May 13, 2020 4:09:29 am
Mumbai has run out of beds for severely ill Covid-19 patients in both public and private hospitals. Patients calling the BMC’s disaster management cell (1916) on Monday and Tuesday were told to register on a waitlist as beds were not available.
Grappling with an acute shortage of beds, BMC plans to add more beds in Nair hospital, KEM hospital, Sion hospital and Seven Hills hospital for the severely ill. It has also reached out to private hospitals to get them to scale up their capacity for Covid-19 patients.
The city had recorded 14,521 Covid-19 cases until Monday night, of which over 10,883 are active cases. As per the state government, three per cent of these are critical and 27 per cent symptomatic cases.
BMC guidelines mandate hospitalisation for critical and in some cases, for moderately symptomatic patients. Of the 10,883, over 3,200 people are symptomatic or critically ill. While there are 4,750 beds for critical patients in dedicated Covid-19 hospitals, of them 1,750 beds added in just the first week of May, beds are still falling short.
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Breathless, patients visit hospital after hospital
A 67-year-old Dadar resident, breathless and experiencing chest pain, spent the entire Monday visiting hospitals to get admitted. Her son initially called BMC’s 1916 helpline number, which coordinates patient admission, and was informed that no beds are available in any hospital.
“They took my details and said they will inform me. But I could not just sit at home with my mother ill,” he said. Thus, he took his mother, also diabetic, to Dhanvantari Hospital and Research Centre, where doctors said they do not treat Covid-19 patients. The woman was yet to be tested for the infection.
The family then went to P D Hinduja hospital where doctors first asked for a Covid-19 test report before admitting her. From there, they went to SL Raheja hospital, where they were told no beds were available.
The son’s doctor friend, who works with Gokuldas Tejpal (GT) hospital, checked and found that both GT hospital and St George’s hospital were full. On Monday night, when they reached Lilavati hospital, they were told all Covid-19 beds were full. After an hour of waiting outside, the hospital agreed to treat the senior citizen in the emergency ward since she urgently required oxygen support.
Also on Monday, a 61-year-old dialysis patient, struggled to get a hospital bed after she tested positive for Covid-19. Her daughter said that as soon as her private lab reports came, she called SL Raheja hospital, PD Hinduja hospital and Seven Hills hospital, where all beds were full.
“I then called Bombay hospital. They had a bed but no dialysis facility for Covid-19 patients. Finally, we used some influence to get her admitted to Nanavati hospital, where a patient had just been discharged,” the daughter said. The family believes the woman contracted the virus from a dialysis machine at another hospital.
Growing load, skeletal staff
BMC officials said enough beds were available to quarantine high-risk slum dwellers and admit asymptomatic infected patients across Covid care centres and health facilities, but they are short of beds when it comes to critical patients who need oxygen support and intensive care.
“The current situation is so bad that we have to wait for a patient to get discharged to admit another. The beds are always occupied,” said Dr Mangala Gomare, deputy executive health officer.
Each hospital is supposed to provide real-time updates on a BMC portal if a bed is available. In some hospitals, civic officials said hospitals are not swift enough.
In Lilavati hospital, there are 37 beds for Covid-19 patients, of which six are ICU beds. All the beds were occupied on Tuesday. “This morning, we had three discharges, and already three patients were waiting in casualty to get admitted, all requiring ICU support,” said Dr V Ravishankar, chief operating officer in Lilavati.
Private hospitals have been asked by BMC to add more beds. “It is not easy. We do not have enough staff to increase the number of beds. We now plan to change staffing pattern – one nurse to look after three beds instead of two. Only then can we add more beds,” Ravishankar said.
St George’s hospital has 102 Covid-19 beds, and all were full on Tuesday. Twenty-six patients were on ventilator. One patient requiring emergency hospitalisation had to be kept in the casualty ward, as no ICU beds were vacant. A doctor said they cannot keep patients in casualty for long and had four more patients on a waiting list.
The hospital will add 24 more beds for Covid-19 patients by Wednesday. “But if we are asked to add beds beyond that we do not have enough doctors,” said medical superintendent Dr Akash Khobragade. The hospital has 25 doctors in one shift who manage casualty, out patient department, normal wards and ICUs. It does not have the required staff to handle more patients.
There are three levels of Covid-19 treatment facility – Covid care centres, Covid facilities and dedicated hospitals.
Covid care centres admit asymptomatic or mildly symptomatic patients. There are 14,000 beds in such centres. Moderately ill patients, for instance those with fever but not gasping for breath, are admitted in Covid facilities, which are over 10,000 beds. And critically ill patients are admitted in dedicated hospitals. There are over 4,750 beds for such patients.
Realising that the worst hit are the critical patients, BMC now plans to add beds with ICU support in Worli’s NSCI so that patients who need oxygen support and primary intensive care can be admitted there. The NSCI currently admits only asymptomatic or mildly symptomatic infected patients. BMC also plans to scale up beds in Covid care centres to 34,000.
“The discharge policy is also being strictly followed to ensure beds get free on time for another patient,” said deputy executive health officer Dr Daksha Shah.
Since Monday, BMC has started following Union government’s latest protocol on discharge. Asymptomatic and mildy symptomatic patients will be discharged after 10 days without a test if they develop no symptoms in the last three days. Those with moderate or severe symptoms will be discharged after one negative test result, and if they are stable. Civic officials said the new discharge policy will help free beds quicker.
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