Unwilling to be in hospital, Covid-19 patients die at home

Ali Akbar, 70, a resident of Narayanganj, went to his daughter's house in Nabinagar, Brahmanbaria, three months ago. There he contracted fever on June 14. Though he took medicine for fever and cold for five days at home, he was not taken to any hospital. He died at home on June 19. After his death, it was revealed that Ali Akbar had been Covid-19 positive.

Akbar's son-in-law Helal Uddin told The Business Standard that a Covid-19 test report had to be shown if a fever-cold patient was to be admitted to hospital. Besides, even if one had gone through a test, one would not get a report easily. Akbar was not taken to hospital due to the suffering patients went through there.

"My father-in-law died on June 19 and we received his test report on June 30," he said. "Would it have been very beneficial to have a test before his death? He would have died without treatment even after undergoing the test."

Though Ali Akbar was not taken to hospital, Badrul Haque, 66, of Sylhet, returned home without having his treatment completed. He died at home. He was hospitalised at North East Medical College Hospital in Sylhet with fever for seven days before returning home on June 17.

He was tested for Covid-19 at the hospital. After he went home, it was known that he was Covid-19 positive. However, Badrul did not want to go to the hospital as he was not comfortable with the environment of the hospital. He was given oxygen at home when his breathing problems increased. He died on 28 June.

Badrul Haque's son Jabed Ahmed Akhand told The Business Standard that his father did not like the hospital environment and so even though he was ill, he did not want to be admitted to any hospital.

Talking to the family members of several Covid-19 patients who died at home, The Business Standard learned that coronavirus patients feel comfortable receiving treatment at home rather than suffer or experience the poor environment in hospitals.

But when patients' conditions suddenly worsen, there is no scope of taking them to hospitals or giving them oxygen. Thus relatively young patients as well as patients who are elderly or have co-morbidity have been dying at home.

The health directorate reported the first death of a Covid-19 patient at home on May 19. Since then, deaths have been occurring every day at hospitals as well as at home. So far 2,096 people have succumbed to the novel coronavirus in the country. Of them, 380 died at home and 27 on the way to hospital. The figure represents 19.41 percent of the total number of deaths.

Experts say patients are dying at home with severe symptoms but even then are not going to hospital, which is not a good sign. If the number of deaths at home continues to increase, it will not be possible to reduce the death rate.

Dr M Mushtuq Hussain, advisor to the Institute of Epidemiology, Disease Control and Research (IEDCR), told The Business Standard that patients should go to hospitals to recover but it was not a good sign if they did not want to go to hospital.

"One doctor should be tagged with each patient. The doctor will tell the patients under what conditions they have to go to hospital. It is the responsibility of the government during a pandemic," he added.

At the beginning of the coronavirus outbreak, Dr Mushtuq said the IEDCR communicated with coronavirus patients until April.

"But after May, when the number of patients grew, the health directorate took responsibility for tests but did not maintain contact with the patients. But that has to be done too. The doctor will advise the patients about when to be admitted to hospital and will arrange for their hospitalisation."

Analysing the data of the health directorate, it is seen that in the 11th week of the coronavirus outbreak in the country, information on the first home death and deaths on a wider scale was released on May 19. At the time, 20 people died at home and 10 on the way. Since then, an average of 50 coronavirus patients have died each week on their way home or to hospital.

The highest number of Covid-19 patients died at home in the 15th week. Between June 14 and 20, 93 Covid patients died at home and five died on the way.

Professor Nazrul Islam, a virologist and a member of the government's technical advisory committee on coronavirus, told The Business Standard that hospitals needed to be patient-friendly to reduce the number of deaths of Covid patients at home.

"Relatives cannot see the patients at most Covid hospitals. Relatives can visit patients at Dhaka Medical College Hospital. In all hospitals, like DMCH, at least visiting hours should be introduced for the relatives of the patients. Hospitals need to be humane towards patients. And when the doctors of the health directorate are advising the patients online, they must try to convince them so that critical patients do not stay at home."

Dr Rizwanul Karim, member secretary of the health directorate's Covid-19 integrated control room, told The Business Standard that patients with mild symptoms were asked to stay at home as per WHO guidelines.

But most of the coronavirus deaths in the country were also related to people with co-morbidity and who were over 50 years of age. When the condition of many Covid patients with co-morbidity suddenly becomes critical, they die due to lack of oxygen. So those who have co-morbidity and are over 50 years of age should be admitted to hospital even if they do not have symptoms. Most hospital seats are vacant.