ECONOMYNEXT – Sri Lanka is expanding Coronavirus treatment facilities adding intensive care and high dependency unit (ICU and HDU) and is also ordering more non-invasive mechanical breathing equipment, while training staff, Health Minister Pavithra Wanniarachchi said.
Whether an ICU patient comes out alive depends on the skill of nurses who have to clear the airways, suck out fluid from lungs of intubated patients on an ongoing basis and monitor and manage medication ordered by doctors to pressure and kidney function, observers say.
Sri Lanka has seen confirmed patients rise to 1,900 a day rapidly filling up available hospital beds for symptomatic patients and treatment centres for asymptomatic ones.
“With the increase in COVID patients in the country there is some shortage in hospitals beds,” Minister Wanniarachchi told parliament.
“By the next two weeks we will add 10,000 more beds.”
By May 04, 13,814 patients were in hospital or treatment centres, with 1,923 confirmed the day before and 944 discharged during the day.
Sri Lanka has confirmed over 1,800 patients for the past four days, while discharges have picked up to half the level so far.
By the end of the day on May 04 1,914 new Coronavirus patients were confirmed of which 1,860 were domestic and the balance foreign returnees.
Sri Lanka has seen daily admissions rise from around 150 to 1,900 with more patients needing mechanical breathing support with a UK SARS-Cov-2 variant beginning to spread after the New Year.
If daily admissions cannot be kept below 2,000 more than 20,000 beds would be needed, observers say. Sri Lanka is actively tracing contacts and isolating contacts.
Though Sri Lanka s no longer institutional quarantine, which is needed to bring outbreaks to zero, the country is providing institutional treatment, which is an important part of battling the spread of Covid-19 by taking infected persons out of circulation, observers familiar with the practices in East Asia say.
Sri Lanka is said to have around 700 ICU beds for all patients.
“We have allocated 104 ICU beds for Covid patients,” Minister Wanniarachchi said. “Earlier when there were fewer than 200 Covid-19 patients, we have used these beds for other patients as well.
“But now 104 beds are been allocated, also High Dependency units 64 have been allocated as well.
Today 58 ICU beds have patients in serious condition.
“We have 138 ICU beds and 56 HDU beds to use if necessary.”
Wanniarachchi said more ventilators and non-invasive continuous positive airway pressure (CPAP) and bi-level positive airway pressure (Bi-PAP) machines were on order.
Sri Lanka’s health system now had 315 High flow oxygen machine, 875 Ventilators, 400 Transport Ventilators (battery powered ventilators that can be used on ambulances), 200 Portable Ventilators.
There was also 310 CPAP and BiPAP machines in store and will roll out if necessary. CPAP and BiPAP machines which do not require intubation could used outside of an ICU setting.
.”We have ordered 175 high flow machines and 350 CPAP and Bi-PAP machines” she said.
“We expect to get 25 high flow oxygen machines and 80 CPAP and BiPap machines in the next two weeks.”
Sri Lanka has also ordered more oxygen cylinders she said.
Sri Lanka’s top medical oxygen provider has suggested to authorities to install high capacity liquefied oxygen tanks in more hospitals. The firm has also suggested that its staff be vaccinated on a priority basis to ensure that oxygen production is kept up.
However ICU and HDU units need trained nursing and medical staff for round the clock observation and management of patients. Other Wards also needed more staff.
“Specially, we observed we need to increase the staff,” Minister Wanniarachchi said. “Doctors who are studying for Post graduate diploma and MSc and nurses who are following basic courses, have been released from studies and directed for Covid 19 treatments.”
Minister said if necessary, Ministry of Health will release final year training Nursing students for treatments as well.
“We have also started ICU treatment training and first aid Covid 19 treatments training for in house doctors as well.”
In Sri Lanka ICUs are managed by anesthetists for historical reasons that are not clear. (Colombo /May04/ 2021)