20% beds in 117 private hospitals to be reserved for Covid-19 surge
The capital has 117 private hospitals that will be covered by this rule, which officials said was necessitated because dedicated privately run Covid hospitals were now running close to their capacity.Updated: May 25, 2020 00:08 IST
Private hospitals with 50 or more beds will need to set aside 20% of their bed strength for Covid-19 patients, the Delhi government ordered on Sunday in a measure meant to prepare the city’s health care system for a surge in infections.
The capital has 117 private hospitals that will be covered by this rule, which officials said was necessitated because dedicated privately run Covid hospitals were now running close to their capacity.
In exchange, the government has allowed these hospitals to add 25% more beds by invoking the natural calamity or disaster clause in the Delhi Nursing Home Rules 2011.
Delhi reported 508 new Covid-19 cases on Sunday, taking the count to 13,418. According to the health bulletin, 30 more deaths were added to the death toll that now stands at 261.The new deaths appeared to have taken place more than 24 hours ago and added to the Covid fatality tally after reviews.
“It has been found that in the recent past majority of the beds earmarked for Covid-19 patients in dedicated private hospitals are occupied at any given time. Therefore, there is a need to increase the number of beds dedicated for Covid-19 patients in the private hospitals in the city,” the order, issued by director general of health services Dr Nutan Mundeja, said.
The 117 hospitals will be allowed to bill Covid-19 patients as per their rates. But for the extra 25% beds allowed, they can charge non-Covid-19 patients only 50% of the treatment cost in the most economic category.
“The billing of non-Covid patients admitted on extra beds shall not be more than 50% of the lowest economy category of the concerned hospital as per earlier practice during upsurge of cases of vector-borne diseases,” the order read.
During the 2015 dengue outbreak in the city, when almost 16,000 were infected and 60 people died, the Delhi government had in a similar manner asked private hospitals to reserve beds for the treatment of dengue patients.
“An increase in the number of cases in the city is likely, but even if there is a surge, the administration and the health teams in Delhi are prepared to handle it,” said Dr SK Sarin, director of Institute of Liver and Biliary Sciences and chairperson of a five-member committee set up by the government in March to guide the chief minister on preparedness measures.
Reacting to the government directive, Dr Sanjay Mehta,head of medical services, BLK Super Specialty Hospital, said there was no question of not abiding by it.
“I haven’t seen the order yet but if there is a directive we will abide by it. Even though we are not a dedicated Covid hospital but as a responsible organisation, we have taken steps keeping patient and staff safety in mind such as first-level triaging, separate wards for clinically suspect cases, etc. 20% is a huge number so we will have to arrange for manpower, etc., as you cannot mix the staff, which can be harmful for patient safety,” he said.
While large hospitals are expected to cope with the rule, it could lead to feasibility concerns for smaller ones if they were to spare beds from their existing strength.
“My hospital primarily offers cardiac services, and at any given time my bed capacity is 90% filled with serious cardiac patients who cannot be discharged unless fully recovered. Currently, you cannot even refer these patients anywhere as not many hospitals would be open to taking patients from other hospitals. In such a scenario, taking out 20% of my 106 beds will be difficult. It’s not that I don’t want to help the government but there’s genuine problem,” says Dr RN Kalra, medical director, Kalra Hospital.
“Delhi government is working on adding more beds in the private sector next week,” said a senior official from Delhi’s health department.
Eight private hospitals with a capacity of 617 beds are presently treating Covid-19 patients. Of these, Indraprastha Apollo Hospital in Jasola is at full capacity of 81 patients, according to government data.
Another four of the eight hospitals, Max Smart Super-Specialty hospital in Saket, Maha Durga Charitable hospital in Model town, Fortis Shalimar Bagh and Sir Ganga Ram City hospital in Rajinder Nagar have been running at 80% capacity.
Only the recently added Cygnus hospital was at 20% occupancy, Delhi’s daily health bulletin shows, but the hospital was shut down on Saturday and the patients evacuated after a fire broke out.
Two other hospitals – Saroj hospital in Rohini and Khushi hospital in Dwarka – with 100 beds in total, have been designated as a Covid-19 hospitals by the Delhi government and are yet to start accepting patients, as they have only recently been designated.
Apart from private ones, two Delhi government and four central government hospitals have a bed capacity scalable up to almost 4,000 beds. These hospitals on an average are running at 44% capacity, according to the data.
The All India Institute of Medical Sciences (AIIMS) is running at about 85% capacity of around 600 beds that are presently operational, but is in the process of adding another 200 beds. “The hospital has about 500 patients and space for another 100 or so. But the capacity can be scaled up to 800 beds,” said Dr DK Sharma, medical superintendent, AIIMS.
Lok Nayak, which has reserved all of its 2,000 beds for Covid-19 patients, has the highest bed capacity in a government hospital. At present, 536 people are admitted, meaning it is running at almost 27% capacity.
“In March, when one of the first cases in the city was reported, nobody thought so many people would get infected. And, now with the lockdown being eased, people are on the streets, markets are open and the number of cases is likely to go up. However, even if there is a surge, the cases can be managed well if the government and the private sector work together,” said Dr GC Khilnani, chairman of PSRI Institute of Pulmonary and Critical care in New Delhi and former head of pulmonology at AIIMS.