2,500 asymptomatic patients in Mumbai to be discharged to free up beds

The 35,009 beds in Mumbai that were reserved for asymptomatic Covid-19 patients will now be kept for symptomatic patients only. The 2,500-odd asymptomatic patients

The 35,009 beds in Mumbai that were reserved for asymptomatic Covid-19 patients will now be kept for symptomatic patients only. The 2,500-odd asymptomatic patients who are kept under observation at Covid care centres (CCC) will be discharged soon as per the new policy of the Indian Council of Medical Research (ICMR).

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As per the earlier guidelines issued by the Brihanmumbai Municipal Corporation (BMC), high-risk contacts of Covid patients with comorbidities were shifted to CCC-1, while asymptomatic patients who did not require critical care were sent to CCC-2. Serious patients with fever and low oxygen saturation were sent to dedicated Covid hospitals (DCH).

However, according to the new rules, all asymptomatic patients will be discharged from CCC-2 and will be kept under home quarantine. This will free up beds at CCC-2 for patients showing mild symptoms and those who do not require critical care.

“It is up to the doctors to decide who is mildly, moderately, and severely infected. Normally, patients who just have a cough and cold with no other complications would be kept in CCC-2 while patients with fever and low oxygen saturation with breathing problems would be shifted to hospitals,” said Dr Pramod Ingale, former dean of Lokmanya Tilak Municipal General Hospital, also known as Sion hospital. Dr Daksha Shah, deputy health officer also confirmed the new development.

At present, 2,425 asymptomatic patients have been kept under observation in converted CCC-2 in 138 schools, 15 buildings, 19 hospitals, 40 halls, and several gymkhanas and hotels. If they do not develop any symptoms, they will be discharged and all the 35,009 beds that were reserved for asymptomatic patients will be saved for the treatment of mild symptomatic patients.

“Our main priority is symptomatic patients, so we will reserve all these beds for them. If they develop complications, then we will shift them to dedicated hospitals. We are also in the process of increasing the number of Covid beds in hospitals,” said Dr Ramesh Bharmal, director of major civic-run hospitals and current dean of Sion hospital.

The plan to discharge these asymptomatic patients has raised concerns among health activists. They have opined that if asymptomatic patients are discharged in red zones like Dharavi, Worli, Govandi, and Kandivli, the virus may spread further as social distancing is an uphill task in these congested areas.

“Most people in Mumbai stay in one-bedroom houses and many others in slums where social distancing is a myth. Just being a carrier of the virus doesn’t mean that the asymptomatic patient can’t spread it to others. It is impossible to maintain safety in congested areas with common toilets,” said Dr Ravikant Singh, a health activist.

When HT asked ward officers about this safety aspect of the discharge plan, they said that there is no clarification on the matter so far. “We are not in favour of this new rule. We have segregated the patients after days of fieldwork. Now, if we release them, we will be back to square one,” said a ward officer, on condition of anonymity.

However, as per BMC officials, asymptomatic patients from slums will be given alternative accommodation. “During discharge, all these patients’ profiles are being checked. If anyone is found to be staying in slums, congested areas, or with family members with high-risk comorbidities, we will make alternative arrangements. Patients can even request the doctor in-charge for a separate accommodation after discharge,” said Dr Gautam Bhansali from Bombay Hospital, who is part of BMC’s Covid team.

Highest CCC-2 bed count in these five wards

An analysis of the data shows that the G/N ward, comprising Dharavi, Dadar, and Mahim, has a maximum number of asymptomatic patients kept under CCC-2 facilities. Among the 24 BMC wards, this area has recorded 1,230 cases — highest in the city.

It is followed by G/S ward which has 13 CCC-2 centres with 5,868-bed facilities. The ward has 272 asymptomatic patients and they are kept under observation at the National Sports Club of India, Worli, which has 500 beds. This ward has recorded the second-highest number of Covid cases in the city.

E ward, has 2,917 beds of which 221 are occupied by asymptomatic patients. Out of this, 123 are admitted to a Nagpada maternity home. This ward comprises areas like Byculla, Mumbai Central, and Nagpada, with 1,046 Covid cases. L ward has six centres with 2,899-bed capacity, however, only 180 of them are occupied. In the fifth position, H/E ward has 164 asymptomatic patients undergoing treatment.