Concerns for low-resource countries, with under-prepared intensive care units, facing the COVID-19 pandemic

Infect Dis Health. 2020 Nov;25(4):227-232. doi: 10.1016/j.idh.2020.05.008. Epub 2020 Jun 5.

Abstract

Background: Low-resource countries with fragile healthcare systems lack trained healthcare professionals and specialized resources for COVID-19 patient hospitalization, including mechanical ventilators. Additional socio-economic complications such as civil war and financial crisis in Libya and other low-resource countries further complicate healthcare delivery.

Methods: A cross-sectional survey evaluating hospital and intensive care unit's capacity and readiness was performed from 16 leading Libyan hospitals in March 2020. In addition, a survey was conducted among 400 doctors who worked in these hospitals to evaluate the status of personal protective equipment.

Results: Out of 16 hospitals, the highest hospital capacity was 1000 in-patient beds, while the lowest was 25 beds with a median of 200 (IQR 52-417, range 25-1000) hospital beds. However, a median of only eight (IQR 6-14, range 3-37) available functioning ICU beds were reported in these hospitals. Only 9 (IQR 4.5-14, range 2-20) mechanical ventilators were reported and none of the hospitals had a reverse transcription-polymerase chain reaction machine for COVID-19 testing. Moreover, they relied on one of two central laboratories located in major cities. Our PPE survey revealed that 56.7% hospitals lacked PPE and 53% of healthcare workers reported that they did not receive proper PPE training. In addition, 70% reported that they were buying the PPE themselves as hospitals did not provide them.

Conclusion: This study provides an alarming overview of the unpreparedness of Libyan hospitals for detecting and treating patients with COVID-19 and limiting the spread of the pandemic.

Keywords: COVID-19; Intensive care units; Outbreak; Pandemic; Personal protective equipment; SARS-CoV-2.

MeSH terms

  • Betacoronavirus / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • Clinical Laboratory Techniques / statistics & numerical data
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / therapy*
  • Cross-Sectional Studies
  • Delivery of Health Care / statistics & numerical data
  • Health Facilities / statistics & numerical data
  • Health Facilities / supply & distribution
  • Health Personnel / statistics & numerical data
  • Health Resources / supply & distribution*
  • Hospitals / statistics & numerical data
  • Hospitals / supply & distribution
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Intensive Care Units / supply & distribution*
  • Libya / epidemiology
  • Pandemics
  • Personal Protective Equipment / statistics & numerical data
  • Personal Protective Equipment / supply & distribution
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / therapy*
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Ventilators, Mechanical / supply & distribution
  • World Health Organization