Shutdowns at 9 Mumbai’s coronavirus hospitals put 1,700 beds off treatment grid
Nine major private hospitals in Mumbai with a cumulative capacity of 1700 beds have been asked to partially or completely shut down their emergency and out-patient department (OPD) services, in addition to some hospitals being told to not admit new patients. The reason: Over the last two weeks, 99 medical staffers from these hospitals have tested positive for Covid-19.
Shushrusha at Shivaji Park on Friday was the latest hospital to be placed under the Covid-19 scanner by the Brihanmumbai Municipal Corporation (BMC) after two nurses tested positive. Following this, 28 nurses in the hospital were put under quarantine and the hospital was asked to shut down its emergency services immediately and shift existing patients to other hospitals in the area within two days. It has 130 regular beds and 17 intensive care unit (ICU) beds.
Earlier, Jaslok (Pedder Road), Saifee (Charni Road), Bhatia (Tardeo), Wockhardt (Agripada), Breach Candy (Bhulabhai Desao Road), Nanavati (Vile Parle), Sai (Chembur) and Hinduja (Khar) had been placed under various degrees of restrictions by municipal authorities.
BMC officers said they are taking action as per Union health ministry rules. “Covid-19 is a highly transmissible virus. As a precaution, we have to close down some hospitals for the safety of other patients and staffers. We fumigate the hospitals and take samples of all close contacts, and keep others under observation for 14 days,” said Dr Daksha Shah, deputy health officer, BMC. “Most of these patients were asymptomatic, so it is quite possible that medical staffers got unknowingly exposed to the virus and turned into carriers,” she added.
Wockhardt and Jaslok have reported the highest number of cross-hospital transmissions. At Wockhardt, 56 medical staffers, including doctors, nurses and ward boys have contracted the virus, making it the worst-affected hospital in Maharashtra with in-house infection cases. This 20-storeyed tertiary care hospital has 350 beds.
At Jaslok Hospital, 1005 staff members were tested, of which 21 were found infected with Sars-Cov-2, the coronavirus responsible for the current pandemic. The multi-speciality hospital has 364 beds with 75 ICU beds. At Breach Candy hospital, which has 201 beds, one doctor and two nurses contracted the infection. At Saifee hospital, two doctors contracted the disease through close family contacts. This hospital has approximately 250 beds with 44 ICU beds and nine operation theatres. On Thursday, a nurse at Nanavati Hospital also got diagnosed with Covid-19. This multi-speciality suburban hospital has 350 beds with 75 critical care beds and 11 operation theatres.
The number of infected staffers at Bhatia hospital (capacity: 200 beds) increased to 14 on Friday. This is in addition to three patients that had tested positive. Hinduja, with one Covid-19 positive patient and Sai Hospital with three have also come under BMC’s scanner.
Following the infections, all hospitals barring Sai Hospital, tied up with the state health department to provide treatment to Covid-19 patients in their isolation wards at concessional rates. However, BMC has not only stopped new admissions but has also kept close 500 medical staffers from these hospitals under quarantine, thus taking away crucial medical manpower resources.
Doctors HT spoke to said partially or completely shutting down hospitals for 14 days is impractical, especially since all of them have government accreditation to handle infectious diseases. “A rescue plan to isolate infected workers and the sanitisation of premises should be formulated to reopen these institutions within 24–48 hours instead of a prolonged shutdown of 14 days or more,” said Dr Ramen Goel, President, Indian Association of Gastro-intestinal Endo-Surgeons (IAGES).
Other doctors raised the need to divide healthcare facilities into Covid and non-Covid hospitals to protect uninfected patients from the virus. “In China when over 3,000 medical staffers contracted the infection, the country made a makeshift hospital with a 5,000 bed facility. This not only decreased the chances of infection among other patients but managing the resource became handy,” said Dr Vikrant Shah, infectious diseases specialist from Zen Hospital in Mumbai.
Dr Mukesh Gupta, president of Association of Medical Consultants said it is important to start more fever clinics at private hospitals, and these should be dedicated for patients with symptoms. “There is a need to have a separate exit and entry point for these fever clinics. If a patient has symptoms, he or she should be directly referred to Covid-19 care facilities,” he said.
Doctors also blamed the unavailability of protective kits as the reason behind the spread of the infection within hospitals. Due to a sudden surge in demand for personal protective equipment (PPE), the price of per kit has increased to Rs5000, which, according to the government, shouldn’t cost more than Rs1000.
“We can’t use the same PPE for more than one patient. The patients get scared if we have examined any infected patient with the same gloves,” said Dr Avinash Bhondwe, president, Indian Medical Association (IMA), Maharashtra. “There is so much scarcity of PPE that doctors are now wearing raincoats,” he added.
In a meeting held on April 8 with the state health minister Rajesh Tope, IMA said it had asked for Rs 1crore to be assured for doctors in they died performing Covid-19 duties.
Meanwhile, on Friday, in a meeting with the representatives of private hospitals, civic chief Praveen Pardeshi warned the hospitals to abide by the safety rules.
“The hospitals have been asked to use PPEs and ensure there are separate exit-entry routes for suspected and confirmed Covid-19 patients, failing which they must stop admitting coronavirus patients,” said a doctor who was a part of the meeting.