Both machines work as ventilators.
“Not a single Covid-19 patient either in Jamshoro or Hyderabad is on ventilator in ICU,” LUH focal person Dr Aftab Phul said while sharing breakup of 71-bed ICU and HDU in Jamshoro and City branches.
Bed occupancy in ICU and HDU remained usually full to capacity. Of 18, 16 ICU beds in LUH City were occupied while 17 out of 18 were occupied in HDU. Likewise, seven beds in ICU were occupied in LUH Jamshoro out of 15 and 9 in HDU out of 20, he said.
LUH remains overburdened 51 Covid19 patients died in LUH in April 2021 which is 24pc of total admitted patients – 217 till April 30 – and according to data LUH continues to receive patients from other cities.
An official said that controlling attendants in Covid-19 wards had become increasingly difficult. Patients’ desperate attendants don’t respond to compliance with SOPs despite calls. Rangers are needed in LUH,” he said.
District Health Office (DHO) Hyderabad also plans establishing 187-bed facilities to be divided in hospitals of Latifabad, City and Qasimabad for managing patients as far as patients with oxygen saturation issue are concerned. DHO has only five anaesthetists for handling any patient in ICU in the entire district.
DG Health Services has already questioned ‘planning’ of LUH management to handle Covid-19 patients from Hyderabad and other cities in his May 1 letter, describing LUH’s capacity as “not encouraging’. LUH director administration, Sattar Jatoi, however, disputed his contention.
Government hospitals in big cities like Sanghar, Mirpurkhas and Naushahro Feroze remain without services of ventilators and patients from these cities are referred to tertiary level facilities like Hyderabad or Shaheed Benazirabad.
Mirpurkhas – divisional headquarter for Tharparkar, Umerkot and Mirpurkhas – does not have a Covid-19 ICU. Critical patients from here and two other districts are shifted to LUH normally.
“We have 30-bed isolation ward but mostly patients are in home isolation. We have a positivity ratio of just 3.5pc,” said DHO Mirpurkhas Dr Mushtaq Shah. “Demand is submitted for ventilators and trained staff to Sindh directorate of health,” said DHO Dr Shah.
The situation in Sanghar is same where a 100-bed isolation centre was working in Poly Technical College Sanghar besides 40-bed treatment centre in civil hospital along with monitors for oxygen saturation of patients.
Critical patients are shifted to tertiary hospital in Nawabshah. “Two ventilators that we had were provided to Jinnah hospital in Karachi in 2020 pandemic,” said a doctor from Sanghar.
Peoples’ University of Medical and Health Sciences for Women (PUMHS), Shaheed Benazirabad has five-bed Covid-19 ICU where currently only one patient is admitted. It also has 10 -bed HDU where nine patients are admitted. Other than LUH and PUMHS no other hospital has ICU for Covid-19 patients.
Naushahro Feroze district has 10 ventilators but they need installation. “These vents were in fact sent to Karachi during last pandemic but on account of litigation by a citizen -- questioning shifting of vents meant for Naushahro Feroze to Karachi – those were brought back,” said Naushahro Feroze DHO Dr Abbasi.
“Mere installation of ventilators serves no purpose. We need trained human resource and pulmonologists for an ICU as it involves multidisciplinary approach. There is already dearth of qualified pulmonologists in market. We are ready to appoint them,” said director general of Health Services Sindh.
Published in Dawn, May 4th, 2021