Delhi hospitals treating Covid patients told to reserve more beds

Delhi chief minister Arvind Kejriwal on Thursday also urged hospitals to delay all non-critical and routine surgeries and procedures for the time being to free up beds.

The Delhi government has ordered 42 private hospitals to reserve 80% of their total intensive care unit (ICU) for high-dependence unit beds for the treatment of coronavirus disease (Covid-19) patients -- which would add 249 ICU beds to the present strength of 3,700.

On November 6, the government had ordered 14 private hospitals to allocate 50% of their bed strength for treating Covid-19 patients, adding 685 beds to the city’s total bed strength. (Biplov Bhuyan/HT Photo)

In another order, the government told 90 private hospitals to reserve 60%, instead of 50%, of their total beds for Covid-19, which will add 2,644 beds to the nearly 17,000 beds earmarked for Covid-19 treatment.

“In the last fortnight, there has been an unprecedented surge in the number of clinically severe Covid cases, having less than 90% oxygen saturation at the time of arrival to the hospital, requiring intensive care. The hospitals listed are directed to reserve 80% of their total ICU/HDU bed capacity for treatment of Covid-19 patients with immediate effect,” read one of the two orders issued by Dr RN Das, medical superintendent of Nursing homes in Delhi.

Delhi chief minister Arvind Kejriwal on Thursday also urged hospitals to delay all non-critical and routine surgeries and procedures for the time being to free up beds.

“Last week, after the court allowed us, 80% ICU beds were reserved in 33 private hospitals. Now, this will be implemented across all hospitals in Delhi to increase the number of ICU beds further by 300-400. Along with that, we had asked private hospitals to reserve 50% beds, which will be increased to 60% for some days,” he said.

On November 6, the government had ordered 14 private hospitals to allocate 50% of their bed strength for treating Covid-19 patients, adding 685 beds to the city’s total bed strength.

Routine surgeries had been pushed my all hospitals when the country went into a lockdown in March. Only emergency surgeries and surgeries for diseases such as cancer were being performed. Routine surgeries were slowly resumed after the unlock started in June.

The government had ordered 11 of its own hospitals to increase its ICU capacity – with and without ventilators – by 663.

“Yesterday, the Delhi government ordered its hospitals to add 663 ICU beds, the Centre has also promised us 750 ICU beds. In total, about 1,413 more ICU beds will be available in Delhi in the next few days,” Kejriwal said.

The Defence Research and Development Organisation (DRDO), which started a makeshift Covid-19 hospital in Dhaula Kuan at the Centre’s behest, said in a tweet on Thursday, “ICU beds in SVBP (Sardar Vallabh Bhai Patel) Covid hospital made by DRDO are increased to 500 and additionally ICU monitors, HFNC (high flow nasal cannula needed for non-invasive ventilation) are being provided. Existing oxygen pipeline is upgraded. Medical professionals from CAPF’s ITBP and armed forces have flown in and joined the patient care.”

At present, 88% of the ICU beds in the city are occupied, shows the Delhi Corona app. About 56% non-ICU beds are also occupied.

The chief minister appreciated the efforts of doctors and staff in managing the pandemic. “New York had seen a peak on April 6. 6,353 cases were reported on that day and 575 people had died. The videos that had emerged showed patients in corridors; there were no beds available. Patients were waiting on the streets outside the hospitals, waiting for a bed. Bodies were dumped on one another. Such photographs emerged from Sweden, France, Italy as well. In Delhi, this is not the case, our doctors have managed the situation very well,” he said.

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“The government needs to take a holistic approach. If 80% ICU beds are reserved, what happens to patients with other ailments? Also, when there is such mixing of patients, it pushes those with ailments other than Covid-19 to not go to hospitals, aggravating their conditions and increasing both morbidity and mortality. But these deaths are not being counted. Second, how will a hospital reserve 80% beds in a 40-bed ICU, they can’t put up a wall all of a sudden. This can lead to cross-infection,” said Girdhar Gyani, director general of Association of Healthcare Providers (India), which had challenged Delhi government’s initial order of reserving 80%.

“Also, I think this high requirement for ICU is because in many places – especially tier 2 and 3 cities – the treatment protocols being followed is quite different and the patients need ICU care to recover. We also haven’t educated patients on when to come to a hospital or when to go to a Covid Care Centre. Till these issues are addressed, we will keep taking knee-jerk actions like this,” he said.

Later in the day, Kejriwal urged the central government to expedite the process of providing ICU beds in Delhi hospitals. “I request the central government to sent ICU beds at the earliest. We need them at this moment.”

After Sunday’s meeting with Union home minister Amit Shah, Kejriwal had said the Centre had assured 750 ICU beds for Delhi, of which 250 would be ready in two days. The beds are supposed to be added in the DRDO facility.