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'Nepal has just one ventilator for 114,000 people'

KATHMANDU, April 8: While the government on Monday extended the nationwide lockdown to a third week to prevent a possible outbreak of COVID-19, several stakeholders in the health sector say that Nepal will not be able to handle an outbreak as it has less than 300 working ventilators for the entire population.
By Ashim Neupane

Hospitals can handle only 5,000 COVID-19 cases: Experts


KATHMANDU, April 8: While the government on Monday extended the nationwide lockdown to a third week to prevent a possible outbreak of COVID-19, several stakeholders in the health sector say that Nepal will not be able to handle an outbreak as it has less than 300 working ventilators for the entire population.


The country does not have enough life-saving ventilator machines, which are crucial for keeping alive COVID-19 patients with breathing difficulties, they say.


Although the Ministry of Health and Population (MoHP) claimed that there are 600 ventilators in the country -- 400 in the Kathmandu Valley hospitals and the remaining outside, several stakeholders in the health sector dismissed the government claim as false.


According to them, there are only about 360 ventilator machines in the country and 260 of them are in the Kathmandu Valley. According to them, around 25 percent of these life-saving instruments are not in working conditions and this brings down the number of working ventilators to around 263. If they are to be believed then Nepal has one ventilator per 114,000 population.


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“The country is in a worse situation now. There are not enough ventilator machines, and even the government is not facilitating private hospitals to import ventilator machines,” said a promoter of a private hospital in Kathmandu on condition of anonymity. He said the government should facilitate the import of ventilators machines to combat the pandemic.


According to the Nepalese Society of Critical Care Medicine there are only a little more than 260 ventilator machines in the Kathmandu Valley.


According to the research by the World Health Organization (WHO), out of 100 reported cases of COVID-19, 80 can be treated at home, 15 need hospitalization and the remaining five need serious treatment on ventilator.


According to Dr Anup Subedi, a specialist on infectious disease at HAMS Hospital, Nepal is not prepared for a pandemic. “Even if the government brings new ventilators now, there is a serious lack of manpower to operate the machines. So, the government needs to work very very hard to prevent an outbreak,” said Subedi.


“The available ventilators will not be enough even for Kathmandu. If there is an outbreak, the country won't be able to handle the situation,” said Subedi, adding that almost five percent of COVID-19 patients need ventilator support as they develop acute respiratory distress syndrome (ARDS).


This means, Nepal can handle only a little more than 5,000 cases. If the country sees a total of 5,000 COVID-19 cases, around 250 cases will require ventilator support.


In Nepal, majority of private hospitals and the government have been importing ventilator machines from Singapore and Germany. “But there is already an acute shortage of ventilators around the world, so it would be difficult for Nepal to secure new ventilators,” a promoter of a private hospital told Republica.


“We absolutely need more ventilator machines. And at the same time, the government also needs to train medics to operate the machines,” said Subedi.


Meanwhile, the National Innovation Center is currently working to repair broken ventilator machines at various hospitals of the Kathmandu Valley. According to Mahabir Pun, the chairman of the center, they are currently repairing the machines at four hospitals of the Valley.


“A total of 12 ventilator machines are defunct at the National Trauma Center, six at the TU Teaching Hospital, two at Bhaktapur Hospital and four at Ganeshman Singh Memorial Hospital,” Pun said, adding that a total of 12 engineers have been working to fix them.


He further added that four ventilators at the Trauma Center and one in Bhaktapur Hospital will be ready by tomorrow [Tuesday].

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