By Yoshitha Perera
Expanding hospital capacity to meet the increasing demand caused by the Covid-19 pandemic is a challenging task, and several recent incidents have been reported on the issues and shortages in providing the necessary facilities for Covid-19 patients admitted to hospitals.
Speaking with The Sunday Morning, Health Ministry Medical Technical Services Director Dr. Anwar Hamdani discussed the hospital care capacity and compared it to how it was before the pandemic, while measuring the impact of interventions such as field hospitals, the use of private hospitals, and deployment of existing and newly-appointed medical staff for treatment of Covid-19 patients.
He also explained the current process of the allocation of the critical care (CC) beds, staff, and ventilators to treatment centres.
Dr. Hamadani noted that the Health Ministry had already anticipated a hike in demand for bed capacity, while the requirement for appointing medical staff also keeps rising with the rapid spread of the new variant.
He added that the whole world will experience lockdowns and subsequent Covid-19 waves on and off for about a period of another one or two years. Within that time frame, he noted, people have to be educated on the disease while adjustments are made to the level of priority it is given, in that countries will need to curtail it to an appropriate level to balance health safety and public needs.
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“On 24 May, it was only 24,000 beds we needed; within a day we had to increase it by adding 500 beds. So, there are certainly days on which we have to increase the bed capacity and develop the existing stations, while opening new stations and recruiting new staff” Health Ministry Medical Technical Services Director Dr. Anwar Hamdani [/caption]
Current bed capacity
Responding to the query by The Sunday Morning on bed capacity, Dr. Hamdani said that as of now, all treatment centres have a combined bed capacity of 26,000, which had been divided into four categories of institutions.
He highlighted that the requirement is shifting, and health authorities expect to increase this capacity to 28,000 beds soon.
He said: “We have 26,000 beds, which have been distributed in four categories of institutions. Number one is tertiary care level, in which we have ICU facilities and all consultant cover-ups with the ability to manage comorbid patients. There are nine stations at this level, and we have roughly about 1,404 beds.”
Explaining the secondary level of Covid-19 patients, Dr. Hamdani said that in the second category, the Ministry is managing 65 stations, all of which have the Electronic Medical Records (EMR) facility. He said: “From the first wave of Covid-19, we started developing these treatment centres, and now we have roughly 5,762 beds in these stations.”
According to the Medical Technical Services Director, the third category is the intermediate care centres, for which the Ministry already maintains 49 stations with a rough total of 13,070 beds.
The fourth pillar in this system includes private hospitals, which have 34 stations with 5,183 beds, tri-forces treatment centres, and the Prison treatment centre, which cover a total of 163 stations within the country, as per the present situation.
Requirement fluctuating
The country has a short period to increase bed capacity to treat Covid-19 patients, or risk further fatalities. Explaining the situation, Dr. Hamdani said that by 25 May, there were 157 stations that were functioning, with a total bed capacity of 24,501.
“But on 24 May, it was only 24,000 beds we needed; within a day we had to increase it by adding 500 beds. So, there are certainly days on which we have to increase the bed capacity and develop the existing stations, while opening new stations and recruiting new staff,” he noted.
The urgency of the situation is due to the new variant of Covid-19, as Dr. Hamdani noted, which has a much faster rate of spread than the first two variants that entered the country. “In the previous two waves, we had noticed the spread was not this fast; the intensity was low, and the level of complications among people was also low,” he said.
Dr. Hamdani said that during the first wave there were about 50 beds in the entire country. Now the country is dependent on 26,000 beds, which have to be handled by a separate unit. He also added that during the first wave, they noticed that 90% of patients were asymptomatic, while in the second wave, only 5-10% of patients were symptomatic. However, with the spread of the new variant, the health authorities had noticed 30% of cases as being symptomatic.
Dr. Hamdani said: “Out of that 30%, roughly 10-15% patients need oxygen support, and out of them 3-5% needed ICU facilities. So it shows the gravity of the disease and the intensity of spread.”
Discussing the ICU facilities, he said that currently, the country has 109 beds, and as per the present situation, 81 among them are functioning.
“An ICU bed is not just a bed; we need equipment, we need to train staff, maintain infrastructure, and we need compatible technological capacity as well. During the first episode, we had only 13 ICU beds, and during the second, it increased up to 25. On 25 May, it was 78 ICU beds, and by 26 May, we managed to open another two ICU beds – and it was a major victory for a day.”
As of 26 May, a total of 302 critical patients have been managed by all Covid-19 treatment centres with oxygen support, and all these counts were dynamic, Dr. Hamdani said.
Appointing new medical staff
Reviewing the current state of appointing medical staff, Dr. Hamdani said that the Minstry would appoint not only more intern medical officers but also support staff, considering the new situation. He explained that there is a mechanism that the Ministry is currently following in recruiting medical staff, and in the crisis situation, the Ministry had taken measures to recruit them urgently.
He said: “Even if we take on these new staff, we have to train them, and it might take some time to get familiarised with this new system. What we are planning is to get the staff in and mobilise them to normal hospitals for training. As the Health Ministry, we are doing all these things while attending to the normal healthcare services.”
Dr. Hamdani said that the new staff would be recruited to the Covid-19 treatment centres after a particular period of training at the normal hospitals.
Efforts made by current staff
Discussing the current efforts made by healthcare workers and his unit, the Medical Technical Services Director said that all Covid-19 patients have been mobilised by his unit from day one, and from the time the patients tested positive, the unit has been obtaining information from the ground level.
He added that the healthcare staff is paying special attention to the important cases, while categories such as cases that have comorbidities, and cases that might need ICU facilities or any special attention, like maternal care and early childhood care, are sorted out differently.
He also warned that even after discharging a patient from the treatment centre, there remains the possibility of complications arising because of the new variants.
He added that from the very first Covid-19 patient detected in Sri Lanka, he has been handling the special Covid-19 operation unit at the Ministry; at that point, he had only one medical officer with him to manage the entire country. Dr. Hamdani said that there are currently about 14 medical officers working under him.
“On 24 May, it was only 24,000 beds we needed; within a day we had to increase it by adding 500 beds. So, there are certainly days on which we have to increase the bed capacity and develop the existing stations, while opening new stations and recruiting new staff” Health Ministry Medical Technical Services Director Dr. Anwar Hamdani [/caption]
Current bed capacity
Responding to the query by The Sunday Morning on bed capacity, Dr. Hamdani said that as of now, all treatment centres have a combined bed capacity of 26,000, which had been divided into four categories of institutions.
He highlighted that the requirement is shifting, and health authorities expect to increase this capacity to 28,000 beds soon.
He said: “We have 26,000 beds, which have been distributed in four categories of institutions. Number one is tertiary care level, in which we have ICU facilities and all consultant cover-ups with the ability to manage comorbid patients. There are nine stations at this level, and we have roughly about 1,404 beds.”
Explaining the secondary level of Covid-19 patients, Dr. Hamdani said that in the second category, the Ministry is managing 65 stations, all of which have the Electronic Medical Records (EMR) facility. He said: “From the first wave of Covid-19, we started developing these treatment centres, and now we have roughly 5,762 beds in these stations.”
According to the Medical Technical Services Director, the third category is the intermediate care centres, for which the Ministry already maintains 49 stations with a rough total of 13,070 beds.
The fourth pillar in this system includes private hospitals, which have 34 stations with 5,183 beds, tri-forces treatment centres, and the Prison treatment centre, which cover a total of 163 stations within the country, as per the present situation.
Requirement fluctuating
The country has a short period to increase bed capacity to treat Covid-19 patients, or risk further fatalities. Explaining the situation, Dr. Hamdani said that by 25 May, there were 157 stations that were functioning, with a total bed capacity of 24,501.
“But on 24 May, it was only 24,000 beds we needed; within a day we had to increase it by adding 500 beds. So, there are certainly days on which we have to increase the bed capacity and develop the existing stations, while opening new stations and recruiting new staff,” he noted.
The urgency of the situation is due to the new variant of Covid-19, as Dr. Hamdani noted, which has a much faster rate of spread than the first two variants that entered the country. “In the previous two waves, we had noticed the spread was not this fast; the intensity was low, and the level of complications among people was also low,” he said.
Dr. Hamdani said that during the first wave there were about 50 beds in the entire country. Now the country is dependent on 26,000 beds, which have to be handled by a separate unit. He also added that during the first wave, they noticed that 90% of patients were asymptomatic, while in the second wave, only 5-10% of patients were symptomatic. However, with the spread of the new variant, the health authorities had noticed 30% of cases as being symptomatic.
Dr. Hamdani said: “Out of that 30%, roughly 10-15% patients need oxygen support, and out of them 3-5% needed ICU facilities. So it shows the gravity of the disease and the intensity of spread.”
Discussing the ICU facilities, he said that currently, the country has 109 beds, and as per the present situation, 81 among them are functioning.
“An ICU bed is not just a bed; we need equipment, we need to train staff, maintain infrastructure, and we need compatible technological capacity as well. During the first episode, we had only 13 ICU beds, and during the second, it increased up to 25. On 25 May, it was 78 ICU beds, and by 26 May, we managed to open another two ICU beds – and it was a major victory for a day.”
As of 26 May, a total of 302 critical patients have been managed by all Covid-19 treatment centres with oxygen support, and all these counts were dynamic, Dr. Hamdani said.
Appointing new medical staff
Reviewing the current state of appointing medical staff, Dr. Hamdani said that the Minstry would appoint not only more intern medical officers but also support staff, considering the new situation. He explained that there is a mechanism that the Ministry is currently following in recruiting medical staff, and in the crisis situation, the Ministry had taken measures to recruit them urgently.
He said: “Even if we take on these new staff, we have to train them, and it might take some time to get familiarised with this new system. What we are planning is to get the staff in and mobilise them to normal hospitals for training. As the Health Ministry, we are doing all these things while attending to the normal healthcare services.”
Dr. Hamdani said that the new staff would be recruited to the Covid-19 treatment centres after a particular period of training at the normal hospitals.
Efforts made by current staff
Discussing the current efforts made by healthcare workers and his unit, the Medical Technical Services Director said that all Covid-19 patients have been mobilised by his unit from day one, and from the time the patients tested positive, the unit has been obtaining information from the ground level.
He added that the healthcare staff is paying special attention to the important cases, while categories such as cases that have comorbidities, and cases that might need ICU facilities or any special attention, like maternal care and early childhood care, are sorted out differently.
He also warned that even after discharging a patient from the treatment centre, there remains the possibility of complications arising because of the new variants.
He added that from the very first Covid-19 patient detected in Sri Lanka, he has been handling the special Covid-19 operation unit at the Ministry; at that point, he had only one medical officer with him to manage the entire country. Dr. Hamdani said that there are currently about 14 medical officers working under him.