Updated: May 31, 2021 7:21:10 am
An official in charge of the oxygen supply system at the SNR Hospital in Karnataka’s Kolar district, around 60 km from Bengaluru, has a desperate story to tell about the night of April 25, when he and others at the hospital tried to provide oxygen for 250 Covid-19 patients – with an oxygen supply system that could support only 120 patients.
“As the number of patients in the district hospital kept growing we told the officials that the system cannot support 250 patients needing oxygen. Nobody listened. On April 25 we sat the whole night pouring water on the vapouriser of the oxygen system to ensure it does not freeze up and cause a drop in the oxygen pressure,” said Somanna, the technician.
“Even the district surgeon was with us pouring water. He said he would arrange a tanker of water to keep the oxygen system from freezing up and choking supplies,” the technician said.
The next day, on April 26, four people died at the SNR District Hospital in Kolar due to deficiencies in the oxygen system brought on by the excessive demand for oxygen.
The Karnataka government found that the hospital was using too much high flow oxygen to sustain its patients – while 20 ventilators provided through the PM Cares fund – which would guzzle less oxygen – lay idle in the hospital. The district surgeon and resident medical officer at the Kolar District Hospital were placed under suspension after the incident.
“It was like being in the kitchen at a wedding where 200 people have to be fed when there is food only for 100 guests,” Somanna said about the oxygen deficiency incident that occurred at Kolar – a week before 24 people died at the Chamarajanagar district hospital, some 200 km away from Bengaluru, after the hospital ran out of oxygen.
According to officials at the SNR District Hospital in Kolar, the oxygen supplies never ran out at the hospital on the day that four deaths occurred due to the oxygen deficiency but the over-strained system could not provide oxygen at the right pressure to the patients.
“There were too many patients on oxygen. It was bad management. In the government, things are fixed only when systems break down. As the demand for the oxygen system increased we asked officials to move patients to a higher facility but they did not listen,” said the oxygen technician at Kolar.
Since the incident, the Kolar district hospital installed a new oxygen supply system to sustain requirements at the hospital where the 250 beds available for Covid-19 patients, plus 40 ICU beds – including four ventilator beds – are always filled.
The strain caused by the Covid-19 crisis on the healthcare system in rural Karnataka is very evident in the district of Kolar – which is backward in terms of development despite its proximity to Bengaluru. Ambulances have lined up at the entrance of the SNR District Hospital – the sole referral government hospital in the region – for days now.
On May 26, a 78-year-old patient arrived in an ambulance from the Bangarpet taluk, some 22 km away from Kolar, with oxygen saturation down to 86 per cent against the normal of 95 per cent. With a patient already waiting in an ambulance at the hospital emergency for a bed, Chikappa remained in the ambulance supported by oxygen from a cylinder.
“They did not have ICU beds. They are going to admit him in the emergency and move him to a proper bed when one is available,” says a nephew of the patient who arrived with the ambulance. “We were in a hospital in Bangarpet but they said they do not have the facilities to look after him since his oxygen levels were dropping,” the nephew Suresha said.
“We have 250 oxygenated beds and all are full. The beds have been increasing but there has been no parallel increase in staff. Everybody is overworked. We have 20 ventilator beds but only four or five are being used because we have no technicians. We are getting them trained now to use all the ventilators. We also have 20 ICU beds,” said new district surgeon Dr Ravi Kumar – appointed after the suspension of the previous surgeon over the April 26 oxygen fiasco.
Kolar reported a 588% spike in 28 days
Kolar recorded 19,887 Covid-19 cases between April 26 and May 26 compared to 5567 between March 26 and April 26 and 302 cases between March 26 and April 26. The positivity rate in the region is at 28.56 per cent compared to 19 per cent for the state.
For the period between April 21 and May 19, the district of Kolar featured at 28 among the 50 districts in the country with a very high moving growth rate for infections over 28 days. Kolar reported a 588 per cent growth in infections over 28 days suggesting there was a heavy demand for medical infrastructure and resources to reduce deaths.
The number of official Covid-19 deaths recorded in Kolar between April 26 and May 26 was 162 deaths compared to 29 deaths between March 26 and April 26. The highest number of deaths in the region – 11 deaths – was reported in the official bulletin on May 25. The case fatality rate in Kolar was 1.16 for the past week compared to 1.87 for the state.
It may be anecdotal that people talk about the death numbers in Kolar being much higher because many patients head out to Bengaluru for hospital beds when patients are serious instead of relying on the creaky infrastructure in Kolar and its taluks.
In the Malur taluk of the district, around 45 km from Bengaluru, the taluk hospital with 70 beds plus four ICU ventilators and four regular ICU beds are all filled up, said a board put up outside the hospital.
A social worker who has been helping out with the last rites of people in the taluk says there have been days when the last rites of 12 to 15 people have been conducted in the tiny taluk. The official death count for the taluk on May 26 was only 54, however.
“The deaths have reduced now and there have been only one or two conducted each day in the last week. It was regularly four or five earlier and even went up to 12 and 15 at the peak. Many of the deaths occur in Bengaluru and the bodies are brought here so the deaths must be accounted for in Bengaluru,” said Syed Nadeem, a social worker in Malur, who has been helping in carrying out the last rites in Covid-19 deaths for people across communities.
The city of Bengaluru has recorded 7,576 deaths between March 26 and May 26 including 6243 deaths in the last month alone and 1333 deaths in the March 26-April 26 period.
At a street corner in the entrance to the BEML Nagar in the Kolar Gold Fields region – where posters of people who have died recently are pasted – there were 11 posters this week announcing deaths that occurred between late April and May 26.
Huge demand forced officials to re-open a 140-year-old hospital in KGF
The huge demand on the health infrastructure system in Kolar has resulted in the re-opening of a 140-year-old Bharat Gold Mines Limited Hospital in the Kolar Gold Fields (KGF) taluk of Kolar, around 80 km from Bengaluru – where 70 Covid-19 deaths have occurred.
The hospital which had been shut for over 20 years was cleared of its cobwebs and provided a new coat of paint to create a 250 bed basic Covid Care Centre through an initiative spearheaded by the local BJP MP S Muniswamy and local BJP unit leader Kamalanathan.
“The BJP leaders got a clearance from the Central government to use the abandoned hospital. Local workers from the party and the social workers cleaned up the facility and helped create a basic treatment centre,” said a senior journalist from the KGF region.
On May 26 there were 64 patients in the facility. “There is a high death rate among the elderly in KGF since a lot of people suffer from silicosis from the mining days. There are no ventilator facilities in KGF so patients have to go to Kolar,” said the duty doctor at the hospital.
The BGML hospital does not have oxygen beds as yet but some concentrators have been provided. “Those testing positive but showing no symptoms are being referred. It is an isolation facility,” the duty doctor at the newly revived BGML hospital said.
The intense pressure on the healthcare system has eased a bit in recent days on account of a lockdown in Karnataka which has been in place since April 27 – including a full lockdown since May 14. “The patient numbers remain high but the oxygen demand has reduced. Earlier we were using 30 containers of oxygen every day but over the last few days it has reduced to 22 containers,” said the oxygen technician at the SNR District Hospital in Kolar.
The SNR District Hospital is now scheduled to get a 1000 litre liquid medical oxygen storage tank to supply oxygen to patients at the hospital. “This is how things work in the government sector – when there is a crisis there is a shortage but now that the crisis is passing there is excess capacity. They should not retreat now on the plan for an oxygen storage tank,” a hospital official said.
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