Mixing patients may worsen Covid-19 spread, warn private hospitals
The Delhi government had on Sunday directed 117 hospitals – with 50 beds or more – to reserve 20% space for coronavirus patients, to deal with the surge in Covid-19 cases.Updated: May 26, 2020 08:29 IST
Reserving beds for Covid-19 patients in hospitals treating people with other ailments might lead to a further spread of the infection, warned private hospitals and doctors, who are writing to the government to review its decision.
The Delhi government had on Sunday directed 117 hospitals – with 50 beds or more – to reserve 20% space for coronavirus patients, to deal with the surge in cases. This would have added around 2,000 beds for Covid-19 patients in private sector hospitals, apart from the 677 existing beds in 10 designated hospitals.
Delhi on Monday reported 635 more cases, taking the count to 14,053, the Delhi government’s daily bulletin reported. Fifteen deaths were reported, taking the tally to 276.
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“The bigger hospitals that have several blocks can manage to dedicate these beds. However, the challenge will be for smaller ones as they might not have enough space or separate entry and exits to ensure Covid-19 and non-Covid patients are segregated properly. This might lead to a spread of the infection within the hospitals,” said Dr Girish Tyagi, president of Delhi Medical Association.
Dr PK Bharadwaj, secretary, Delhi Voluntary Hospitals forum, an association of large private hospitals, said, “We should learn from the experiences of other countries. In countries such as Italy and Spain, treating Covid-19 patients alongside non-Covid patients ed to several hospitals becoming transmission hot spots.”
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The Delhi government did not respond to multiple calls and messages for comment.
Doctors from Italy have been reported as saying that the overloaded hospitals became sources of the contagion. In England, around 20% patients hospitalised with Covid-19 had contracted the disease while being treated for other ailments, according to a report by the Guardian a week ago.
In lieu of the beds allocated for Covid-19 patients, the Delhi government allowed the hospitals to add 25% more beds by relaxing norms for space and manpower.
“This means crowding of limited spaces in these hospitals, leading to a further increase in the risk of the spread of the infection. Plus, smaller hospitals might not have enough staff to have some exclusively working in Covid areas. Irrespective of the precautions taken, this is bound to spread the infection. The Centre must step in and reverse the order,” said a private doctor from the city, on condition of anonymity.
Earlier, the Delhi government had decided to designate only independent hospitals or those with separate blocks for the treatment of Covid-19 patients such as one block in Max Smart Super Specialty hospital or the two independent hospitals under Sir Gangaram -- Kolmet and City.
While scaling up Covid-19 facilities at its own hospitals, the Delhi government had initially reserved some beds in five of its hospitals in April first week.
Fearing a mixing of Covid and non-Covid patients, the government decided to use two of its hospitals – the 2000-bed Lok Nayak and 500 bed Rajiv Gandhi Superspecialty hospital – in its entirety days later.
At All India Institute of Medical Sciences, people with Covid are being treated at the Trauma Centre on Ring Road and the Cancer centre in Jhajjar, which are completely isolated from the main campus where non-Covid patients are being treated in the emergency department.
At Safdarjung, a separate Superspecialty block and in Ram Manohar Lohia, a separate Trauma block are being used for Covid patients.
“If the government needs to take over beds in the private sector, instead of getting 2,000 beds in over hundred hospitals, they can take over a few of the bigger hospitals,” said Dr Bharadwaj.
Experts agree. “The government was to scale up its facilities during the lockdown. So why does it need to acquire private hospitals? And even if they do have to, they should take over whole hospitals, pay the rent and salary of the staff and manage cases there. There shouldn’t be any mixing of Covid and non-Covid cases. The Centre seems to have failed in clearly creating and communicating a master plan for management of Covid cases,” said Dr T Jacob John, professor emeritus and former head of virology department at Christian Medical College, Vellore.
The Delhi Medical Association is also writing to the Delhi government to extend the health insurance for health care workers in the government sector to the private sector, ensure availability of PPE kits, masks, sanitisers, and respirators at government rates, and create a separate facility for treating health care workers with Covid-19.