Doctors in a COVID-19 hospital are using ventilators for their patients with caution as they believe the use of the machine, while helpful, can also cause life-threatening issues for those suffering from the coronavirus.

The Afghan-Japan Hospital in Kabul has seven ventilators, one of which is not functional. There are three doctors who are qualified to use the machines. On Tuesday, four patients were breathing with the help of these ventilators at the hospital, according to TOLOnews reporter Anisa Shaheed.

Doctors said that out of 14 patients in the emergency ward, two of them need ventilators, but their families have yet to decide whether to use the machines for them as there are doubts about their effectiveness. 

The doctors said they are using CPAP (Continuous Positive Airway Pressure) machines for their patients but the hospital has only two of them. One of these machines has been donated by a recovered patient, said the doctors.

A ventilator aids a patient who has complete respiratory failure--while a CPAP helps maintain air pressure to keep the airway open for the patient. 

Internationally, particularly in the US, the use of CPAPs have been discouraged because it spreads the virus in the air. NPR in the US reported in March that the American Society of Anesthesiologists issued guidance on Feb. 23 discouraging CPAP use in COVID-19 patients because of experience with the SARS epidemic in 2003. "Studies dating to 2003 suggest that such devices can pump viruses into the air, potentially increasing the spread of a contagious disease," said the NPR report.

“Ventilators are for last resort. We are using them (ventilators) as we have no other option because we have two only CPAC machines. The procurement for (CPAP) machines has been requested, according to officials, but it has not reached us, after three months,” said Jawad Nawrozi, head of the hospital. “There is a lack of the (CPAP) machines, not only here but all over Afghanistan.”

According to Nawrozi, the use of ventilators is “dangerous” for patients and says only two out of 15 patients for whom ventilators were used have recovered over the last two and a half months in the Afghan-Japan Hospital, according to a doctor. The Afghan-Japan is one of the two main centers in Kabul for the treatment of COVID-19 patients.

He said two patients who were attached to the ventilators lost their lives two days ago.

“It (the use of ventilators) is not a simple process. It has its dangers. Unfortunately, some of our patients go unconscious as it causes cardiac arrest. We explain all these threats to relatives of patients (before using the ventilators). After that we write it and get their signature,” he said.  

The price of the CPAP machines, Nawrozi said, is less than $1,000 and they are in dire need of these devices.