Oxygen, ventilators, testing: Central teams flag gaps in key surge states

• Maharashtra has very high hospital occupancy in three districts; three other districts are facing problems with oxygen supply; malfunctioning ventilators found in two districts.
• In two districts of Punjab there is no dedicated Covid hospital; there is a shortage of healthcare workers in three districts, and no RTPCR testing lab in one.
• In Chhattisgarh, there is a shortage of RTPCR testing in three districts; four districts have high hospital bed occupancy rates; the state capital has limited oxygen availability.

These are among the problems identified by central teams sent by the Ministry of Health and Family Welfare in surge districts of three states of concern – Maharashtra, Punjab, and Chhattisgarh – that have been reporting the highest numbers of new Covid-19 deaths in the country.

The expert teams were sent to these states on the direction of Prime Minister Narendra Modi, a day after he held a meeting with all Chief Ministers last week.

India’s active Covid-19 caseload reached 11,08,087 on Sunday, the highest ever. “The five states of Maharashtra, Chhattisgarh, Karnataka, Uttar Pradesh, and Kerala cumulatively account for 70.82% of India’s total active cases. Maharashtra alone accounts for 48.57% of the total active caseload of the country,” the Health Ministry said.

Daily deaths continue to show an upward trend: 839 deaths were reported in the last 24 hours; 309 of them in Maharashtra; followed by 123 in Chhattisgarh and 58 in Punjab.

Besides these three states, the surge in Uttar Pradesh was now a “cause of worry”, and testing numbers in Gujarat were a “big issue”, top government sources told The Indian Express. Over the last 24 hours, UP has reported 12,748 new cases and 46 deaths; Gujarat has reported 5,011 cases and 49 deaths.

“There is a trend in Uttar Pradesh, which is cause for worry. In the video-conferencing, we have told them that although more than 70 per cent of their testing is RT PCR, the (testing) numbers have fallen. They are expected to quickly ramp up testing; last year (during the surge), the state had recorded big testing numbers like Delhi,” a source said.

Three teams are in Surat in Gujarat, examining the gaps in response and assisting health authorities over the worsening situation, the sources said. “This (Surat) was the area of most concern for us. Last year too, they could not ramp up testing. Also, the RT PCR percentage is fairly low. These teams will also go to Rajkot, Baroda, and Ahmedabad,” they said.

Health Secretary Rajesh Bhushan has written separate letters to the health secretaries of Maharashtra, Punjab, and Chhattisgarh, asking them to urgently address the concerns raised by the central teams, including hiring contractual health workers, and ramping up hospital infrastructure. He has flagged specific concerns with these three states.

Maharashtra

1. Occupancy rates of available hospital bed capacity are very high in Ahmednagar, Aurangabad, Nagpur and Nandurbar.
2. Team to Aurangabad reported dependency of the district on neighbouring districts for management of critical patients.
3. Medical oxygen supply was an issue in Bhandara, Palghar, Osmanabad, and Pune; malfunctioning ventilators have been reported by teams in Satara and Latur districts.
4. Acute shortage of healthcare workforce has been reported in Aurangabad, Nandurbar, Yawatmal, Satara, Palghar, Jalgaon, Jalna districts.
5. Testing capacity in Satara, Bhandara, Palghar, Amrawati, Jalna and Latur districts is already overwhelmed, resulting in delay in reporting of test results; delayed reporting by patients to definitive treatment centres in Satara district is leading to a large number of deaths within the first 72 hours of hospital admission.
6. Containment operations were sub-optimal in Satara, Sangli and Aurangabad, with less than satisfactory perimeter control, lack of active surveillance for ILI cases; surveillance and contact-tracing were sub-optimal in Buldhana, Satara, Aurangabad and Nanded, mostly due to limited manpower.

Punjab

Chhattisgarh