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Hospitals brace for likely surge in coronavirus cases
New Delhi Union health minister Harsh Vardhan has directed all states to remain prepared for a likely surge in the cornovirus (Covid-19) cases by expanding quarantine
New Delhi Union health minister Harsh Vardhan has directed all states to remain prepared for a likely surge in the cornovirus (Covid-19) cases by expanding quarantine facilities and isolation wards, maintaining adequate stock of personal protective equipments such as masks and testing kits, among others.
All joint secretaries from the health ministry have been visiting states over the past three weeks to provide technical support to the governments and identify gaps in screening, quarantine facilities, testing mechanism and disease management.
All states have readied designated wards as isolation centres to manage critically ill patients who have tested positive. Intensive care beds and ventilators have also been kept on standby in the states for those people severely ill.
Government hospitals have also decided to cancel non-emergency surgeries in a bid to free up beds and manpower to enhance their “surge capacity” in case community transmission of Covid-19 happens and the number of cases goes up.
“A lot of work has been going on at AIIMS [All India Institute of Medical Sciences] for the last couple of weeks for surge capacity building. There is a plan in place on what we can do if there is community transmission and the number of cases go up in terms of infrastructure and manpower,” said Dr Randeep Guleria, head of the department of pulmonology and the director of AIIMS in New Delhi.
“For scaling up the facilities, we are considering stopping non-essential surgeries – for example, a gall bladder removal, which can wait. The resources would be focused on managing the outbreak if there is one. Cancelling such non-essential procedures will free up the wards as well as doctors and paramedical staff who can also help out if there are a large number of cases. We have also started training them on Covid-19, how to protect themselves and how to manage these patients,” said Dr Guleria.
“Such plans are being made by other hospitals, including private ones,” he said.
Hospitals across Delhi have about 180 functional isolation beds, and 240 more beds are on standby.
AIIMS has kept a 100-bed ward empty at its cancer centre in Jhajjar campus and an intensive care unit (ICU) ward will be set up in the under-construction burns and plastics building in Yusuf Sarai, if need be, according to news agencies. On Monday, the resident doctors at AIIMS wrote to the director pointing to a shortage of personal protective equipment.
Health infrastructure plays an important role in containing the spread of the disease, experts say, pointing out that the progression of Covid-19 will depend on where the outbreak happens. “If we talk of a surge in cases, the context matters. If there is a small spread it can be handled, but if there are several clustered cases in a day then it will become difficult for even the best systems in the world to handle it. Speaking of our health infrastructure, we get what we pay for and we are not spending enough. States like Bihar and UP, what health systems do they have? Where are the beds, where are the ventilators? All of that matters,” said former union health secretary K Sujatha Rao.
“How Covid-19 progresses will depend on where the outbreak happens -- it might happen only in a region like we have seen in other countries-- and the number of cases,” said Dr Guleria. Instead of only depending on the government to manage the crisis, individuals should make it their responsibility to flatten the curve or reduce the number of people who are infected at once, the doctor said.
“All of us have to be alert. Anyone who suspects they have Covid-19 should isolate himself. Wherever such patients visit the doctors must report the cases. There shouldn’t be a situation like in China or in Spain where the number of cases shot up suddenly. Where are the hospitals and all to admit them? Measures such as closing the cinemas and avoiding large gatherings can interrupt the transmission and slow down the spread of Covid-19. The transmission will still continue but there wouldn’t be for example 100 cases in a day. There will be 10 today and 10 the next day and so on and the system can cope with it,” said Rao.
