The move to augment hospital bed capacity came as Delhi experienced a record surge in confirmed infections. The capital on Wednesday added 4,473 new cases of Covid-19 — the highest single-day spike in the city.(Reuters Photo)
The move to augment hospital bed capacity came as Delhi experienced a record surge in confirmed infections. The capital on Wednesday added 4,473 new cases of Covid-19 — the highest single-day spike in the city.(Reuters Photo)

Can’t reserve 80% ICU beds for Covid-19 patients: Private hospitals

“We will be filing a motion in the high court for striking down this order. We have already given a representation to the Delhi government as well as the Union health minister,” Girdhar Gyani, director general of the Association of Healthcare Providers (India).
Hindustan Times, New Delhi | By Anonna Dutt
UPDATED ON SEP 17, 2020 01:54 AM IST

Three days after the Delhi government asked 33 big private hospitals to reserve 80% of their total intensive care unit (ICU) beds for coronavirus disease (Covid-19) patients amid a surge in the number of infections, an association of healthcare providers said on Wednesday that it would challenge the order in the high court.

“We will be filing a motion in the high court for striking down this order. We have already given a representation to the Delhi government as well as the Union health minister,” Girdhar Gyani, director general of the Association of Healthcare Providers (India).

“The order was suddenly given without any consultation with the private healthcare providers or even warning them beforehand,” Gyani said.

On Sunday, Delhi health minister Satyendar Jain said the government of the city-state had ordered all Covid-19 hospitals in the city to increase their bed capacity by 30%, and 33 major private hospitals to reserve 80% of their total ICU beds for patients of the viral infection.

The move to augment hospital bed capacity came as Delhi experienced a record surge in confirmed infections. The capital on Wednesday added 4,473 new cases of Covid-19 — the highest single-day spike in the city.

Delhi government did not comment on the issue, despite repeated attempts.

Gyani said hospital bed occupancy, which was just 20-25% in April and May, has risen recently almost 90% because patients who were suffering from other ailments had got themselves admitted for treatment of surgeries that they had delayed for fear of catching Covid-19.

Also read| Increase number of RT-PCR tests: Delhi High Court to Govt

Gyani said, “These are the biggest hospitals in the city that specialise in surgeries like transplants; these patients have waited long enough. Also, in a big hospital 20 to 30% admission happens from the emergency department. Just because Covid-19 patients are there, the {victims of} road accidents, trauma cases, {people with} heart attacks and stroke will not stop coming in.”

Staff shortage

A shortage of trained staff is the major hurdle for hospitals – both government and private – that have been asked to scale up their intensive care unit capacity for treatment of patients with the coronavirus disease (Covid-19). With the number of new cases and hospitalisations on the rise, hospitals across the city have started running out of ICU beds.

“One, it will be difficult to increase the number of ICU beds. And, even if the hospital purchases everything needed to scale up the capacity, where will we find the intensivists and trained nurses needed to run these ICU beds?. Plus, the Covid-19 ICU needs at least 2.5 times the staff in a normal ICU,” said a representative of one of the biggest private hospitals in the city, requesting anonymity.

Around 36.6% of the total ICU beds earmarked for the treatment of Covid-19 patients in all hospitals were vacant as of Wednesday evening, according to data from the Delhi Corona app.

With private hospitals handling a disproportionately large number of Covid-19 patients, the Delhi government chose to enlist the 33 biggest facilities in ramping up ICU bed capacity for people with the infection. 88% of the total ICU beds in 11 off the 33 big private hospitals are already occupied, according to data from the Delhi Corona app.

Sir Ganga Ram Hospital, one of the 33 that has been directed to reserve beds, already has a high percentage of beds reserved for Covid-19 patients; the problem is the absence of trained staff, hospital authorities said.

Hiring more

“We had been asked to create a 100-bed ICU initially when we had met the health minister even before the June surge. So, we have been slowly able to ramp up our capacity. Now, we have 117 of 167 beds reserved for Covid-19 patients, but with almost all big hospitals doing so there will be a problem for non-Covid patients. For us, the challenge will be manpower; more staff is needed for Covid-19 ICUs so we are in the process of hiring more nurses,” said Dr DS Rana, chairperson of the board of governors at the hospital.

A person aware of the situation at Indraprastha Apollo Hospital, another of the hospitals that have been asked to increase Covid-19 ICU beds, said: “We have already started the transition; however, reaching the capacity will take some time as our ICU beds continue to be full.”

Government hospitals have their share of worries, too.

“The 300 ICU beds are not really ICU beds, they are just ventilators that have been installed in various wards and are managed by doctors who have no clinical expertise in doing so. There are only about 50 actual ICU beds managed by trained resident doctors,” said a doctor at the hospital.

“There are just 33 resident doctors in the anaesthesia department who are currently managing the ICUs, going in for surgeries, as well as managing the OT{operating room} in our civil lines trauma centre,” said a doctor at the hospital.

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