Special Report: Hospitals may soon start facing capacity issues in Punjab

LAHORE: Despite Punjab government’s tall claims of adequate facilities for Covid-19 patients, the healthcare system seems to have choked in the province amid critical patients’ complaints about non-availability of facilities in the hospitals. The Punjab government claims to have allocated 29,015 dedicated beds for Covid-19 patients in the public, private and field health facilities with 679 ventilators, dedicated for critical patients of novel coronavirus in the province.

Till date, on June 3, 2020, the number of Covid-19 cases in Punjab has doubled in the last 25 days after easing of lockdown on May 9, which rose to 31,104 confirmed infections. So far 607 deaths have occurred and 7,711 patients recovered (24.79 per cent) from the disease. Lahore, the provincial capital, has been most affected with 14,569 Covid-19 cases and 226 fatalities.

As per the report, 2,831 healthcare workers were suspected of carrying the virus. All the suspected have been tested and 562 have been diagnosed with the virus so far with a high percentage of 19.85 per cent. The ratio of coronavirus positive amongst healthcare professionals in the province has shot up from the previous 12.7 per cent to nearly 20 per cent after easing of lockdown.

The Punjab government’s home isolation policy for Covid-19 patients and over 25 per cent recovery of patients is being regarded as the reason for low occupancy of available facilities. As many as 22,302 Covid-19 patients have been isolated at their homes in Punjab including 738 in Lahore.

Till May 30, 2020, as per data provided by the Punjab Primary and Secondary Healthcare Department (P&SHD), 1,718 critical patients have been admitted to intensive care units (ICUs) and High Dependency Units (HDUs) across province.

As stable coronavirus patients opted for home isolation, it rendered isolation wards in hospitals nearly empty and entire bed strength almost vacant.

However, there are numerous complaints by relatives/family members of critical Covid-19 patients vis-à-vis denial of admission to the ICUs and HDUs as well as non-availability of ventilators in teaching hospitals.

The patients are forced to go to private hospitals/local clinics for treatment. “My elderly father, who requires ICU bed and ventilator due to severe coronavirus condition, has been denied admission at Mayo Hospital, Sir Ganga Ram Hospital, Services Hospital and Jinnah Hospital due to lack of space,” a patient’s son Zafar Ali told The News, adding that the government had left the serious patients to die.

Another female Covid-19 patient’s family complained that the ICU beds and ventilators were not even available in private hospitals in Lahore.

“The healthcare system for terminally-ill Covid-19 patients has choked due to paucity of the ICU and HDU beds and ventilators in public sector hospitals of Punjab,” said Dr Shahid Shaukat Malik, General Secretary Pakistan Medical Association (PMA), Lahore, while talking to The News.

The government is trying to show the isolation bed strength as critical care facilities. He termed Punjab government’s act of establishing field hospitals “a waste of money”, saying that the home isolation policy had rendered the Field Hospitals and Isolation Wards in teaching hospitals empty.

Instead of wasting public exchequer on Field Hospitals, Dr Shahid Malik said, the Punjab government could have easily used trust hospitals like 1,500-bedded Gulab Devi Hospital, being run on government’s grants, and attached teaching hospitals of private medical colleges equipped with infrastructure, ICUs, ventilators and oxygen. “There are 3,500 ventilators in Punjab, out of which 2,200 are in private sector, yet these private health facilities are lying empty and government chose to spend on field hospitals,” he lamented.

Dr Malik said that at least, 2,100 medical professionals had been infected with coronavirus and 22 died from the virus in Pakistan so far.

Young Doctors Association (YDA), Punjab President Dr Salman Haseeb Chaudhry, who himself has been diagnosed Covid-19 positive, said the critical care health facilities across Punjab had exhausted and human resources exposed to the virus. He lambasted the government for exposing the doctors and medical staff to the virus by denying personal protective equipment (PPE), followed by opening of lockdown to trigger the spike. “The government is not conducting tests of the medical professionals,” he informed while expecting, at least, 10 to 15 per cent of medical staff in hospitals to be diagnosed with coronavirus.

However, contrary to claims of doctors and Covid-19 patients, the Health Department’s official data says that, out of 29,015 dedicated beds for Covid-19 patients in Punjab, 6,237 have been dedicated for critical Covid-19 patients including 4,900 in Isolation Wards, 760 in High Dependency Units (HDUs) and 577 in single-bedded Isolation Rooms in public, private and field health facilities in the province. Out of total beds, 1,500 are occupied, while 4,737 are still lying vacant.

Similarly, out of 679 dedicated ventilators for critical Covid-19 patients, 94 are occupied, and 585 are still available.

As per the break-up of bed strength dedicated for Covid-19 patients in tertiary care hospitals in Punjab, there are 108 dedicated Covid-19 beds out of 410 in Civil Hospital Bahawalpur, 25 out of 1538 in Bahawal Victoria Hospital, Bahawalpur, 97 out of 954 in Shaikh Zayed Hospital, Rahim Yar Khan, 33 out of 540 in DHQ Teaching Hospital, DG Khan, 200 out of 250 in Recep Tayyip Erdogan Hospital, Muzaffargarh, 12 out of 850 in DHQ Teaching Hospital Faisalabad, 31 out of 1500 in Allied Hospital, Faisalabad, 8 out of 250 in Children Hospital Faisalabad, 6 out of 250 in Faisalabad Institute of Cardiology, Faisalabad, all 250 beds are dedicated as Covid-19 in General Hospital Ghulam Muhammad Abad, Faisalabad, 307 out of 450 in DHQ/Teaching Hospital Gujranwala, 241 out of 492 in Aziz Bhatti Shaheed Teaching Hospital, Gujrat, none in 100-bedded in Wazirabad Institute of Cardiology, Wazirabad, 94 out of 400 in Allama Iqbal Memorial Teaching Hospital, Sialkot, 4 out of 134 in Govt Sardar Begum Teaching Hospital Sialkot, 20 out of 149 in Kot Khawaja Saeed Teaching Hospital, Lahore, 6 out of 547 in Punjab Institute of Cardiology, Lahore, none in 1510-bedded Punjab Institute of Mental Health, Lahore, 11 out of 235 in Lady Willingdon Hospital, Lahore, 24 out of 908 in Sir Ganga Ram Hospital, Lahore, none in 30-bedded Punjab Dental Hospital, Lahore, 43 out of 1450 in Services Hospital, Lahore, 338 out of 2484 in Mayo Hospital, Lahore, 3 out of 100 in Govt. Said Mitha Teaching Hospital, Lahore, all 280 beds are dedicated as Covid-19 in PKLI, Lahore, 14 out of 195 in M. N. Sharif Teaching Hospital, Yakki Gate, Lahore, 12 out of 200 in Lady Aitchison Hospital Lahore, 42 out of 1100 in Children Hospital Lahore, 9 out of 300 in Government Teaching Hospital Shahdara Lahore, 31 out of 45 in Govt. Mozang Teaching Hospital Lahore, 30 out of 1000 in Lahore General Hospital, Lahore, 24 out of 149 in Govt. Mian Munshi DHQ-I Teaching Hospital Lahore, 55 out of 1500 in Jinnah Hospital, Lahore, none in 500-bedded PINS Lahore, 104 out of 1700 in Nishtar Hospital, Multan, 24 out of 300 in Children Complex Multan, none in 279-bedded Ch. Pervaiz Elahi Institute of Cardiology Multan, 24 out of 360 in T.B Sanatorium Samli Murree, all 400 beds are dedicated as Covid-19 in Rawal Institute of Urology, Rawalpindi, 7 out of 272 in Rawalpindi Institute of Cardiology, 10 out of 357 in DHQ Teaching Hospital, Rawalpindi, 135 out of 738 in Benazir Bhutto Hospital, Rawalpindi, 40 out of 962 in Holy Family Hospital, Rawalpindi, 41 out of 377 in DHQ Hospital, Sahiwal, 100 out of 120 in Govt. Haji Abdul Qayyum Teaching Hospital, Sahiwal, and 94 out of 731 in DHQ Teaching Hospital, Sargodha.

Provincial cabinet, in its 27th meeting held on March 12, 2020, declared an emergency in Punjab due to the Corona Virus Disease (Covid-19) and relaxed the PPRA rules.

The SHC&ME provided financial support to the hospitals to Combat Covid-19 including a fund of Rs966 million to the hospitals out of which Rs400 million were utilised by hospitals and another Rs140 million spent on PPEs so far. Further required funds are being provided to the hospitals on need basis.

When contacted by The News, Secretary SHC&MED Nabeel A. Awan admitted that after easing of the lockdown, the patient load hit the health facilities more quickly. However, as of now, he said, there is no capacity issue in hospitals, because according to occupancy data, the ICU/HDU beds and ventilators are still vacant in many hospitals. “But we can’t predict as to how many days we can cope with it because with the opening up of lockdown completely and people behaving irresponsibly, we may soon start facing capacity issues,” he added.

However, he said, the department had prepared a contingency plan to rope in five trust hospitals including Gulab Devi Hospital, running with government’s grants, and private teaching hospitals to share the burden of Covid-19 patients’ critical care.

To a question regarding home isolation policy rendering Field Hospitals and Isolation Wards in hospitals empty, he admitted that the asymptomatic Covid-19 patients, having isolation facilities in their homes, have opted for home isolation. “Currently, there are 1,200 to 1,250 patients are home-isolated,” he said, adding that presently there are less than 100 patients in Field Hospital at Expo Centre Lahore.

When asked if it was really needed to set up Field Hospitals sans critical care despite the option of trust hospitals and private teaching hospitals equipped with critical care facilities, he said that the required medical facilities in these hospitals were too little to cope with Covid-19 emergency.

When asked about infections among medical professionals and plan to conduct mass testing of medical staff in hospitals, he said that the government had already increased testing among doctors and medical staff. “We are in the midst of a pandemic and have to face these challenges, yet at the same time, we must protect our frontline soldiers in the fight against coronavirus,” he added.

To a question regarding discrepancies in Covid-19 mortalities in statistics of P&SH and SHC&ME departments, he said that the Covid-19 data of both departments was collectively compiled by the P&SH Department. “If there’s any discrepancy in mortality figures between the two departments, it could be not because of human error but because of some technical IT glitch,” he added.