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Thursday, August 06, 2020

Bengaluru battle: Amid spike, shortage of staff & ICU beds with ventilators

The government healthcare sector, private hospitals and medical colleges, together have only around 225 ICU beds with ventilators available for Covid-19 care, according to data available in public domain.

Written by Johnson T A | Bengaluru | Updated: July 6, 2020 11:36:02 am
Bengaluru battle: Amid spike, shortage of staff & ICU beds with ventilators “Only the private sector has ventilator beds but they have their compulsions and have kept most beds for their own patients who will need ventilator support,” the senior doctor said. (Representational)

ON JULY 4, Santosh Hospital, a private healthcare facility in east Bengaluru, turned away a middle-aged woman with low oxygen levels, since its Intensive Care Unit (ICU) had to be shut down after a nurse working at the unit died due to Covid-19 two days earlier.

“Nine of our nurses are in quarantine. Some of our staff have run away since the ICU ventilator nurse contracted Covid-19 and died. We do not have the staff to look after patients admitted in the ICU,” said Ratheesh Nair, Administrator, Santosh Hospital.

The Saturday afternoon incident at the private hospital is symptomatic of a growing healthcare crisis in Bengaluru, where, amid a sudden surge in Covid cases, a paucity of ICU beds with ventilators coupled with a growing number of healthcare staff infected by coronavirus, is threatening to derail the administration’s efforts to ensure timely and proper treatment.

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Though the BJP government in Karnataka had claimed availability of 4,958 hospital beds in the city for Covid-19, it has not been forthcoming on the availability of ICU beds with ventilators — so critical for emergency care of patients whose vitals slip rapidly due to Covid-19 and Severe Acute Respiratory Infections (SARI).

The government healthcare sector, private hospitals and medical colleges, together have only around 225 ICU beds with ventilators available for Covid-19 care, according to data available in public domain.

“There are around 80 ICU beds with ventilators in government medical colleges and hospitals, and around 40 in the private medical colleges. The shocking part is state-run hospitals in Bengaluru (16 of them) other than medical colleges have only 10 ICU beds. Nothing was done even in the lockdown to equip these hospitals,” said a senior government doctor involved in addressing the issue of hospital beds in Bengaluru. Now, 72 private hospitals have allocated an additional 98 ventilator ICU beds for Covid-19 care out of a total of 403 ICU ventilator beds available in the private sector. This takes the total to 228.

“Only the private sector has ventilator beds but they have their compulsions and have kept most beds for their own patients who will need ventilator support,” the senior doctor said.

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With over 700 Covid-19 cases being reported on a daily basis in the city since June 27, the demand for ICU beds has seen a sharp rise as well. On June 28, there were 155 patients in ICU care for Covid-19 and on June 29, there were 178, pushing ICU bed capacities to their brink. Until June, there were only around 10 patients in ICU care, all at the 36-bed ICU of the Victoria Hospital, the main Covid-19 hospital in the city.

“In a city like Bengaluru, there should be 2,000 beds with ventilators across sectors. The state government had time to put things in place when the lockdown was imposed in March, but it seems to have been unprepared for the surge in cases,” the senior state doctor said.

Waking up to the impending crisis, a ministerial task force for tackling the Covid-19 crisis announced last week that 775 ICU beds with oxygen facilities will be created at government hospitals other than those of the medical colleges. “We have decided to create 775 beds with oxygen facilities at hospitals other than the Victoria and Bowring Hospitals (which now have 50 ICU beds between them),” Home Minister Basavaraj Bommai said after a task force meeting on July 3.

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“The sudden rise in cases has been a surprise and this has put pressure on the healthcare structure in Bengaluru which is quite old. In one or two days, we will tie up everything and private hospitals also will be brought on board which will ensure availability of enough beds,” Medical Education Minister Dr Sudhakar said after the meeting.

In the first three months of pandemic in the city – from March 8 to June 23 – the state government had claimed access to 543 ICU beds, including 254 with ventilators. But after the cases started to spike and hovered over 700 on a daily basis since June 27, the numbers suggest there are barely 200 ICU beds with ventilators in the city.

The state is now scrambling to create a 10-bed ICU over the next ten days at 40-bed Epidemic Diseases Hospital. “We are moving fast to create an ICU in the hospital. We also need to hire staff rapidly for the ICUs. We have been given the freedom to recruit. We are in a situation where people must be recruited – even group D workers – and trained to man ICUs,” said Dr Ansar Ahmed, the District Surgeon for Bengaluru and Medical Superintendent of the Epidemic Diseases Hospital.

Besides Covid-19, another reason which is pushing up the demand for ICU beds with ventilators in Bengaluru is the rising number of SARI cases, which too require ICU ventilator support. At the Rajiv Gandhi Institute of Chest Diseases (RGICD), a government hospital dedicated both as a Covid-19 hospital and a SARI hospital, the 10 ICU beds at both the Covid-19 ICU and the SARI ICU are currently full, said Dr C Nagaraja, Director, RGICD.

“In the last few days, we have seen a lot of SARI cases. If they test positive for Covid-19 they are moved to the Covid wards. Both Covid-19 and SARI cases need almost the same care. There is a shortage of both ventilator support and trained staff,” said Dr J S Akshata of the RGICD’s SARI care facility. All 104 beds for Covid-19 and 40 beds for SARI patients were also full at the hospital last week.

As on July 4, almost 9 per cent of the 8,345 Covid-19 cases in Bengaluru (there are 7,250 active cases, 129 deaths and 125 patients in ICU) has been SARI and Influenza-Like Illness (ILI) cases.

“The situation is grim. Only if private hospitals pitch in, can we tide over the crisis. There is huge pressure on the hospitals. People are coming and demanding admissions and are getting very angry if we say the beds are full. Our staff are in constant fear of being attacked by the desperate families of patients,” a senior doctor at the RGICD said.

With dozens of healthcare sector workers – doctors, nurses, attendants, lab technicians and others – testing positive across hospitals and facilities for Covid-19, there is a gradual depletion of staff that can be deployed for Covid-19 care. “There are hospitals with ICU and ventilator beds, but there is no staff. We need doctors and nurses to run the facilities. Patients are dying because there are not enough oxygenated beds. We are appealing for doctors and nurses to come forward and volunteer in this crisis,” said Mohammed Ummer from the HBS Hospital whose Managing Director Taha Mateen made an appeal on Sunday for health care workers to come out and help patients during the crisis. In his appeal, he said his hospital had oxygen beds and ventilators, but no doctors.

“With the number of cases growing, finding manpower to deal with the crisis and ventilator beds is the real challenge now. Just buying ventilators is not going to solve the problem, there needs to be sufficient staff to use the equipment,” said Ratheesh Nair, Administration of Santosh Hospital.

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