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Friday, August 07, 2020

Explained: The Covid-19 hospital in Delhi that came up in just 12 days

DRDO has built the Sardar Vallabhbhai Patel COVID Hospital, a temporary 1,000-bed medical centre spread over 25,000 sq m of Indian Air Force land in Delhi. The hospital is open to anyone who has Covid-19, and treatment is free.

Written by Ananya Tiwari , Edited by Explained Desk | New Delhi | Published: July 11, 2020 7:12:59 am
New Delhi, Delhi news, Delhi covid hospital, Delhi covid news, Delhi coronavirus cases, Sardar Vallabhbhai Patel COVID Hospital, Indian Express Preparations in full swing ahead of the opening of the hospital earlier this week. (Express Photo: Tashi Tobgyal)

The Sardar Vallabhbhai Patel COVID Hospital, a temporary 1,000-bed medical centre spread over 25,000 sq metres of Indian Air Force land on Ulan Batar Marg near Delhi airport’s domestic terminal T1, opened its doors to patients on Thursday (July 9) evening.

The Defence Research and Development Organisation (DRDO) has built the facility – which was formally inaugurated on July 5 – from scratch in just 12 days. Also involved in building the hospital were the Union Home and Health Ministries, and Tata Sons, the holding company of the Tata Group. Funding has come from a clutch of companies as well as DRDO employees, who contributed a day’s salary, the Home Ministry has said in a release.

The hospital’s 250 ICU beds will boost Delhi’s ICU bed capacity by 11 per cent. On the day of the inauguration, Delhi Chief Minister Arvind Kejriwal had said, “For now, there is no scarcity of hospital beds, we have over 15,000 beds out of which 5,300 are occupied. There is a paucity of ICU beds. If there is any spike in Covid cases, these ICU beds will be extremely critical for us.”

Who can be admitted to the hospital?

Anyone can. “We are open to any Covid-19 positive patient, as long as they have a test report. The patients can be referred by the district administration. But they can also arrive at the facility on their own, as long as they have a test report.” Major General S S Bhatia, Additional DG, Armed Forces Medical Services (AFMS), said.

No patients had, however, been admitted to the hospital until Friday.

What will it cost to receive treatment at the hospital?

All medical treatment at the hospital will be free for patients.

How many medical personnel will be working at the hospital?

A total 146 doctors will be working at the hospital. They will be from the Directorate General Armed Forces Medical Services (DGAFMS) as well as from the Armed Forces Medical College (AFMC) in Pune. There will be approximately 50 nursing staff, also from AFMC, and paramedical and support staff.

“They will in all probability work in three shifts,” Maj Gen Bhatia said. “There is a well-defined area in the premises where they will be doffing and donning the PPE, as well as separate dining and accommodation areas for on-duty staff.”

New Delhi, Delhi news, Delhi covid hospital, Delhi covid news, Delhi coronavirus cases, Sardar Vallabhbhai Patel COVID Hospital, Indian Express A total 146 doctors will be working at the hospital. (Express Photo: Tashi Tobgyal)

Can a patient get a RT-PCR test in the facility?

“Yes, they can,” Maj Gen Bhatia said. “We will collect the samples of the patient and send it to the Defence Institute of Physiology and Allied Sciences, which will conduct the test. The result will be given in a few hours’ time,” he said.

The tests, like the treatment, will be free.

Is the facility attached to a referral hospital?

Since any patient can arrive at the hospital for treatment, provided they are Covid-19 patients, there is no referral hospital connected with the facility.

“If, however, any patient who is admitted needs special, advanced treatment, such as dialysis, they will be referred to the All India Institute of Medical Sciences,” Maj Gen Bhatia said.

Who designed and built the hospital?

The design and planning of the facility was done by DRDO in consultation with the DGAFMS. This took three days, after which work on building the hospital began on June 24.

The hospital is a temporary structure, which has 4 main hangars with 250 beds each. One hangar is reserved for the ICU – it is named Shaheed Col. B Santosh Babu ICU Ward after the Army officer who lost his life along with 19 others in the clash with Chinese soldiers in Galwan, Ladakh. The ICU has 250 ventilator beds.

Each of the wards are connected via an internal concrete pathway. The other general wards are named after other fallen soldiers – Shaheed Nb Sub Satnam Singh Medical Ward, Shaheed Nb Sub Nuduram Soren and Shaheed Nb Sub Mandeep Singh Medical Ward.

There are two toilet blocks, with one toilet and one bathroom unit for every nine patients.

There is a separate Doctors’ Block, and a hangar to accommodate on-duty medical staff.

There is a reception and triage area where patients will be received.

There is also a morgue with a capacity of 10 bodies. Dr K Radhakrishnan, Chief Construction Engineer (R&D), DRDO said, “We asked the DGAFMS, and they said that the fatalities in a hospital with 250 ICU beds will be low. And we will evacuate the dead bodies quickly as well.”

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What materials were used in the construction?

The frames are prefabricated materials made of aluminium alloy, and the sheet is a poly-elastic material, which is fire-resistant. Both have been imported from Germany.

Dr Radhakrishnan said, “These structures are already fabricated and readymade, and we need to just bring it and erect it. They are rapidly constructed.” The structure is flexible and can withstand a regular earthquake.

The cubicles are made of octanorm partitions, which is a material used for temporary constructions.

New Delhi, Delhi news, Delhi covid hospital, Delhi covid news, Delhi coronavirus cases, Sardar Vallabhbhai Patel COVID Hospital, Indian Express The design and planning of the facility was done by DRDO in consultation with the DGAFMS. This took three days, after which work on building the hospital began on June 24. (Express Photo: Tashi Tobgyal)

Does the hospital have any special features?

One of the unique features of the hospital is the central air conditioning and internal negative pressure gradient, which ensures that the air is not re-circulated, possibly causing cross-infections, and is not allowed to leave the hangar.

There are circular air ducts with holes punctured in them passing through the hangars horizontally, and connected to blowers and ducts outside.

Dr Radhakrishnan said, “The system is such that the air inside, which may have the virus, is thrown out, allowing fresh air to always be present inside. This ensures there is no cross-contamination. Usually in hospitals, the air conditioning is such that the air is recirculated inside the wards.” The internal negative pressure gradient will ensure that air inside is not allowed to leave the hangars.

At the end of each ward are exhaust fans which will push out the contaminated air to a height of 9 metres. “As per WHO guidelines, if the air is released at a certain height, it dissipates into the atmosphere and is not harmful,” Dr Radhakrishnan said.

The facility also has a vertical cryogenic medical oxygen tank.

“Covid-19 causes a major issue in breathing, and when one is highly infected, oxygen becomes essential to survival. This tank has liquid oxygen enough for 1,000 patients for a period of 4-days,” Dr Radhakrishnan said.

The tank is connected to each ward through a pipeline system and there are kiosks around beds where an oxygen mask can be plugged in directly. “Usually, 100 per cent oxygen is not available. But we are providing that here,” said Dr Radhakrishnan.

Who has supplied the medical equipment in the hospital?

There are 250 ICU-ventilator beds in the hospital, each with a ventilator that has been procured by the DRDO through the PM-CARES Fund. Some of the ventilators have been built by Bharat Electronics in collaboration with the DRDO; others by AgVa Tech.

All beds will have facilities for oxygen support. A dietician is present at the site to oversee the diets of the patients, including those with comorbidities such as diabetes or kidney ailments.

A pharmacy is being run by Apollo Pharmacy at the site.

There is a laboratory for basic pathology tests such as haematology tests, bio-chemistry tests and serology tests. Radiology tests such as X-Rays, ECG and ultrasounds can also be done.

Other equipment include incubators, urine analysers, electrolyte analysers and deep freezer.

Maj Gen Bhatia said: “The lab work has been outsourced to a third-party called CD Diagnostics, as per an agreement with the DRDO.”

DRDO-developed or procured decontamination tunnels, PPEs, N95 masks, contact-free sanitiser dispensers, sanitisation chambers and four medical robot trolleys will be used at the facility. The trolleys are remote-controlled and can transport food and medicines, as well as offer video-chat services to patients from a distance.

What will be the source of power for the hospital?

When the hospital is functioning at full capacity, with all its AC systems and ventilators, it will require 5.5 MW of power, Dr Radhakrishnan said. Power will be supplied by the Military Engineer Services (MES), which provides engineering support including electricity services to the Indian Armed Forces.

To ensure that the ICU ward does not face any power cuts, it is being connected to a UPS system for back-up supply. Maj Gen Bhatia said: “Ventilators have two hours of separate power back up, but we don’t want the situation in which only ventilators are working. We cannot rely totally on our generator either. The UPS gives uninterrupted power supply.”

What about waste management?

Biomedical waste from the facility shall be disposed of as per protocol.

A sewage treatment plant on the site will treat the water from the toilets. Dr Radhakrishnan said, “We were concerned about the sewage. To save time, we took existing steel tanks, made partitions in them, and connected them together. The water is treated with UV and chlorinated. The treated water can be used in a garden or it can just be let out.”

The DRDO also procured water pipelines from the Delhi Jal Board for the hospital.

What will happen to the facility once the pandemic is over?

Maj Gen Bhatia said, “This structure is temporary, and can be utilised for other purposes. The equipment is from DRDO and the PM CARES fund and can be given to hospitals that need them.”

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