DMA writes to Delhi govt to issue protocols and appoint nodal officer for better coordination
The Delhi Medical Association (DMA) has written to the Delhi government demanding the appointment of a nodal officer, and standard protocols to ensure coordination between the government and the 117 private nursing homes and hospitals that were roped in to treat Covid-19 patients.
The government had last week ordered these institutes with a minimum bed capacity of 50 to reserve 20% of beds for Covid-19 patients and 70 had complied, according to an official.
In the letter to Delhi chief minister Arvind Kejriwal on May 26, DMA’s Nursing Homes and Medical Establishment Forum (NH and MEF) wing wrote that serious Covid-19 cases admitted in nursing homes will need to be treated in tertiary care centres.
Dr. Ajay Bedi, honorary secretary of DMA’s NH and MEF wing, said, “In such a case, the patient needs to be shifted and for this there has to be a nodal officer whom we can call. This officer should be responsible for arranging the bed for the transfer to higher tertiary care facilities and transportation in case of death.”
They also demanded that the doctors and paramedical staff at these facilities be covered under the state government’s insurance scheme for healthcare workers.
The DMA highlighted the difficulty in segregating Covid and non-Covid patients, and also staff shortage in such institutions.
“We are as it is functioning only with just over half our staff strength as the rest live far away and cannot report for duty without public transport. For Covid-19, we will have to keep dedicated staff as we will have to reserve 24 beds. We don’t know how we will manage it,” said the medical director of a 120-bedded hospital in West Delhi, requesting anonymity.
Many of the designated Covid-19 hospitals in the private sector are on the brink of reaching capacity. The number of cases have been increasing in the city in the last few days, with over 1,000 new cases being reported for four days in a row on Sunday.
The Association of Healthcare Providers (India) -- which has at least 10,000 member hospitals across the country -- had also raised concerns over several smaller medical institutions finding it difficult to conform to the strict guidelines issued in the matter by the Delhi government.
“It is difficult for smaller hospitals to completely separate the Covid and non-Covid areas, have separate entrances or stringently implement the standard operating procedures by the health ministry to prevent the spread of the infection,” said Giridhar Gyani, director-general, Association of Healthcare Providers (India). “We suggest that the government could designate two or three hospitals entirely in each district to get the same number of beds.”
Dr. PK Bhardwaj, secretary, Delhi Voluntary Hospital Forum, an association of major hospitals in the city, said: “Many hospitals that were constructed more than 10 years ago do not have planned isolation areas. This means that the air conditioning system and the gas pipeline is shared throughout the hospital. Now, this pipeline is also used for suction of fluids that go into a central repository, this can lead to further spread of the infection within the hospitals.”
When contacted, a senior Delhi government official aware of the development said, “The government is working on protocols for these hospitals. It will have details about what kind of arrangements have to be made at these hospitals. We are making all the possible arrangements to ensure people don’t face any kind of difficulty.”
On designating hospitals to treat Covid-19 patients, another senior government official said, “We would have preferred to designate full hospitals en-bloc to treat the rising cases, but hospitals did not come forward for that.”
Dr. Jugal Kishore, head of the department community medicine at Safdarjung Hospital, said, “This is the time when all medical institutions should pitch-in. As far as appointing a nodal officer is concerned, the government should appoint area-wise nodal officers for better coordination between various hospitals. The number of ventilator-beds available should be accessible to all.”