Cases on rise, govt reviews hospital admission criteria

nNEWDELHI: With almost 26% of all active Covid-19 cases in Delhi admitted to designated hospitals, the city government is reviewing the criteria for admissions, to ensure there are enough beds for severely ill patients. Delhi’s hospital admission rate is nearly four times the national average of 6.39%, according to the latest available figures, from last week.

In Delhi, 2.3% of the active cases are admitted to the intensive care units of the city and 0.36% on ventilators. This is lower than the national average of 3% in intensive and 0.45% on ventilators.

“The government is reviewing the admission criteria to ensure that there are beds available for the sick patients,” said a doctor aware of the matter.

Delhi recorded 1,024 new Covid-19 cases on Thursday alone.

According to Delhi’s guidelines, those with mild symptoms like fever and upper respiratory tract infection have to either be in home isolation or be admitted to Covid Care Centres if the former is not possible.

Those with moderate symptoms like high-grade fever, respiratory rate between 15 and 30 breaths per minute (normal is between 12 to 20 breaths per minute), or oxygen saturation between 90 and 94% (normal is 95 to 100%) have to be admitted to Covid Health Centres.

Those with severe symptoms — respiratory rate higher than 30 and oxygen saturation lower than 90% — have to be admitted to the dedicated hospitals.

Of the 8,470 active cases in Delhi, 2,196 are in hospital.

“Almost all of our beds are full. Now, when the number of cases go up with the easing of lockdown, we have to start discharging the mild cases to make space for those with severe symptoms,” said Dr Balvinder Singh, medical superintendent of Safdarjung hospital.

The designated private hospitals in the city are currently running at around 86% of their capacity on average, whereas government hospitals on average have utilised 61% of their capacity.

Around 50% of active cases in Delhi are in home isolation.

“We follow the criteria while referring patients to government sector hospitals or Covid Care Centres, but people can choose private hospitals, so even though many might not need admission they can get it,” said a district official, on condition of anonymity.

To cope with a potential surge in the number of cases, Delhi government has designated 1,500 beds to treat Covid-19 in Guru Teg Bahadur hospital. Another 2,000 paid beds have been added, by asking 117 private hospitals in the city to reserve 20% of its beds to treat Covid-19 patients.

“The number of admissions are driven up by people who do not have enough space at homes or live with the old and those with comorbidities and request to get admitted in the hospitals. This is mostly because they do not want to go to government isolation centres for mild cases,” said Dr Neeraj Gupta from the department of respiratory medicine at Safdarjung hospital.

“If there is a surge in the number of cases — which is now likely to happen — the services at the hospitals have to be optimised to admit only those with severe symptoms and other risk factors who actually need admission,” Gupta said.