Delhi govt reverses decision to turn nursing homes into Covid-19 facilities

Experts and nursing home owners have argued that the decision would not have helped in handling the Covid crisis and taken away an emergency lifeline for the people in the local neighbourhoods.

Within 24 hours of issuing an order that mandated all nursing homes in the city to start treating coronavirus disease (Covid-19) patients, the Delhi government on Sunday scrapped it after it met with stiff resistance from the medical fraternity.

Health workers seen in PPE kits outside COVID ward, at Ganga Ram Hospital, in New Delhi, India. (Sanchit Khanna/HT PHOTO)

“The competent authority has directed that order… by medical superintendent nursing homes to keepers of all nursing homes… having bed strength between 10 beds to 49 beds declaring them as Covid nursing homes has been withdrawn with immediate effect…” says Delhi government’s revised order issued on Sunday.

Experts and nursing home owners have argued that the decision would not have helped in handling the Covid crisis and taken away an emergency lifeline for the people in the local neighbourhoods.

Most small nursing home owners had found the decision flawed on many counts, and believed it would have worsened the situation rather than providing relief to the people. Many of these facilities, which work with bare minimum staff, are the lifeline for local neighbourhoods. By taking away that lifeline government was leaving people with no option for emergency non-Covid care in this pandemic, nursing home owners had argued.

Lack of adequate infrastructure

Smaller private hospitals or nursing homes that have less than 30 beds that are meant to handle basic health conditions and minor surgeries. Handling rush of patients suffering from a virulent pandemic was not possible in a small set-up, many said. Complying with the requirements for treatment of Covid-19 such as separate entry and exit, and triaging facility, and enforcing overall social distancing norms, is not possible with the limited infrastructure that they have.

“Most of these hospitals are non-Covid hospitals located in residential areas. The move could have led to spread of disease in the particular colony where the facility was located, and would have been a big risk factor for community transmission in the long run,” says Dr Naresh Chawla, former president, Delhi Medical Association (DMA).

Lack of adequate testing capacity

None of these small clinics have their own testing labs or investigative tools to quickly ascertain the rapidly changing vital parameters of Covid19 patients. All of these hospitals would have been outsourcing samples for testing, especially Covid-19 testing, that would have significantly increased the turnaround time for reports.

“We are just economically viable as we aren’t big, money making corporate hospitals, we would have been left with no option but to shut shop,” said a private hospital owner who did not wish to be identified.

Loss of options for non-Covid patients

With most big hospitals having been turned into Covid hospitals, the smaller ones are where many patients were turning to for routine medical and emergency care. The presence of Covid-19 patients, most felt, would act as a deterrent for non-Covid patients suffering from heart, kidney, or other ailments, and requiring procedures such as gallstone or appendix removal, to approach these nursing homes.

There are about 700 nursing homes in the city, most of which have around 20 beds, according to estimates by the Delhi Medical Association.

“Where would have the non-Covid patients gone since many big hospitals were already treating Covid patients. There should be an option for other patients also. This was not the right move by the Delhi government, and I was sure they would reverse it,” Dr Chawla added.