Concerns for low-resource countries, with under-prepared intensive care units, facing the COVID-19 pandemic. 2020

Muhammed Elhadi, and Ahmed Msherghi, and Mohammed Alkeelani, and Ali Alsuyihili, and Ala Khaled, and Anis Buzreg, and Tariq Boughididah, and Mohamed Abukhashem, and Ayiman Alhashimi, and Samer Khel, and Rawanda Gaffaz, and Najah Ben Saleim, and Sumayyah Bahroun, and Abdelmunam Elharb, and Mohamed Eisay, and Nafati Alnafati, and Bushray Almiqlash, and Marwa Biala, and Esra Alghanai
University of Tripoli, Tripoli, Libya. Electronic address: Muhammed.elhadi.uot@gmail.com.

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. 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. 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. 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.

UI MeSH Term Description Entries
D007362 Intensive Care Units Hospital units providing continuous surveillance and care to acutely ill patients. ICU Intensive Care Units,Intensive Care Unit,Unit, Intensive Care
D008002 Libya A country in northern Africa, bordering the Mediterranean Sea, between Egypt, Tunisia, and Algeria, having southern border with Chad, Niger, and Sudan. Its capital is Tripoli.
D011024 Pneumonia, Viral Inflammation of the lung parenchyma that is caused by a viral infection. Pneumonias, Viral,Viral Pneumonia,Viral Pneumonias
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D012122 Ventilators, Mechanical Mechanical devices used to produce or assist pulmonary ventilation. Mechanical Ventilator,Mechanical Ventilators,Respirators,Ventilators, Pulmonary,Pulmonary Ventilator,Pulmonary Ventilators,Ventilator, Pulmonary,Ventilators,Respirator,Ventilator,Ventilator, Mechanical
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D003695 Delivery of Health Care The concept concerned with all aspects of providing and distributing health services to a patient population. Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D006268 Health Facilities Institutions which provide medical or health-related services. Facilities, Health,Facility, Health,Health Facility
D006282 Health Personnel Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976) Health Care Professionals,Health Care Providers,Healthcare Providers,Healthcare Workers,Health Care Professional,Health Care Provider,Healthcare Provider,Healthcare Worker,Personnel, Health,Professional, Health Care,Provider, Health Care,Provider, Healthcare
D006295 Health Resources Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services. Resources,Health Resource,Resource,Resource, Health,Resources, Health

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