A PCR test being done 
Pics By Samantha Perera

• 46 COVID-19 patients are reported to have died within 15 days at the Theldeniya Hospital
• COVID-19 patients admitted to the Kandy and Peradeniya Hospitals are transferred to the Theldeniya hospital as it is dedicated to treating COVID-19 patients
• Theldeniya hospital has now reached maximum capacity
• Even though there is enough oxygen in the country problems have arisen with regard to lack of facilities needed to provide oxygen
• Reports reveal that the daily death toll is between 5-6 patents at the Kandy hospital with two deaths reported daily from the Theldeniya Hospital
• The authorities at the Kandy National Hospital have paved way for the rapid spread of the COVID-19 disease at the hospital

At the beginning of the second wave of the pandemic in Sri Lanka, there were only 38 ICU beds for COVID-19 patients despite other parties maintaining that there were more such facilities. Only six were available for the Kandy district and there were no separate ICU beds for COVID-19 patients at the Peradeniya Hospital. However with the rise of the COVID-19 spread, three wards at the Peradeniya Hospital were isolated with the process including four ICU beds for the treatment of COVID-19 patients. 

COVID-19 patients admitted to the Kandy and Peradeniya Hospitals are transferred to the Theldeniya hospital as it is dedicated to treating COVID-19 patients. COVID-19 patients from not only Kandy district, but from nearby areas are admitted to the Theldeniya hospital which has now reached maximum capacity. On May 17, 120 patients were receiving treatment at the hospital with internal hospital sources confirming this figure. Accordingly, 40 of them needed to be given oxygen as they had shown serious symptoms with 20 of them needing oxygen urgently due to showing signs of pneumonia. However since there were only four ICU beds available at the hospital 16 patients were said to be fighting between life and death. 

So far, many COVID-19 patients who have showed signs of pneumonia at the Kandy and Theldeniya hospitals had died due to not being administered with oxygen, the sources said. Even though there is enough oxygen in the country problems have arisen with regard to lack of facilities needed to provide oxygen. Accordingly there is a lack of oxygen pipes in wards and oxygen devices not being attached to the available beds at the hospital. These problems associated with administering oxygen has directly affected COVID-19 patients.

It was reported on May 17 that there were 15 COVID-19 patients at the Kandy National Hospital requiring oxygen, but being unable to receive it. 25-35 COVID-19 patients in Kandy and Theldeniya hospitals are in a condition where they require oxygen daily. Some of them remain alive because of the strength within or thanks to sheer luck. Others have no choice but to embrace death. Reports reveal that the daily death toll is between 5-6 patents at the Kandy hospital with two deaths reported daily from the Theldeniya Hospital. The reason for these deaths is the Covid pneumonia condition. Internal sources at these hospitals said that these deaths occur due the inability to supply patients with oxygen.

"China and New Zealand are better examples for a study regarding the management of COVID-19. If 100 patients are reported in China during a day, people in the whole province are subjected to PCR tests. That is not the situation in Sri Lanka. Our people have to wait in queues to get PCR tests done”-    Committee member of the All Island Medical Officers Association - Dr. Hansaka Wijemuni"

Health Trade unions contended that 46 COVID-19 patients reported to have died within 15 days at the Theldeniya Hospital. By May 15 six patients had needed oxygen and two of them had died as a result. However Health authorities attached to the hospital stated that that figure was “unacceptable”. By May 15 six patients had needed oxygen and two of them had died as a result.

Committee member of the All Island Medical Officers Association, Dr. Hansaka Wijemuni, who serves the Cardiology Unit of the Kandy National Hospital, said that serious issues have arisen at the Kandy National Hospital with regard to treating COVID-19 patients. 

“China and New Zealand are better examples for a study regarding the management of COVID-19. If 100 patients are reported in China during a day, people in the whole province are subjected to PCR tests. That is not the situation in Sri Lanka. Our people have to wait in queues to get PCR tests done and wait for 1-2 weeks in hospitals being unsure whether they are infected. When PCR results are delayed we cannot come to any conclusion about people outside. PCR tests conducted for 15000 were limited to 3000. The number of patients reported also decreases concurrently. If 200,000 PCR tests are done, 25000-3000s patients would be detected. The Government is deliberately concealing real results and this is wrong.

"Due to the admission of COVID-19 patients to normal wards not only those patients but even our staff is exposed to high risk. There was no use of informing the hospital authorities about this. If no solution is provided we would take to union actions from next Thursday -  All Island Nurses’ Union President Prabath Palipana"

“Even without PCR tests, people outside may show symptoms. They have no access to PCR tests. The limited number of Public Health Inspectors are also engaged in COVID-19 related activities. Instead of increasing the labour resources the Government has focused on the vaccine. That alone cannot control the virus and it only controls the spread temporarily. Public institutions in Kandy have seven PCR machines and the PCR test capacity could be increased by using them. There is also a shortage of necessary equipment to do PCR tests in Kandy and it is another reason why results are delayed. There is a shortage of staff in the laboratories. People come to the hospital from all over the island and soon this place would be the hospital with the largest spread of the COVID disease. 

Patients requiring oxygen not considered 

“When COVID-19 patients die due to other complications or diseases the authorities issue reports concluding that those conditions were the cause of death; thereby decreasing the number of Covid related deaths. Several such diseases are heart diseases, diabetes and cancer. There is no shortage of oxygen in the country. The problem is whether the patient who urgently needs oxygen receives it. Treatment of COVID-19 patients at the Kandy National Hospital is not organised well. There are 30 beds at the COVID-19 ward with 70 patients receiving treatment. Patients who require oxygen are not taken into consideration. In such a situation the death of COVID-19 patients by pneumonia cannot be prevented.

“There are six ICU beds at present and they are insufficient. The hospital required 50-60 beds. When an ICU bed is made, oxygen pipes and other necessary equipment should be attached, but they are not made in a proper way; hence  the reason why it is unthinkable to administer oxygen. There are oxygen cylinders, but the patients to whom oxygen should be administered are not considered. The authorities at the Kandy National Hospital have paved way for the rapid spread of the COVID-19 disease at the hospital. The truth is that the 70 COVID-19 patients at the Kandy Hospital are staying under beds and tables. To minimise the number of patients at the ward, the authorities have transferred COVID-19 patients with symptoms of neurological diseases, cancer and heart diseases to wards where people with such diseases are treated. Not only other patients, but their visitors are likely to contract the virus as a result. COVID-19 affected patients are kept in a corner of the same ward where other patients are and they are in the same corridor and are using the same washrooms. Not only patients and their visitors even the hospital staff is exposed to risk. This situation at the Kandy National Hospital, where the COVID-19 spreads rapidly, underscores that the authorities have violated national and international laws. The patients’ rights are also violated. Informing the authorities was of no use. They would not take steps to isolate  the COVID-19 patients or to build a separate ward. We worked according to a proper methodology during the COVID-19 second wave. However that methodology has been completely ignored during the third wave of the pandemic.

“There is a plan to offer treatment to asymptotic patients at their homes and our assistance has not been requested so far. We are ready to offer treatment outside our regular hours without accepting payments, but no such request has been made yet.
“The COVID-19 spread has become almost uncontrollable by now. The Government is in hot water after attempting to deal with the COVID-19 pandemic applying traditional concepts. We have to get used to a life with COVID-19,” he added.

"We made the decision to retain normal patients and COVID-19 patients at the same ward with the approval of Consultants. They admit COVID-19 patients to medical wards and this method was tested in four medical wards”
-  Director of the Kandy National Hospital, Consultant Dr. Chandana"

All Island Nurses’ Union President Prabath Palipana said that the first and second waves of the pandemic were controlled well. “The measures taken by authorities at the Kandy National Hospital during the third wave have created a risky situation at the hospital. The COVID-19 ward at the hospital has reached maximum capacity. There are only 25 beds. Yet there are 74 COVID-19 patients kept together with normal patients in 14 normal wards from May 18 onwards. Three and six COVID-19 patients died respectively on 17 and 15 of this month. As patients are kept in every ward it is not possible to administer oxygen to them due to the lack of oxygen pipes. Providing oxygen using small tanks is practical problem. The number of patients is increasing daily. By 6 am on May 19 there were 35 patients at the COVID-19 ward which has 25 beds. There are 79 beds in normal wards. Three deaths were reported on the same day at 6 am. Due to the admission of COVID-19 patients to normal wards not only those patients but even our staff is exposed to high risk. There was no use of informing the hospital authorities about this. If no solution is provided we would take to union actions from next Thursday.” he warned.

Director of the Kandy National Hospital, Consultant Dr.Chandana said that the purpose was to get a separate ward for COVID-19 patients. “They have to be given wall oxygen. We can finish giving them wall oxygen within 20-21 days. If all COVID-19 patients are moved to one place, even the labourers will not be able to enter. The contractors will be building a new ward soon and that problem would be solved. 

“We made the decision to retain normal patients and COVID-19 patients at the same ward with the approval of Consultants. They admit COVID-19 patients to medical wards and this method was tested in four medical wards and the decision was made to sent these patients later to a separate ward. There are people who would test positive from random PCR tests. If a heart patient tests positive how will he be categorised? He may die not from COVID-19 but from heart failure. Therefore he should be directed for cardiology treatments. The same applies for an asthma patient. Patients admitted to hospital might test positive after random PCR tests. But they cannot be admitted to separate wards as COVID-19 itself cannot be the only cause of death.

“This is a complicated situation. We made these decisions after discussing with the Consultants. Heart patients must be admitted to the Cardiology Ward until their condition returns to normal and then they can be transferred to receive COVID-19 treatment or else the person would die not from COVID-19, but from heart disease.

“Akurana hospital in Wattegama is under our control now. We monitor the hospital through Satellite technology. There are COVID-19 patients in that hospital and admitting them to medical wards has created a risk. But we do the examining rigidly. As every ward is under our supervision there is no need to fear. Do visit the Kandy Hospital for any treatment regardless of what others say. We are safe from COVID-19 and we have enough oxygen and Consultants are available at all times. Do come for any kind of treatment without fear. Several parties accuse us, but none of these accusations is true. There are COVID-19 patients in every ward and it is impossible to reduce the number of patients to zero. Patients might die as a result. We are controlling the situation to a certain extent. Similar to the Army ending the war our dedication should be to eradicate COVID-19,” he added.

"We have enough oxygen and we have begun to build a new oxygen plant. We have patients from everywhere. COVID-19 patients are in their worst condition when they are admitted. They have no ICU beds in nearby hospitals. If they die in this hospital we are made accountable - Consultant at the National Centre for Treatment of COVID-19 in Theldeniya Dr. Imesh Prathapasinghe"

Consultant at the National Centre for Treatment of COVID-19 in Theldeniya Dr. Imesh Prathapasinghe said that even though it is said that 46 patients have died within 15 days, only 16 have died during the period between April 20 and May 19. 46 is unacceptable. “I came here three weeks ago and I am not sure if this data is presented together with the previous data. The number of deaths is as follows. April 20 – 30 CDU 5= 2,CDU 6 = 01 with one death reported from the ICU. May 01 – 09 CDU 5 =2, CDU 6 = 3 with six deaths from the ICU. It may be that your calculations are based on data related to previous deaths before I assumed duties. We have enough oxygen and we have begun to build a new oxygen plant. We have patients from everywhere. COVID-19 patients are in their worst condition when they are admitted. They have no ICU beds in nearby hospitals. If they die in this hospital we are made accountable. 

“There is no shortage of oxygen. Small and large cylinders are used. We can even make a request from nearby hospitals if there is a shortage. Some of our patients require more oxygen and we have the facility to provide  them with oxygen accordingly. Sometimes 10-15 oxygen tanks are required daily. We would be given oxygen tanks in the future.

“Thereafter there will be no oxygen shortage. We have the necessary equipment. There are patients receiving oxygen in wards already. 16 of our patients are receiving oxygen. We implemented a method to supply oxygen to 56 patients with the necessary facilities. There are other issues such as lack of staff members as we have to focus more on COVID-19 patients. There are only 16 members so far and the staff will have to be increased with the increase of the number of COVI-19 patients. We do have enough oxygen.”, he added.
Several attempts made to reach Health Minister Pavithra Wanniarachchi for her comments proved futile.