Mumbai: Only 43 ICU, 19 ventilator beds are vacant

Even as the city inches towards near-complete utilisation of Intensive Care Unit (ICU) beds and ventilator beds – on Sunday, there were only 43 and 19 vacant according to the municipal authority’s dashboard – the 24 war rooms, set up during the first wave of the pandemic to ensure decentralised distribution of beds, are also finding it difficult to cope with the surge in requests

Even as the city inches towards near-complete utilisation of Intensive Care Unit (ICU) beds and ventilator beds – on Sunday, there were only 43 and 19 vacant according to the municipal authority’s dashboard – the 24 war rooms, set up during the first wave of the pandemic to ensure decentralised distribution of beds, are also finding it difficult to cope with the surge in requests.

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HT called the helplines of all war rooms, set up to manage 24 wards together, and found that while citizens living in the eastern suburbs and those in south and central Mumbai could connect easily with representatives of their war rooms, the numbers of control rooms in the western suburbs were either busy or went unanswered in the western suburbs.

To be sure, a surge in cases (Mumbai recorded 8,468 on Sunday) and fast depleting beds (of the 20,608 hospital beds, 17,005 are occupied) have made it difficult for war rooms to allocate beds. To add to this, the city is also facing a shortage of oxygen – the Brihanmumbai Municipal Corporation (BMC) on Saturday shifted 168 patients out of six hospitals to jumbo Covid centres due to the unavailability of medical-grade oxygen needed to treat critical patients.

Yet citizens around the city have complained of their inability to get through the helplines; many have also said that they have had to wait for at least 24 hours to get a bed for critical patients.

“The problems encountered with ward war control rooms are also being looked into. Considering suddenly there is a surge in cases and the staff is also getting adapted with the changes. We are making all efforts to ensure that every citizen gets a bed,” Suresh Kakani, additional municipal commissioner, said.

The BMC set up 24 war rooms set up at various wards in Mumbai last May as a decentralised bed management system; each is headed by an assistant commissioner who takes decisions related to the hospitals and Covid centres, ventilators and beds; and residents are required to call the helpline number if they require a bed.

On March 30, as the daily caseload began to rise rapidly, BMC commissioner IS Chahal issued an order reiterating that all hospital admissions should be routed through the ward level war rooms to avoid the chaos experienced during the first wave when several patients ran from the pillar to post to get a bed.

No direct admission in any Covid Care Centre or private hospitals would be permitted without prior intimation to the ward war room. The order also stated that 80% of the total beds and 100% of ICU beds in private hospitals shall be kept reserved only for the allotment through the ward war rooms for Covid-19 patients.

“We have faced some difficulties recently in finding a ventilator bed for patients, or an ICU bed. If BMC beds are fully occupied, we start calling private hospitals to check if beds are available in the 20% quota of reserved private beds. We then inform the patient of this availability and ask them if they can pay,” a war room official said, on condition of anonymity.

At present, the city has 10,227 oxygen beds (661 are vacant), 2,765 ICU beds, and 1,415 ventilator beds.

War room officials have admitted that there are delays of a few hours in allotting ventilator and ICU beds to covid-19 patients, due to the rise in cases. They said it was easier to allot beds to asymptomatic patients in quarantine centres, or to mild symptomatic patients who do not need ICU and ventilator beds.

A spokesperson from Dr LH Hiranandani Hospital, Powai, said, “For the past month, all Covid-19 beds in our hospital are occupied. While 80% of them are allotted by BMC’s war room itself, we frequently receive requests from the war room to check availability in 20% beds also. We also directly receive calls from patients to check if beds in this quota are available.”

Citizens have complained that beds allotted by the control room in a private hospital end up being occupied after reaching the site.

Vile Parle resident Nita Gupta said, “It took me around two days to get my 73-year-old father admitted to a hospital. He has multiple comorbidities, and his symptoms included high fever, shivering, weakness and dipping oxygen. But we did not get a bed for 24 hours. Later, on the second day, we got allotted a bed, but when we called the hospital, they said they do not have any bed. It was finally on Friday afternoon that my father could get a bed. I hope we have not lost crucial time. The system should be such that citizens are allotted beds within hours of reporting. We do not want patients to die because they did not get any treatment or bed.”

Each morning at 4 am, officials at a war room receive a list of Covid-19 positive patients, along with their reports on email. Within two hours, operators at the ward war rooms begin to call patients: they enquire about the severity of symptoms to check if beds need to be allotted, or whether the patient needs to be shifted to a quarantine centre. Each war room has close to 40 officials who work in three, eight-hour-long shifts.

The doctors appointed at the war room decide whether an oxygen bed, ICU bed, ventilator bed or a normal hospital bed is to be allotted to the patient. Once a bed is assigned against a patient’s name in the system, an ambulance from the ward is dispatched. While every call lasts for about 10 minutes, it can take over an hour to dispatch an ambulance to the patient’s home, a ward official said.

“We are getting calls from around 500 to 600 patients daily requesting us to arrange beds for them,” Ruben Mascarenhas, national secretary from Aam Aadmi Party Mumbai, said.

A BMC official said, “The allocation at ward war control room is done based on severity and there is no scope of leaving any patient without a bed. Also, helplines may be difficult to be in touch with considering western suburbs also have the highest case-load of active cases due to which helplines are busier there than compared to other parts of the city.”