From banquet halls and stadiums to hotels and school buildings - Delhi government is going all out to meet the tall order of 15,000 beds by end of June and 80,000 by July 31 to deal with rising Covid-19 cases.
Delhi government has also directed private hospitals to reserve 40 per cent bed capacity for Covid-19 patients. Delhi’s Chief Minister Arvind Kejriwal said that if the current trend of 50 per cent occupancy of Delhi hospitals by outsiders continued, the actual number of beds required by July 31 would be 150,000 or nearly twice the earlier projection.
“If the public and private sector can work in coordination then this challenge can be easily met,” said Alok Roy, Chair-Ficci Health Services Committee.
Private hospitals presently have 1,441 beds for Covid-19 patients which is now being increased to 3,456. Of these, the maximum will be in Batra Hospital in Tughlakabad (400), followed by Apollo Hospital in Sarita Vihar with 300 Covid-19 beds.
The bigger challenge, however, is not ramping up the number of hospital beds but increasing the manpower - trained doctors and nurses.
“For 80,000 beds, around 6000 nurses would be required. This is assuming that in a normal ward with non critical patients, one nurse can cater to 15 patients. There are three shifts, and one nurse needs to be rested periodically,” said the owner of a mid-sized hospital in Delhi.
Shaleen Mitra, officer on special duty to Delhi’s Health Minister Satyendar Jain said that all district magistrates had been asked to submit the list of banquet halls and stadiums in their area and many of these facilities have been surveyed.
When asked about the shortage of manpower, Mitra said, “Personnel management comes under the purview of the Delhi Disaster Management Authority which is chaired by the lieutenant governor.”
One of the district magistrates, who did not wish to be named, suggested that final year medical students or dentists be deployed to do the job. “Each makeshift Covid-19-care centre would need five staff members including a doctor and medical and paramedical staff. Our best bet is to bring down the requirement of beds in the first place,” the state government official said.
A senior doctor in a private hospital said that the government had hired a lot of junior doctors which had added numbers, but had not solved the problem. “Many of the junior doctors and nurses either do not know or are not confident enough to intubate patients or put patients on the ventilators,” he said.
Industry insiders in Delhi pointed out that the government would provide the beds and the oximeters, while the Delhi Medical Association had been asked to provide the staff, the laundry services and oxygen cylinders.
The facility owner, for example a banquet hall owner will provide the housekeeping staff and receive rent for his facility.
“India can expect to see a mismatch in terms of beds and clinicians just like the other countries like Italy and Spain saw. We need to prepare ahead of it," HS Chhabra, medical director of Indian Spinal Injuries Center said. The hospital has converted 37 of its 185 bed capacity for Covid-19 patients.
Chhabra said that in a pandemic situation degrees needed to be handed out to doctors and specialists without any delay to add to the manpower.
Some of the hospitals such as Max Healthcare have started a homecare service in Delhi for coronavirus positive patients with mild symptoms which includes tele-review with a doctor every third day, case assessment by nurse case-supervisor, guidelines on self-monitoring, isolation, personal and home hygiene, as well as home delivery of medicines.
Another issue which has been raised by the health industry in Delhi is the policy flip-flop. “In a war the soldiers need one general. Too many generals spoil the case. This is what is happening in Delhi now," said a renowned doctor and also the owner of a speciality clinic.
Congress leader Ajay Maken said while it was good to see that “the chief minister has woken up”, he should have been more alert three months ago. “Forget about expanding capacity. Are they even using the existing ones at their disposal properly. If so, why despite availability of beds, patients are not being admitted,” he said.