9 districts with high case loads lack adequate facilities: Centre
The total Covid positive cases in these 23 districts on Tuesday were 19,254 on Tuesday, about 62% of the total 31,329 positives cases in the country.Updated: Apr 30, 2020, 01:48 IST
A document created by the health ministry and shared with states and union territories on Wednesday caused a flutter after it was circulated on social media and showed that nine of the 23 districts with a high load of Covid-19 cases don’t have enough health facilities to cope with the projected number of cases on May 15.
While officials from at least four states confirmed the existence of such a document and said it was mainly about the caseloads , health ministry spokesperson Manisha Verma clarified in a statement that the document was “an exercise to tell states to be regular with uploading information on case numbers, health infrastructure, manpower, etc. ... so that it shows on the central database in real-time.”
She further added that the document was “not reflective of the actual situation on the ground, in terms of cases vs beds, ventilators, doctors, etc,” and that the document “was created for internal discussion and not meant to be a public document as this doesn’t portray the real picture. “
That doesn’t appear to be the impression the states walked away with, though . One senior health official from a large state said on condition of anonymity that the presentation was to get the states to do more to control the pandemic and to highlight districts where the most pressing challenges would likely be faced in terms of medical infrastructure.
“Luckily, we don’t have any district in Punjab in this list as of now. But, to use the old adage, forewarned is forearmed,” said Punjab’s special chief secretary, SBS Sidhu.
The total Covid positive cases in these 23 districts on Tuesday were 19,254 on Tuesday, about 62% of the total 31,329 positives cases in the country. By May 15, the health ministry has projected that the total cases with the current rate of growth will increase to 80,210. However, health ministry spokesperson Verma underplayed the accuracy of the numbers and said “the number crunching was done internally just to get a sense of the situation” and that “it doesn’t mean these will be the actual numbers”.
However, what’s probably more important is that the document points out the expected shortages of isolation beds with oxygen, intensive care unit beds and ventilator facilities on specific dates for each of these cities.
“The projections have been based of the weekly increase in cases in these districts since April 9. The calculation is based on slowing down of the doubling rate in these districts,” a government functionary, who was not willing to be named, said. He said the projection on gaps in health infrastructure was derived from state health department’s daily report on Covid infrastructure.
The presentation named Case Load and Infra Gap Analysis showed that Mumbai and its suburban areas, Indore, Surat, Chennai, Krishna, Kanpur Nagar, Kasaragod, Agra and Kolkata are expected to see shortage in health infrastructure between April 27 and May 15, if the Covid cases increased as per the projection.
The 28-page presentation was sent to the states a day after the Indian Council of Medical Research (ICMR) revised its guidelines saying the asymptomatic patients should be put in home quarantine, thereby creating more space for symptomatic and more serious patients in hospitals.
Mumbai, which has the highest number of Covid-19 patients, could fall short isolation beds with oxygen supply by May 11, the projection said. With the spike in the cases, Mumbai would be short of 421 ventilators and Pune will be short of 40 ventilators by May 11. Besides, Mumbai will be short of 20,462 isolation beds with oxygen.
The state health department, however, dismissed the projection and said that multiple mathematical models have given various projections and said that it is basing its plans on “realistic” assessment.
State health minister Rajesh Tope said that the state may plan to shift asymptomatic patients in Mumbai into home quarantine as per the revised guidelines of the Indian Council of Medical Research (ICMR).
“It is being said that beds aren’t available in Mumbai; there have been no such complaints. As per the new guidelines of the ICMR, asymptomatic patients can be kept into home quarantine. In Mumbai, 83% of patients are asymptomatic, it may be possible to shift some of them who are not that severe into home quarantine. Those beds would be made available for more serious patients,” he said.
The officials in Pune, where the ministry projected that there can be shortage of ventilators by May 11, said they were working hard to ensure adequate health facilities. Pune’s divisional commissioner, Deepak Mhaisekar, said, “If the present Covid condition of the Pune city worsens I will urge private hospitals to come forward and help. I can assure private hospitals that the administration will support them. We are facing shortage of health workers”
A Madhya Pradesh government official said there was no reason to get scared as health facilities in Indore were being ramped up. “In Indore, we have 4704 isolation beds with 200 ICU beds and availability of 65 ventilators,” the official, who was not willing to be named, said. The health ministry presentation said that with cases in Indore likely to double by May 15 from present 1,208, there would be shortage of isolation beds. “Only 32% of the isolation beds are occupied (now). We have informed the health ministry about it,” said the official.
According to Dr Ram Gopalakrishnan, an infectious disease specialist at Apollo Hospital who is part of a committee of healthcare and medical experts that consults with the Tamil Nadu government, the state needs more Covid-19 centres to deal with the rise in cases. According to the document, Chennai which has a current case load of 496 (as of April 28) and projected case load of 4141 on May 15 may face shortage of ‘Isolation Beds by May 11.
Andhra Pradesh special chief secretary (medical and health) K S Jawahar Reddy said all major government hospitals in the state are fully equipped and if required, the government would take over all the private super specialty hospitals in the state for treating Covid-19 patients.
Telangana health minister Eatala Rajender said the number of positive cases in the state would almost become negligible by first week of May as per the health ministry’s projections. Responding to the ministry’s document, Rajasthan health minister Raghu Sharma said the state has made adequate arrangements for equipment and protective gear in view of the COVID-19 outbreak. “I have asked for 1500 more ventilators for the state at a video conferencing with union health minister (Harsh Vardhan),” he said.
(With inputs from Sowmiya Ashok in Chennai, Swapnil Rawal in Mumbai, Urvashi Dev Rawal in Jaipur, Ranjan in Bhopal)