I have been on a weekly tour of duty every month for the last one year at the Dhaka Medical College Hospital (DMCH). My experience with each weekly tour of duty has been different from the previous one. I should have written about all of them but for one reason or another, I could not do that.
Recently I completed my 13th tour of duty at DMCH. In this article I will highlight my latest week's observations, focusing on the Delta variant of the Covid-19 virus.
I think the first noticeable difference between last year's and this year's variant is the age group of the patients. Last year, most were elderly but this time, a significant number of patients are younger. The ratio of elderly to young patients in the Covid-19 ward of DMCH is currently 3:1.
Several of the elderly patients are vaccinated with both doses. All those who are vaccinated are doing comparatively better than the others and are recovering faster.
But there is also a grim side of the newest variant. Last year, most patients got sicker in the second week after the onset of symptoms. But this year, alarmingly, the conditions of the patients are getting worse within three days of infection on average.
The first symptoms for most patients this time are headaches or diarrhea, or both. After three or four days, patients start to experience sudden shortness of breath and develop a cough. When we measure the oxygen saturation of these patients, it is often less than 90 and X-rays and CT scans show pneumonia in both lungs. But the surprising thing is, most patients experience a cough or shortness of breath for just one day.
Previously, patients who died had other illnesses including diabetes, high blood pressure, and kidney complications. But during the latest Covid-19 wave, younger patients, who were healthy even three or four days ago, are dying.
Ever since the monsoon began, many have started getting admitted to DMCH as suspected Covid-19 patients with fever and headache. But after testing, we discovered that they did not have the virus but dengue instead. Some patients have both the virus and dengue.
It is even more heartbreaking to see patients coming to DMCH from remote areas of the country because they failed to get admitted to hospitals in their area. Most of these patients spend their life-savings coming to the capital and in the process they miss getting started on treatment right away.
Another problem we are facing this time also, but perhaps worse than last year, is our low hospital capacity.
On my latest duty cycle, I was placed in the male ward of suspected Covid-19 patients. We did not have any vacant beds in the confirmed Covid-19 ward, so we had to separate positive patients on one side of the ward for suspected Covid cases. Suspected patients whose Covid-19 test results came out positive had to continue to stay in the same ward for suspected cases, as the confirmed ward could not accommodate anyone new.
Sometimes we also had to keep female patients in the male ward as there was no room for new patients in the female wards. Under normal circumstances, patients or their relatives would have objected to this, but now, given the circumstances, they are grateful just to get a bed and oxygen.
If infections continue at the current rate, all the beds in the hospitals around the country will be full by next week.
Institute of Epidemiology Disease Control and Research (IEDCR) says that the Delta variant currently accounts for some 80% of all infections in Bangladesh. But whatever the variant may be, a good quality face mask can give us the ultimate protection. I strongly urge readers to wear face masks and get vaccinated the first chance they get.
Dr Nazirum Mubin is Medical Officer of Dhaka Medical College Hospital