No Intensive Care Units (ICUs) in most civil hospitals, limited ventilators and just a handful of government medical colleges and private hospitals for tertiary care — these are some of the reasons why small towns are struggling to keep up with the rising cases of Covid-19 and an increasing mortality rate. As a result, Malerkotla, Gidderbaha and Amloh recently declared temporary lockdowns, while the number of containment zones is being increased in several cities and rural areas.
Lockdown was imposed in Malerkotla town of Sangrur district on Tuesday and Wednesday, while Amloh in Fatehgarh Sahib district observed lockdown on Monday and Tuesday. Both towns will be observing it again this weekend. While Malerkotla had recorded 246 cases and 11 deaths till Wednesday afternoon, Amloh has had only 11 cases so far. Meanwhile, lockdown in Gidderbaha of Muktsar district was from Saturday to Monday after 11 cases were recorded there.
Malerkotla has a civil hospital with only 44 beds, and 95 active patients. In addition to this, only 60 patients can be kept at its recently set up quarantine centre. Both facilities are occupied at the moment because of the increasing number of patients. Malerkotla has 26 beds with oxygen supply lines, but no ventilators, and got a basic life support system ambulance only last week. In fact, Sangrur district, which had 499 cases till Monday, has only one ventilator. The district has level 1 and 2 arrangements for mild and moderate patients, but critical patients are sent 60 km away to Rajindra Medical College, Patiala. Hence, many patients are going to Ludhiana’s private hospitals, which are 46 km away. With 11 deaths, contact tracing is going on here in full swing.
Amloh has 150 beds for level 1 (mild, asymptomatic) patients, while moderate patients are sent 40 km away to Gyan Sagar Institute, Rajpura. Level 3 patients are sent to Rajpura or Rajindra Medical College, Patiala (40 km away). Amloh has no ventilator, no oxygen beds.
Barnala district also has facilities for level 1 and 2 patients, but for tertiary care, they are sent 100 km away to Patiala. Barnala has three ventilators and will soon have an ICU. Dr G B Singh, civil surgeon, Barnala, said, “However, we refer patients well in advance to Patiala if we feel they need tertiary care, hence their time is saved.”
‘200 tertiary care beds for 6 districts’
Six districts — Faridkot, Mansa, Bathinda, Muktsar, Ferozepur and Fazilka — are dependent on Faridkot Medical College, which has 200 beds as a tertiary care unit. In case a Covid patient needs critical care, government authorities refer him/her to Faridkot. Dr Amrik Singh, civil surgeon, Bathinda, said, “We have no tie up with any of the private hospitals of Bathinda as of now. Hence, we refer critical patients to Faridkot Medical College only.” Faridkot is 70 km from Bathinda.
Bathinda meanwhile has 500 beds for level 1 patients and 230 for level 2 patients. Dr Amrik said, “So far a majority of mild or moderate patients are being treated here.”
Ferozepur and Fazilka
Same goes for Ferozepur and Fazilka, who are catering to level 1 and 2 patients and Guru Gobind Singh Medical College and Hospital (GGSMCH), Faridkot, which is at a distance of 32 km and 94 km respectively, is the only answer for critical patients. Both Ferozepur and Fazilka don’t even have any well-equipped tertiary care private hospitals.”
”So far, only mild to moderate patients have come here. Faridkot is just 20-25 minutes away from Ferozepur. We have three ventilators, but so far we have not used them,” said Amit Gupta, SDM, Ferozepur. Muktsar is 50 km from Faridkot.
Ludhiana, which is the most thickly populated district of Punjab, also has no ICU in its civil hospital. Even its four ventilators have been shifted to Christian Medical College and Hospital where they pay per bed charges to CMCH, in case a patient is shifted on these ventilators. Varinder Kumar Sharma, Ludhiana DC, said, “We have a 500 beds for Covid care centres which can be increased to 1,200 beds as well while an additional 2,300 beds have been arranged. There are 150 beds in the civil hospital for moderate patients. In case a patient is critical, we first refer the patient to any of our government medical colleges, and if there are no beds or if the patient is willing to go to private hospitals on his/her own, they pay as per the Central Government Health Scheme (CGHS).” In Ludhiana however, there is tie-up with Dayanand Medical College and Hospital, CMCH and few other private hospitals as well.
The state Covid mortality rate reached 2.6 per cent Wednesday evening. Jalandhar has the only district hospital (government) in the state which has an ICU. Punjab Health Minister Balbir Singh had even told The Indian Express that they are going to spend Rs 600 crore on the infrastructure development of government hospitals to upgrade them to tertiary care units.
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