By Mohammad Omar Farooq:

HYDERABAD (SARIA) No ventilator in Covid-19 intensive care unit at the Liaquat University Hospital (LUH) is functioning, discloses a professor of Liaquat University of Medical and Health Sciences (LUMHS) in a letter to the hospital’s medical superintendent.
The letter written by chairperson of the department of anesthesiology and ICU LUMHS on July 10 said that there was also acute shortage of nurses and technicians at the Covid-19 ICU.
The letter stated, “All ventilators of different make and brand have become non-functional due to a number of faults that include calibration, oxygen sensor and no battery backup in case of power failure. Circuits of ventilators are old and leaking. Six ventilators don’t have compressors at all, hence they consume large amount of oxygen and there use is hazardous. Some ventilators don’t have option for non-invasive ventilation.”
It urgently sought good quality Continuous Positive Airway Pressure (CPAP) machines with face masks. “CPAP machines have hard and poor quality face masks that do not seal tightly with the patient’s face. There is spillage of viral load in ICU. Intubation trolley and emergency trolley is prerequisite in ICU and be made available,” it said.
It pointed out acute shortage of nursing staff and paramedics at the ICU. “There is one staff nurse in morning shift alone, three dispensers for 18 patients in ICC/HDU for a varying number of patients,” said the letter.
It demanded immediate provision of trained and qualified technical staff and called for “relocating ventilators (Hamilton C), monitors and other machines to Covid-19 ICU which were made available by Sindh health department”.
The Pakistan Tehreek-i-Insaf questioned the funds spent by the Sindh government in the name of coronavirus pandemic and demanded an independent audit of the funds released for the fight against Covid-19, casting doubts over the role of private hospitals and non-governmental organizations which it felt were being “obliged” out of the way, the city president of the PTI MPA Khurram Sher Zaman said if the Sindh government failed to come up with answers his party had every right to take them to courts. “Billions of rupees are being given to hospitals continuously,” he said. “So far Rs2.5 billion has been spent in the name of coronavirus pandemic. A huge amount of money was given to the Indus Hospital but unfortunately there are no facilities in any of the hospitals. They [Sindh government] are giving money to hospitals and NGOs but the situation of our healthcare system is still the worst.”
The health department has recruited 22 anesthetists but only seven have joined so far. “I have highlighted the most sensitive issue which needs redressed on emergency basis and functioning ventilators must be shifted to the ICU so that we are able to ventilate patients. Repair of existing ventilators in the ICU is not recommended,” the letter concluded.
Sources in LUH and the university said that shortage of technicians and nursing staff was a serious problem. “The ICU lacked required number of nurses as well as trained technicians,” said a staff member at the ICU.
They said that critically ill patients in ICU often tended to remove masks out of irritation if they were connected with non-invasive ventilation system. “It requires a technician or a nurse to observe such patients all the time and it seems impossible in this ward because of shortage of staff,” said a doctor.
The doctor disclosed that used ventilators had been provided to the ICU. While the existing ICU was yet to perform, the administration was establishing yet another in Jamshoro as it appeared more interested in “procurement of machinery”, said the doctor who wished not to be named.
Sindh health department has recently posted a new MS in LUH, relieving acting MS Dr Zawar Shah who was scheduled to address a press conference on Sunday but cancelled it at the eleventh hour for unknown reasons.
Hyderabad deputy commissioner had also highlighted ‘pathetic conditions’ in the ICU in a letter sent to authorities concerned in June.
Mortality rate in the ICU appears to be on constant increase. Out of 68 deaths of patients in Hyderabad, 47 have taken place in LUH from April till July 11, showing that the provincial government is not carrying out its duties and responsibilities with the due diligence required. If this carries forward Sindh and Hyderabad along with Larkana and Karachi will face a dire situation especially since it is currently the only province where covid cases are on a net rise where the current total has surpassed more than a 100,000 cases and in no way does it look like it is slowing down.