- Dr. Md. Motiul Islam
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, a city in the Hubei Province of China. It rapidly spread, resulting in an epidemic throughout China, followed by an increasing number of cases in other countries throughout the world. In February 2020, the World Health Organization designated the disease COVID-19, which stands for coronavirus disease 2019. The virus that causes COVID-19 is designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); previously, it was referred to as 2019-nCoV.
Globally, over 80 million confirmed cases of COVID-19 have been reported.
Since the first reports of cases from Wuhan, a city in the Hubei Province of China, at the end of 2019, cases have been reported in all continents, except for Antarctica.
The reported case counts underestimate the overall burden of COVID-19, as only a fraction of acute infections are diagnosed and reported. Seroprevalence surveys in the United States and Europe have suggested that after accounting for potential false positives or negatives, the rate of prior exposure to SARS-CoV-2, as reflected by seropositivity, exceeds the incidence of reported cases by approximately 10-fold or more.
We at Asgar Ali Hospital have been getting COVID-19 patients from as early as March, 2019 and we were not reluctant at all to treat COVID patients. As patient count was rising in the community, we couldn’t sit still watching our patients suffer around us, going door to door for proper medical care. Asgar Ali Hospital jumped in action from the very first day. A special task force was formed led by the head of the institution and other senior consultants of different specialties and a “Standard Operating Procedure (SOP)” was implemented to manage COVID patients. We came up with a plan lock stock and barrel to continue serving our patients, both COVID and non COVID alike. From emergency room to out-patient department to dialysis room, from operating room to intensive care unit to in-patient departments, everywhere we made separate “Red” and “Green” zones for both our COVID and non COVID patients. All necessary infrastructural changes were done almost overnight, including separating the “red” and “green” zones by physical barrier, ensuringadequate negative pressure ventilation areas for our COVID patients, setting up state of the art dedicated PCR lab for COVID testing etc. Our existing infection control team had to keep a third eye open specially to ensure that virus contamination does not occur from COVID zone to non COVID zone. Cleaning, waste disposal everything has been taken care of as per local and international guidelines. Extreme precaution has been taken from the very first day regarding health care workers’ safety, particularly ensuring adequate supply of high quality masks, respirators and other personal protective gears.
It is said that what doesn’t kill you makes you stronger. But COVID-19 has killed us and made us stronger at the same time. Many of our team members got affected by COVID despite taking all precautions but fortunately all of them got better and returned work in due time with full enthusiasm.
Intensive care unit (ICU) can be regarded as the nucleus of a hospital. If the nucleus functions properly, rest of the parts follow. The Department of Critical Care Medicine (ICU) of Asgar Ali Hospital is no exception to that. Asgar Ali Hospital proudly claims to be the pioneer in building up of one of the largest (in terms of bed capacity) intensive care unit (ICU) of the country with 40 COVID beds and 12 non COVID beds, from as early as June, 2019. Our COVID ICU is fully negative pressure ventilation area equipped with all the standard equipments needed to run a state of the art ICU. The hospital had central oxygen supply and all beds were oxygen therapy enabled from day 1 of its inauguration, a blessing in treating COVID patients specially in a pandemic scenario. Moreover, we are among the pioneer users of “High Flow Nasal Cannula”, a devise that has come to the lime light in the COVID era but we have been using them from as early as 2016 and that gave us an extra edge, undoubtedly. Whenever we talk about ICUs we talk about the machines but often forget to mention the brains behind the machines. Our ICU team is a highly motivated, experienced, dynamic and talented team, one of the best in the field. Treating the critically ill is not only our noble profession but at the same time our passion. At the start of the pandemic when many of the ICUs of the country were facing “lockdown”, Asgar Ali Hospital ICU team was working their hearts out. When other hospitals were compelling their ICU physicians to take forced leave, we at Asgar Ali, were recruiting so that we could face the pandemic boldly!
As of today, we have treated a total of around 3,000 COVID patients in our in-patient departments and countless ones at out-patient departments and emergency rooms. Among the admitted patients approximately 1,000 were critically ill and around 2,000 were not so critical. During the pandemic we continued to conduct our academic activity to increase general awareness and physician training through webinars, podcasts etc to keep ourselves at the edge of emerging medical practice. In the face of the initial COVID attack we had the vision in our eyes and knew the mission at our heart by the grace of the Almighty. We want COVID to disappear from the face of the earth for good and we want all the people around us to stay as healthy as ever but at the same time we want to assure that Asgar Ali Hospital is here to stay, to continue to serve and to create new hope when it is needed the most.
The author is an Associate Consultant & HOD, Critical Care MBBS, MCCRC (Korea), MD (Critical Care Medicine).
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