In hospitals, it’s a race against time. At home, weariness settles on them

Over the last two-three weeks, medicine specialist HM Nazmul Ahsan's mobile phone has kept ringing frequently, and it is either a relative, a friend or a patient reaching out to him for help. All have got infected with the coronavirus.

At Shaheed Suhrawardy Medical College Hospital in the capital where Nazmul is posted as an associate professor of the medicine department, non-Covid units are being converted into Covid wards. Still, beds are falling short of patients swarming the public healthcare facility.

Doctors and nurses have been falling ill with Covid-19 as well and their colleagues are having to fill in the gaps caused by their absence from work, increasing the individual workload further.

"Many have been infected twice, even thrice. We are getting exhausted," Nazmul says.

Even Covid beds at the city's upscale private hospitals, like Evercare and United, have been filled up. Having been turned away, patients are going to doctors' chambers for medical advice.

Many of them ended up in Nazmul's private chamber where he sees patients in the evening.

He particularly remembers the story of a family of four – a couple, a seven-year-old child and a grandparent.

They all took medications at home, and in a few days the child's mother, aged 32, started feeling breathing distress. She was rushed from one hospital to another but there was no bed available. By the time, she could be admitted to a healthcare facility and given oxygen support, her condition worsened. She succumbed the next day.

When the rising numbers of infected cases and the dead are aggregated into statistics, sounding the alarm, healthcare providers are the ones who are watching each incident in agonising details – patient wheeled into the emergency of a hospital, his fear for losing the battle with the virus, and family members running around for the patient's admission, medicines and assurance that their beloved one will live through the episode.

While witnessing one such episode itself has an enduring impact on one's mind, healthcare providers are part of every journey of patients who live or die, bearing the responsibility of a saviour.

They cannot surrender to exhaustion when hospitals are accommodating more patients than their capacity because patients cannot simply be left to suffer and die. Still, breaking the limit has a limit.

Nazmul says between rosters of Covid duty he treats non-Covid patients at the hospital though he is supposed to stay in quarantine. "We are handling as many as 5-6 times our regular patients. More and more doctors are deployed to treat Covid patients. So, work pressure has intensified."

And amid the widespread Covid infection, Nazmul says, "Public hospitals are crowded with patients and their family members. It is impossible to identify who is transmitting the virus and who is not. So, we do not have any protection against the disease."

According to the latest 24-hour reporting cycle until Wednesday 8am, 7,626 people were tested Covid positive. Sixty-three people died.

Of the infected, about 5,500 were residents of the capital. According to data provided by the health directorate, the number of Covid general beds – in both public and private hospitals – in the city is 3,550 and of ICU beds 305.

Not all Covid patients need hospitalisation, and those who need it, they do not need it immediately after diagnosis. So, if the daily infection rate does not increase and stands where it is now – 22% – days and weeks from now the healthcare system will even cross the limit of carrying the extra burden.

Nur Nahar Ayrin of the internal medicine department at Evercare Hospital, Dhaka, and her entire family suffered from the disease in October last year. Her husband was hospitalised and needed longer than the others to recover.

Gaining back her health, she has joined work.

Ayrin says there was panic among doctors and other healthcare providers at the beginning of the pandemic because they had little knowledge about the disease. Later on, they became accustomed to the work pressure and the strict health measures to be followed to stay safe.

But now, things are different. The healthcare setup established over the last year is failing to cope with the load of patients.

The latest wave of Covid infection is suspected to have been caused by new highly infectious strains of the virus imported from the UK and South Africa.

Patients' health condition is deteriorating fast now, with severe damage done to lungs, and young patients are suffering more than before and dying too, Ayrin says.

"We suspect it is the new strains making things worse. I worry about carrying the virus home and my family members being infected again," she says.

The notion that older generations particularly need protection from the coronavirus infection no longer applies now, with the new variants on the prowl, says Dr Shirin Parvin, medical officer working at the intensive care unit of Kurmitola General Hospital.

The hospital had more than 400 patients admitted against 275 general beds as of Thursday. All of its 10 ICU beds were occupied.

Recently, two patients below 30 died before her eyes at the ICU, Shirin says.

"Once a patient's health worsens, it is difficult now to revive it. We are often having to decide whom to admit to the ICU from a long queue of patients," she continues.

Younger patients with less severe comorbid conditions are the priority because they have higher chances of survival after receiving intensive care.

Deciding who should be saved must be an emotionally painful job.

Returning home, when healthcare providers look at the faces of their loved ones, they are likely to feel fear at a magnitude unfathomable to people oblivious to the reality at healthcare facilities.

"I leave my two children in the care of my mother-in-law, who is 69, as I go to hospital. After coming back home I cannot stay in isolation because the children are too young. I am scared of infecting them and my mother-in-law," says Farhana Haque Happy who also treats ICU patients at the Kurmitola hospital.

Health experts suggest stringent measures to contain the contagion.

Covid cases exploded over the last month and the numbers will leap exponentially if public movement is not restricted, says Nazmul of the Suhrawardy hospital.

"To keep the wheels of the economy running, businesses have been kept open. No one has listened to what public health experts, epidemiologists and doctors said. But we are getting exhausted."