Managing Dengue: Imminent saline shortage feared as demand jumps over 1000%

As the dengue onslaught continues, demand for liquid saline in hospitals has increased exponentially, reaching 10-12 times (over 1000%) the usual requirement, leading authorities to fear an imminent shortage in supply.

Several medical institutions in Dhaka, including Suhrawardy Medical College Hospital, Mugda Medical College and Hospital, Dhaka Medical College Hospital, Sir Salimullah Medical College, and Institute of Child and Mother Health have already reported shortages.

Patients are now apprehensive about the possibility of government-sponsored intravenous (IV) fluids running out due to the high demand for saline.

The Essential Drugs Company Limited (EDCL), responsible for supplying medicines and saline to government hospitals, upazila health complexes, and sadar hospitals nationwide, is facing challenges as it does not manufacture saline itself. Instead, EDCL procures saline from various private pharmaceutical companies to meet the demand.

Dr. Ehsanul Kabir, Managing Director of EDCL, said, "We do not produce saline, and it has to be obtained from private pharma companies. Given the current circumstances, companies cannot meet this increased demand overnight, and buying saline at retail price is not an option."

He said, the current demand surge is 10-12 times higher than normal, which has raised concerns about potential saline shortages.

The price of saline is also an important consideration in this situation. A 1000 ml saline bag containing 5% dextrose and 9% sodium chloride is priced at Tk 87, while baby saline costs Tk 63. To ensure affordability, all types of saline, including 500 ml bags, are being supplied to government hospitals at reduced prices, he said.

Niatuzzaman, acting director of Mugda Medical College and Hospital said, "The hospital has 500 beds, and currently, we have around three times more dengue patients admitted already. In July, the number of dengue patients increased, resulting in a saline shortage. We require about 1000 to 1200 IV fluids per day, and our current stock will run out within a week."

Dr. Khalilur Rahman, Director of Suhrawardy Medical College Hospital, said, "Eighty percent of dengue patients require saline. EDCL used to supply saline monthly, but now they must supply it every week. Although more than 15,000 saline bags are still available, they might only last for a week. If the number of patients keeps increasing, a saline shortage may arise in the next 10 to 12 days."

Currently, EDCL is purchasing and supplying saline from six companies: Beximco, Acme, Popular, Opsonin, Orion, and Libra. Additionally, hospitals experiencing high saline demand for managing the dengue situation are being issued No Objection Certificates (NOCs) to procure saline from outside sources.

Director General of the Department of Health, Abul Bashar Mohammad Khurshid Alam said "The increase in the demand for fluid saline due to the rise in dengue patients is indeed a legitimate concern. We will discuss the matter with EDCL to explore ways to increase the supply and ensure that there is no scarcity of saline. However, I want to mention that there is no need to panic over the fear of a saline crisis."