Hong Kong’s public hospitals have been stretched so thin by an influx of Covid-19 patients during the fifth wave that there are not enough staff to check the oxygen levels of those hooked up to oxygen cylinders, overwhelmed medics have said.
A Princess Margaret Hospital (PMH) doctor who spoke to HKFP said that hundreds of elderly Covid-19 patients at the Kwai Chung hospital have been left in waiting areas, physiotherapy halls and lift lobbies as general and isolation wards were full. Patients who require oxygen are given portable oxygen cylinders because, unlike in general or isolation wards, there is no central oxygen supply in these makeshift areas.
The portable oxygen cylinders, which resemble scuba diving tanks, “run out in a few hours at most,” the doctor told HKFP, on condition of anonymity.
Each cylinder contains 700 litres of oxygen. According to the doctor, a tank would commonly be used at a rate of 4 litres per minute, meaning that each lasts for 175 minutes on average. But more serious patients can consume 15 litres per minute, causing the tank to last for just 45 minutes.
But the sheer number of patients meant that medics have been unable to check on the oxygen levels of every cylinder being used, or to ensure that empty tanks are changed in time. In some hospital areas, especially in lobbies or corridors, there was not enough space to fit all the gas cylinders required, the doctor said.
“We would see a patient wheeze more seriously before and then realise their tank was empty,” the doctor said. The condition of a patient could easily deteriorate if they do not receive sufficient oxygen. “It’s easy to tip from serious to a critical condition.”
Medics at other hospitals reported similar issues. On Tuesday, the accident and emergency room at Queen Elizabeth Hospital was running very low on oxygen cylinders until around 100 arrived near midnight, according to local media.
Addressing questions from the press on Thursday, Hospital Authority official Larry Lee said there has been no shortage of hospitals’ supply of oxygen, but admitted there were “logistical issues” surrounding the provision of gas cylinders. “Because we do have a lot of patients who are in places without central oxygen supply, so there may be some problems with the [logistical] flow. We are looking to smoothen that out,” he said.
As of Thursday, the city had a total of 6,698 patients in public hospitals, North Lantau Hospital Hong Kong Infection Control Centre and the Asia World Expo, according to Lee. Seventy-eight of them were in critical condition and 116 were in serious condition.
‘Needless isolation facilities’
The city will see about 70,000 bed spaces added to community isolation facilities, according to Ming Pao, including 3,900 at a newly-constructed makeshift facility in Tsing Yi.
But directing resources to places designed for Covid-19 patients with mild or no symptoms, with little need for oxygen, and who are able to look after themselves is of no help to hospitals already flooded with patients that cannot be put elsewhere, the PMH doctor said.
While each community treatment facility has its own patient admission criteria, a medical step down document shown to HKFP indicated that they would typically only admit patients who are clinically stable, 60 years of age or below, can care for their daily needs independently, or require less than two litres of oxygen per minute, a threshold the doctor described as “very low.”
All other Covid-19 patients will have to be placed in public hospitals, and there were already too many of them for hospitals to take in.
“Stop wasting resources on needless isolation facilities for the well,” the doctor said. Instead, the government should “upgrade” AsiaWorld-Expo with oxygen supply so it could take in more bedridden elderly patients, he added.
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