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Thursday, June 04, 2020

Mumbai: St George’s converts into infectious disease hospital

In just a month, the city’s St George’s hospital, housed in a heritage building, has transformed itself into a dedicated infectious disease hospital to cater to critical Covid-19 patients.

Written by Tabassum Barnagarwala | Mumbai | Published: May 20, 2020 5:11:12 am
St George’s hospital, coronavirus cases, mumbai cases, mumbai news, Indian express news A newly readied ward for Covid-19 patients.

A new nursing station with glass windows in each ward, a newly constructed donning and doffing area for doctors and nurses with a bathroom right next to it, a coffin room, an oxygen tank with a capacity of 5,000 litres, and two upcoming wards equipped with 70 ventilators that will start functioning in 10 days. In just a month, the city’s St George’s hospital, housed in a heritage building, has transformed itself into a dedicated infectious disease hospital to cater to critical Covid-19 patients.

In the coming days, the hospital’s bed capacity will be increased from 100 to 242, as the government attempts to plug a shortage of ICU beds.

The hospital had started functioning as a Covid-19 facility since March 27. State officials said they had first decided to convert JJ hospital’s skin department and later Gokuldas Tejpal hospital into a coronavirus facility. Eventually, they decided on St George’s. However, the heritage structure required major alterations.

A series of recommendations by a seven-member infection control committee that visited the building included separate entry and exit for patients and medical staff in each ward, a sealed nursing station that would allow nursing staff to sit in a ward, creating iron or aluminium walls between wards and outer corridors to limit interface with patients and separate donning and doffing area outside every ward where personal protective equipment (PPE) could be worn and removed, followed by showering facilities.

The hospital began construction around the same time as patients started getting admitted. Within the first week, a patient succumbed. Panic-stricken, several class IV employees refused to report to work, so did construction workers.

“We began training for staffers on how to wear a PPE, how to maintain distance while working in Covid-19 wards. All that helped,” a resident medical officer said. Labourers from the public works department (PWD) were also assured that disinfection would be undertaken thrice a day where they work.

When workers would set up the aluminium and glass nursing station in a ward, its patients were moved to another. While the donning and doffing area and a washroom are still under construction, aluminium walls have been erected to create cubicles for patients that will separate them from staff. Each ward has three nurses, who go to the isolation ward in turns to limit their exposure.

The infection protocol system seems to have worked. So far, five nurses and two doctors have been infected as opposed to over 50 infected staffers at Sion, Bhatia, Wockhardt and Jaslok hospitals in Mumbai.

In the initial days, the hospital had recorded a high number of deaths. “We realised most patients become breathless and require oxygen support,” a resident medical officer said. A 5,000-litre capacity oxygen tank was installed to supply to each bed. Wards were modified, and electric connections were installed to fix ICU beds. There are 30 ICUs, including nine for children. Two new wards are being prepared to have 70 more ICUs. The oxygen support has helped reduce mortality in critical cases and increased recovery, a doctor said.

Till May 17, a total of 337 patients had been admitted to hospital of whom 86 died and 103 were discharged. The hospital also has 10 dialysis machines for Covid-19 patients with renal support.

Most patients come after they are referred to by other hospitals. A huge hall serves as a waiting area where white coloured square boxes have been painted for patients to stand and observe social distancing. “During the 2008 terror attack, I remember counting 86 bodies here in this hall,” medical officer Dr Gokul Bhole said.

Two contact-less Covid-19 testing booths have been installed to test suspected cases, however, a disinfection tunnel set up near the casualty ward became defunct after a week.

The hospital received Rs 20 crore from the PM Relief Fund, besides donations, officials said.

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