Preparedness for Coronavirus Disease in Hospitals of Nepal: A Nationwide Survey

Abstract

Introduction: Coronavirus disease pandemic has affected large number of peopleglobally and has continued to spread. Preparedness of individual nations and the hospitals isimportant to effectively deal with the surge of cases. We aimed to obtain nation wide data fromNepal, about hospital preparedness for COVID-19.
 Methods: Online questionnaire was prepared in accordance with the Center for Disease Controlrecommendations to assess preparedness of hospitals for COVID-19. The questionnaire wascirculated to the over 800 doctors across the nation, who are the life members of six medical societies.
 Results: We obtained 131 completed responses from all seven provinces. Majority of respondentshad anaesthesiology as the primary specialty. Only 52 (39.7%) participants mentioned that theirhospital had policy to receive suspected or proven cases with COVID-19. Presence of isolationward was mentioned by 83 (63.4%) respondents, with only 9 (6.9%)mentioning the presenceof airborne isolation. Supply of personal protective equipment (PPE) was inadequate as per 124(94.7%) respondents. Critical care services for COVID-19 patients were possible only in hospitals of42 (32.1%)respondents. RT-polymerase chain reaction could be performed only in the hospital of 6(4.6%) respondents.
 Conclusions: It is apparent that most of the hospitals are not well prepared for management ofpatients with COVID-19. Resource allocation and policy making should be aimed to enhance nationalpreparedness for the pandemic.

Professional and personal opinions of doctors in training during the first wave of the COVID19 pandemic

“…Only half of respondents from a Jordanian survey reported access to institutional protocols to deal with COVID19 cases [ 16 ]. Less than 40% of respondents from a study carried out in Nepal reported a policy to receive suspected or proven cases with COVID19 [ 17 ]. Most respondents had been trained on donning and doffing PPE and felt comfortable doing it.…”

Anesthesiology and Critical Care Response to COVID-19 in Resource-Limited Settings

“…However, ICU equipment and trained personnel are scarce. 12 It is difficult to procure essential ICU equipment and personal protective devices as medical manufacturing facilities are non-existent in the country. The government, as well as private institutions, have already spent enormous sums developing new makeshift intensive care units and procuring consumables; it is doubtful whether most of these institutions can fund the additional cost of running optimal services in the operating rooms (ORs) and intensive care units.…”

Early Epidemiological Features of COVID-19 in Nepal and Public Health Response

“…Nepal represents a real scenario of low-and middleincome countries (LMICs) where pandemic mitigation efforts are impacted largely by the lack of medical supplies and infrastructure. This includes personal protective equipment (PPE) and ventilators, the limitation of well-trained manpower, the unavailability of enough diagnostic kits; a lack of a proper coordination mechanisms among stakeholders, and poor reporting and documentation of cases (41)(42)(43)(44). This pandemic has taught Nepal that it should invest more in research and development in the public health sector, besides the current primary focus on curative medicine.…”