Spike in Covid cases bares gaps in Delhi, Mumbai critical care infra

Industry says govt makeshift facilities lie vacant as patients scramble for private hospital beds

Covid-19 cases in Delhi and Mumbai, after having relented, are rising again and, with the increase, has returned the wait for critical care beds.

Industry insiders say while many makeshift facilities are empty and most government hospitals are reporting spare capacity, people are crowding private hospitals.

Last week, the Delhi government ordered 33 hospitals to reserve more ICU beds for Covid patients. It asked 28 of these to reserve 80 per cent of their ICU beds for them while the remaining five were declared dedicated Covid hospitals. While the Delhi government’s move has been criticised for putting non-covid patients at risk, Mumbai is reaching out to clinicians in leading private hospitals to guide the government makeshift set-ups.

The Municipal Corporation of Greater Mumbai (Brihanmumbai Municipal Corporation or BMC) has roped in 35 leading doctors from top city hospitals to monitor cases and guide doctors in Covid care centres through telemedicine.

According to the Delhi government data, more than half of its 14,409 beds for Covid patients are lying vacant and nearly three-fourth beds in Covid health centres are occupied.

Around 91 per cent of ICU beds in private hospitals in Mumbai are occupied. Mumbai currently has a capacity of 1,732 ICU beds. On September 15, only 141 were available. The scramble for beds with ventilators is worse — only 67 are available.

The administrator of a private hospital in Mumbai said the bed crisis was a myth. Influential people are booking beds in private hospitals, even if they do not need hospitalisation, he said.

“Many are mildly symptomatic or even asymptomatic. But the moment they get a Covid-19-positive report, they panic and admit themselves into leading private hospitals.”

Meanwhile, big facilities, which include ICU beds created by the BMC, are lying vacant, even though the local authorities have said treatment in such hospitals is as good as any private hospital.

The BMC is now racing to add another 250 ICU beds by the end of this week. The Defence Research and Development Organisation (DRDO) is operating a similar facility with 1,000 beds, 250 of which have ICU and ventilator facilities. The makeshift hospital, set up within 12 days, is providing treatment free of cost to patients and has vacant capacity. The DRDO has not received any direction yet for further increasing hospital infrastructure.

Delhi’s largest Covid-dedicated hospital, Lok Nayak Jai Prakash Narayan

Hospital (LNJP Hospital), which has 255 ICU beds in its 2,010-bed facility, has been asked to add another 245 ICU beds. With more than half its capacity lying unoccupied, LNJP Hospital has asked the government to help in increasing manpower.

“We need anaesthetists, technicians, and people for ICUS, even if they can be hired temporarily... Because of the increase in cases, other hospitals are referring patients to us. But compared with June, we are prepared now to handle them,” said Ritu Saxena, chief medical officer, LNJP Hospital.

Private hospitals in Mumbai, in a meeting with the BMC, had anticipated a potential increase in cases three weeks ago. “We had then estimated the daily new cases can mount to 3,000 or so. Thankfully, they are still below that,” said Joy Chakraborty, chief operating officer, Hinduja Hospital in Mumbai.

Chakraborty attributed the rise in cases to Ganpati festivities. Towards the end of August, the daily numbers had dropped below 1,000 and climbed to 2,200 in September.

While the government has attributed the higher cases to increased testing, experts say a fatigue with the rules, lack of compliance with social distancing, and not wearing the mask have caused the spike in cases, especially in Delhi, where the number of daily cases, after dropping to fewer than 1,000 in July, is more than 4,000 now. A senior doctor said that footfall for Covid had gone up significantly.

“ICU beds are not available in our hospital. As soon as one vacates, we get another patient,” said Rajesh Chawla, senior consultant (respiratory medicine), Indraprastha Apollo Hospitals in Delhi.

Hospitals are now resorting to improve patient management.

“If members of the same family are admitted, we try to accommodate them in one room. Since we are present across the entire spectrum of Covid management — from homecare to testing to critical care — we also see who can be monitored at home. If needed, then they are taken in,” said S Narayani, zonal director, Fortis Hospitals, Mumbai.