Top private hospitals fast running out of ICU beds for Covid care in Delhi
The national capital recorded 3,609 new Covid-19 infections as on Monday, taking the number of active cases to 22,377 – the highest since July 8, the government’s daily health bulletin showed on Tuesday.
There are no intensive care unit (ICU) beds with ventilators available for Covid-19 patients in eight of the Capital’s 11 top private hospitals, data from the Delhi government’s real-time occupancy tracking app, Delhi Corona, showed on Tuesday, raising concerns that the city may face a shortage of critical care resources if the current spike in new infections worsens.
The national capital recorded 3,609 new Covid-19 infections as on Monday, taking the number of active cases to 22,377 – the highest since July 8, the government’s daily health bulletin showed on Tuesday. The number of people in hospital has risen in tandem: from 3,590 beds occupied August 24 to 5,218 on September 7.
While this still leaves 8,788 of the 14,202 beds vacant, the concern particularly relates to ICU beds – of the 14,202, only 2,117 are in the intensive care category.
“With the increase in the number of cases, we will have to start optimising our resources and may have to follow a strict cut-off like what was being followed in June -- only those with oxygen saturation below 94% were being admitted to hospitals. However, by then sometimes the condition already starts deteriorating,” said Dr Neeraj Gupta, professor of pulmonology at Safdarjung hospital.
The beds data from the Delhi Corona application reflect a drastic imbalance in people’s preference, with large private hospitals being the most sought after. The high occupancy also extends to ICU beds without ventilators in the top eight private hospitals, where 85% of these were occupied. In three of these, Max Patparganj, Fortis Shalimar Bagh and Apollo, there were zero vacancies even though 35% of such beds were reported vacant across the city.
The Delhi government and top health officials acknowledged that beds in private hospitals were seeing high demand, but added that there is adequate resources for now. “There are enough ICU beds available, there is no need to worry,” a Delhi government spokesperson said.
“It is the big private hospitals that have started getting full. And, this is mainly because many prefer to go to these possibly the big multi-speciality ones that have doctors from all disciplines available,” said Dr SK Sarin, director of Institute of Liver and Biliary Sciences and chair of the first expert committee that had been set up by the Delhi government to manage Covid-19 in the city.
Accounting for all private hospitals in the city, 78.6% of ICU beds with ventilators and 66.3% of regular ICU beds were occupied. These numbers were correspondingly higher than government hospitals, where 37.6% of ICU beds with ventilators and 50% regular ICU beds were already full.
Sarin said fatality trends indicate the infrastructure was able to handle the load and the situation was unlikely to become like when it was in June, a time when the capital’s hospitals were stressed. “Even with the increase in the number of hospitalisations, the proportion of deaths is not that high. And, this is because of the standardised treatment protocol that is now in place. Doctors have understood the importance of high flow nasal oxygen, started proning patients to improve their oxygen saturation, started administering antiviral medications and steroids, and of course administering plasma therapy,” he added.
Since the June spike, Delhi has beefed up its Covid-19 hospital resources. The city has ordered all private hospitals to reserve 20% of their beds for Covid-19 patients, the army set up a new a field hospital, the operations of two of Delhi governments newly constructed hospitals were expedited and makeshift hospitals were created adjacent to existing ones and in banquet halls.
Among the people hospitalised in Delhi are also many who are not from the city. Over 30% of all hospital admissions due to Covid-19 in Delhi were patients from neighbouring states of Uttar Pradesh, Haryana, and Rajasthan, according to the Delhi government.
Among them was a 53-year-old patient from Saharanpur who was brought to the Sir Ganga Ram hospital after doctors in his UP hometown detected pneumonia patches in his lungs. “We booked a car immediately and landed up in Gangaram hospital because I have faith in the doctors here. However, the doctors told us that there were no ICU beds available and we would have to wait. Our family suggested we take him to other hospitals nearby but we did not want to. So, we waited for a bed to become available in the emergency department. He was admitted there for two days,” said the patient’s son, who asked not to be named or for his father to be identified.
Dr DK Sharma, the medical superintendent of All India Institute of Medical Sciences (AIIMS) agreed this was one of the factors. “The number of hospitalisations are on the rise in Delhi mainly because of two reasons -- one, the migrant population is returning to the city as the economic activities are picking up and are then getting the disease; two, large number of people from the neighbouring and sometimes even far away states are travelling to Delhi for treatment. For example, in AIIMS 35-40% of the Covid-19 admissions are in people from other states,” he said.
“There might not be bed available in the hospital of your choice, however, there will definitely be a bed available for you,” said Sharma.
Doctors say it is important to remind people to not become complacent. “We have seen a rise in numbers in the past few weeks for mainly the below mentioned points: 1) the number of tests have gone up, thereby pushing up the diagnosis of the disease; 2) Delhi has eased its earlier lockdown norms. This is visible with increasing traffic and in markets and offices re-opening. People have to be careful in observing social distancing, wearing masks and following hygiene steps because the transmission of virus has picked up pace,” said Dr Sandeep Budhiraja, group medical director, Max Healthcare.