Updated: April 26, 2021 12:41:57 pm
Between the first and second waves of Covid-19 infections in Bengaluru in 2020 and April 2021 the number of ICU ventilator beds available for patients in government hospitals in the city went up by only 18 beds despite nearly 2,025 ventilators being supplied to the Karnataka government by the Centre last year.
While there was an initial panic by health authorities to increase ventilator beds in Bengaluru, soon complacency crept in as cases began receding in October 2020. Now, this has resulted in a situation where patients are again running between hospitals to find ICU ventilator beds.
According to official data shared by Bengaluru civic authorities last year, the total number of ICU ventilator beds available in government hospitals in Bengaluru at the peak of the Covid-19 crisis in 2020 was 99 — 77 beds in two medical college hospitals and 22 at 15 government hospitals. According to the centralised hospital bed allocation system for Bengaluru that has been put out in the public domain since the second Covid-19 wave began in the city in early April there are 117 ICU ventilator beds in government hospitals for Covid-19 patients at present — 47 in the medical college hospitals and 70 beds in 13 other government hospitals.
This is an increase of only 18 ICU ventilator beds from what was available in 2020 whereas the central supplies of ventilators was reportedly meant to increase the numbers of ventilator beds in the government sector in Bengaluru to at least 300. Incidentally, all of the 117 ICU ventilator beds in the government sector and 217 in the private hospitals in Bengaluru for Covid 19 have been consistently full for over a week on account of an average of over 15,000 cases being reported in the city over the last week compared to around 4,000 cases in the first week of April.
As a result, no ICU ventilator bed options are available for the seriously ill, poor patients in the city. Bengaluru has witnessed 1,200 deaths in April alone, the highest for any month across the first and second waves of the Covid-19 crisis.
ICU ventilators are considered essential for treating seriously ill Covid-19 patients while high-flow oxygen is needed for moderate cases and home isolation is sufficient for mild cases. At many government hospitals in Bengaluru the dozens of ventilators provided last year by the centre under the PM Cares scheme has been consigned to warehouses since there is a lack of infrastructure and staff to deploy the ventilators.
At the Lady Curzon and Bowring Hospital, a government medical college hospital, the number of ICU ventilator beds for Covid-19 patients has remained stagnant at 10 despite the hospital receiving nearly 45 new ventilators under the central scheme last year to increase capacity.
According to senior officials at the hospital, the new ventilators were not deployed as yet on account of a limited oxygen storage and supply system at the hospital and a reliance on high flow oxygen systems when the severity of the first wave of Covid-19 was receding last year.
“Until last week, we never anticipated that there would be a large demand for ICU ventilator beds because only seven or eight people were needing ventilators,’’ said Bowring Hospital director Dr Manoj Kumar. The hospital has nearly 96 ventilators in stock, he admitted, adding that a majority were not deployed and were being used only as a backup facility.
Charaka Hospital, a government hospital facility attached to the Bowring Hospital — the old Broadway Hospital of the Bengaluru municipal corporation — renovated with Rs 10 crore funding from the Infosys Foundation and meant to have 48 ICU ventilator beds has failed to take off after the inauguration during peak of the first wave. “The engineers have said they cannot put up an oxygen storage tank at the Charaka Hospital, so we cannot use it until this issue is addressed,’’ Dr Kumar said.
At the Epidemic Diseases Hospital, where civil work was carried out to create an ICU facility with 20 ventilators last year, no ventilator bed facility has been created due to a lack of trained staff. PM Cares ventilators meant for the facility have been diverted to the KC General Government Hospital in the city which is better equipped, said hospital authorities.
Ventilators procured by the Karnataka government under the PM Cares scheme was also meant to be supplied to other government hospitals in Bengaluru like the Jayanagar General Hospital, KC General, Vani Vilas and other general hospitals with no ICU facilities – but only KC General has increased its ICU ventilator capacity among Covid hospitals until now.
“Many hospitals have put the ventilators in their warehouses. I am sure that out of 50,000 supplied (nationwide) at least 15,000 to 20,000 were not installed. The doctors of the hospitals have not told the government that the machines are not installed because then they will come under pressure to take patients,’’ said Vishwaprasad Alva, managing director of Skanray Technologies, the firm that supplied a large chunk of ventilators for the PM Cares scheme.
“The distribution of the ventilators has not happened based on the capabilities of the hospitals. Some hospitals have got 10 ventilators but they have no intensivists and others that have 25 intensivists have also got 10 ventilators. It has not been matched to the capacity of hospitals, the infrastructure and the requirement. This has been very bad management by the government,’’ he said over the lack of ventilator beds despite the excess supply last year.
The Skanray MD said he had carried out an audit of the number of ICU ventilators deployed since the first wave and found that many key government hospitals had not utilised the ventilators supplied to them. ”They had one full year of time to build up capacity and they knew that the second wave was coming. The whole world was talking about it and they did nothing. This is gross negligence by the centre and the state,’’ he said.
“Now everything is in panic mode, but if they had started preparing in January or last October then by February we could have been 60 per cent efficient but today we are not even 10 per cent efficient,’’ the Skanray Technologies founder said.
In 2020, the PM Cares Fund Trust had allocated Rs 2,000 crore for supply of 50,000 ‘Made-in-India’ ventilators to government-run COVID hospitals in all states/UTs and Skanray Technologies was one of the main suppliers chosen to provide 30,000 of the ventilators.
Karnataka’s additional chief secretary and health secretary Jawaid Akhtar, however, said all ventilators procured by the state through the centre last year had been deployed and that very few were still in the possession of the government. “All the ventilators provided by the centre have been installed and some we are keeping. We have given some to private hospitals that have doctors and this has been done in recent weeks. Very few are with us and this has been done strategically to cope with changing requirements. Some 50 or 60 with us,’’ the health secretary said.
“We started ICUs in taluk hospitals and this has consumed large numbers. It has been spread around medical colleges, district hospitals and taluk hospitals. Last four or five days we have given around 30 to private places where there is a caseload and doctors are available,’’ he said.
Amid the spiralling cases of deaths in Bengaluru at present — there were 124 deaths on April 23 and 149 deaths on April 24 (the highest single day Covid 19 death numbers across the crisis) — the Karnataka government has announced plans to increase ventilator beds in Bengaluru by 10 fold.
“In 15 days, at least 2,000 makeshift ICU beds will be ready. As many as 800 of them will have ventilators. In the Victoria Hospital campus, 250 ICU beds will be set up and in another new building 150-200 ICU beds will be arranged. Among these 100 will have ventilators,’’ Health Minister Dr K Sudhakar claimed.
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