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Tuesday, May 18, 2021

Beds, oxygen, medicines: How Chhattisgarh dropped Covid ball

Documents accessed by The Indian Express also show that the actual number of ventilators in the state is 497, about half the number, 937, mentioned by the state on a government portal.

Written by Gargi Verma | Raipur |
Updated: April 24, 2021 7:26:17 am
Not enough beds for symptomatic patients waiting for their test results at a Covid hospital in Jagdalpur. (Express photo)

In the second Covid-19 wave sweeping the country, Chhattisgarh is among the worst-hit states in terms of both cases and deaths, ranking only behind Maharashtra and Delhi on days. However, data show that between the last peak of August 2020 when it was seeing around 4,000 cases daily and now, when its daily caseload is 17,000-plus, the state has added just two Covid hospitals amounting to 722 extra beds.

Documents accessed by The Indian Express also show that the government Covid centres had 497 ventilators in August 2020, about half the number, 937, mentioned by the state on a government portal. Of these, only 384 are in dedicated Covid hospitals, apart from 23 in Covid care centres. The total number of ICU beds for Covid-19 patients in government hospitals in the state is only 477, with 1,881 ICU beds in private facilities.

Chhattisgarh currently has more than 1.3 lakh active cases, with 150-plus deaths being recorded daily for almost a week now. In the past 24 hours, the state saw 16,750 cases and 207 deaths.

While the government is racing to increase capacity, this means extra oxygen, life-saving drugs and trained manpower, which are proving difficult to arrange. For example, while the state has two large oxygen plants, both in Bhilai, there are not enough containers to stock the gas. So even as the number of patients on oxygen support is rising, empty cylinders have to be rushed back for refilling.

After the first wave, Chhattisgarh had planned to set-up nine liquid medical oxygen storage spaces along with 23 oxygen plants, for which work started in November last year. Five months later, none of the nine storage units is ready, while of the 23 oxygen plants that should have been completed by January 31, only 15, in districts, were ready by early April. The others will be ready only by the first week of May, sources said.

“We have taken cylinders from some district plants. We have also placed orders for more cylinders and are converting industrial oxygen cylinders into medical cylinders,” a Health Department official said.

On the other essentials too, Chhattisgarh is lagging. Said an official, “The tenders for drugs and other paraphernalia were floated only in the second half of March. For remdesivir, we were just finishing our tenders when the demand shot up, so the companies reneged, which led us to tender for it again in April.” According to sources, the last procurement happened in November 2020, after which officials appointed on special duty for Covid-19 were moved out, essentially halting the procurement drive. The then health secretary, for example, went on leave from September, and a new one was appointed.

The lull also saw the number of beds available in Covid care centres go down by nearly half. From 186 centres with 21,883 beds in August 2020, Chhattisgarh numbers are down to 101 centres and 11,442 beds. However, while in August these centres did not have ICUs or ventilators, the centres have 23 ventilators and 46 ICU beds now, apart from about 2,000 beds with oxygen supply.

In state capital Raipur, where all the 11 Covid care centres are up and running, these are being besieged by patients who can’t get beds elsewhere. The result being that these centres, meant to handle mild and moderate cases — and equipped with only 592 beds with oxygen, and three ventilators in all — are being forced to take serious cases.
Raipur has in all 3,776 beds in private hospitals, including 1,583 with oxygen. Government hospitals, including AIIMS, Raipur, have 1,156 beds and 488 with oxygen. Raipur’s tally of active cases is more than 18,749.

“Covid care centres can’t replace ICU beds, HDU (high-dependency unit) beds and other facilities of hospitals. What we need are specialists and better institutions,” a doctor based out of Raipur said, asking not to be named.

Sources in the Health Department said Health Minister T S Singh Deo had written to Chief Minister Bhupesh Baghel at least twice between April 2020 and April 2021 seeking funds to increase the ICU bed capacity, but was told that districts would be increasing the capacity on their own.

While Bilaspur, Raipur and Durg, the worst-hit of the state’s 27 districts, got Rs 10 crore each to augment facilities, these too are floundering. Durg, Baghel’s home district, for example, has only three government hospitals with 798 beds, while Bilaspur has limited ventilators. Durg has upwards of 12,000 active cases currently, and Bilaspur 10,000.

Baghel denied the lack of preparation. Asserting that health facilities had been augmented substantially from last year, the CM told The Indian Express, “Money is being given freely to all districts and the Health Department and all our departments are working in complete synergy.”

Singh Deo said the shortage of ICU beds was hurting the most. “A file has already been moved from our office for more ICU beds, let’s hope it is passed.” He also lauded private hospitals for “working together” with the government, “unlike last time”.

Under the surge, laboratories are struggling to handle RT-PCR tests, with the lag in results up to five days hurting containment efforts. Many cases are being traced to hospitals as patients wait for tests.

The BJP has accused Baghel, who had been handling the Congress’s campaign in Assam, of being absent even as Covid surged. A BJP leader, Ajay Chandrakar, said the tussle between Baghel and Singh Deo, rivals for CM post, was responsible for “the lack of direction” in the state’s anti-Covid efforts, a charge repeated by many. Ex-CM Raman Singh has accused a cricket tournament organised by the government in March of adding to the infections.

Accusing the BJP of “petty politics”, Baghel said, “None of them is helping, bas meen mekh nikaal rahe hain (they are just nitpicking)… They are blaming our cricket match when they are the ones organising super-spreader events. Chhattisgarh is much better on all fronts in the war against Covid-19 in comparison to BJP-ruled states.”

The CM said it was the new Covid-19 variants that were behind the crisis. “Last year, people were getting better faster. The variants are more dangerous, oxygen levels are dropping suddenly in even patients not suffering from comorbidities. Young people are getting ill faster.”

***

Clarification

This report initially said there were “only 32 ventilators in dedicated Covid hospitals against 384 claimed by the government”. The state has more than 500 ventilators and, according to Health Minister T S Singh Deo, has requested for 285 additional ventilators from the Centre.

There were 32 Covid-19 treatment centres across Chhattisgarh in August 2020. That number was inaccurately mentioned as the number of ventilators.

The error is deeply regretted.

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