Maharashtra: 880 patients in four regional mental hospitals had Covid, 24 succumbed

Data accessed by The Indian Express showed that in the four district mental hospitals in Pune, Thane, Nagpur and Ratnagiri, 883 patients living with mental ailments contracted novel coronavirus between March 2020 and September 2021, with 6.3% positivity rate.

The Yerwada Mental Hospital, Pune — the largest district mental hospital in the state with nearly 1,500 bed capacity — reported the highest Covid cases. In the same period, the hospital conducted 4,569 Covid-19 tests on its patients, of which 385 were positive.

This is followed by the Nagpur district mental hospital, where 2,020 patients were tested and 226 were positive. In the Thane district mental hospital, 211 patients were diagnosed with Covid-19 among the 6,399 tested. The district mental hospital in Ratnagiri reported the lowest number of Covid-19 infections — only 61 of the tested 198 patients were diagnosed with Covid-19.

Out of the 883 Covid infections among patients living with mental ailments, 24 succumbed to the infection. This means a 2.71% case fatality rate. which was higher than the state’s average of 2.13% recorded last September.

The Thane hospital reported 10 deaths — the highest among the four hospitals — with case fatality rate at 4.7%. This is followed by Pune with seven deaths, Nagpur with six deaths and one death in Ratnagiri. Dr Sanjay Bodade, Superintendent, Thane Mental Hospital, said, “There are several abandoned patients in the hospital who roam the premises without masks and get exposed to carriers. They also acted as super spreaders.”

A total of 221 hospital staffers were also infected with Covid-19 at the four hospitals till September 2021. Out of the 2,713 staffers tested, 221 were diagnosed, with 8.14% positivity rate.

Hospitals authorities pointed to infected staffers as the primary source of infection among patients. “The spread of infection started with the infected staffers. Also, rescued and abandoned patients brought by police and social workers were often found Covid-19 positive due to wide exposure,” said Dr Abhijit Phadnis, medical superintendent of the Pune hospital. In the early stage of the pandemic, as the government and social organizations were focused on controlling the spread of the virus among the community, insufficient attention was paid to patients in mental hospitals. Many staffers complained that they were provided poor-quality PPEs.

“At the start of the pandemic, we were provided PPE kits which were often torn. There was scarcity of N95 masks, so we had to keep wearing the same masks for 3-4 days,” said a staff from Thane mental hospital.

Mohammed Tarique, assistant professor of Tata Institute of Social Science and project coordinator of Koshish, a field action project working with homeless and destitute people, said that as most mental hospitals are overcrowded, the virus spreads faster.

All four mental hospitals later established isolation wards where mildly symptomatic patients were provided treatment. Severely infected patients were shifted to dedicated care hospitals. “As these patients have special requirements, we would have patients accompanied by a staffer who would counsel them while they undergo treatment,” said Dr Phadnis.

Doctors said that Covid-appropriate behavior is limited among these patients as they often refuse to wear masks or sanitize hands regularly. So, the state has escalated immunization programmes at all four mental hospitals on priority. Dr Phadnis said that all 1,100 patients at Pune’s hospital have been fully vaccinated.
“Despite a large number of patients in these mental hospitals, with quick surveillance, testing and isolation, we have been able to contain the spread. The mortality rate is also limited,” said Dr Sadhana Tayade, Director, DHS.