Despite doubts about ‘low-end’ machines, Karnataka to deploy 640 PM Cares ventilators

Faced with a rapidly escalating caseload, the state is staring at an acute shortage of high-end ventilators needed to assist patients with severe lung damage. As of Monday evening, there were only six ICU ventilators available, out of a total of 22 in 15 government hospitals, and only two of 77 in government medical college hospitals across the state capital. As of the same time, there were 332 patients in ICUs in Bengaluru hospitals.

The healthcare infrastructure in Karnataka, and Bengaluru in particular, is under severe pressure in the middle of a massive increase in Covid cases – from 4,555 on June 30 to 34,943 cases reported in the city as on July 21. These include 26,746 active cases. As many as 623 of 698 Covid deaths in Bengaluru have occurred since July 1.

The state has recorded a total 71,069 cases, including 45,865 active cases, as of Tuesday; there have been 1,464 deaths so far.

The 640 ventilators received by the state under PM Cares is part of 1,600 approved by the Centre for supply to Karnataka. The state has, in all, sought 2,149 ventilators.

The machines delivered under PM Cares met with some questions after two hospitals in Mumbai and one in Delhi reported dissatisfaction over their capabilities in supporting Covid-19 patients. Modifications and improvements have been sought in ventilators supplied to a government hospital in Delhi, while in Mumbai 81 machines were reportedly returned by two hospitals.

Some doctors in the state’s government sector have also questioned the efficacy of these ventilators for seriously ill patients. “Around 600 ventilators supplied under PM Cares fund are waiting to be deployed in hospitals run by the Health Department,” a senior Karnataka medical official had said recently. “These are low-end machines, so we need to check their quality before deploying them (in hospitals). There are reports of procurements not being to specifications. It will have to be tested.”

AgVa Healthcare, a start-up which has a tie-up with Maruti Suzuki India Limited and a BEL-Skanray Technologies consortium, is the main manufacturer of ventilators being procured by HLL Lifecare, the Union government’s procurement agency, under PM Cares.

But maintaining that these ventilators meet the “basic requirements”, Health Secretary Akhtar said on Monday, “We have checked with Maharashtra health authorities and found that PM Cares ventilators are in use in that state. There is no other choice (for Karnataka) at present. It has been provided free of cost and meets the basic requirement.”

Soon after the first coronavirus case in the state was reported on March 8, the government procured 108 ventilators, 80 of them basic models and 28 high-end ones.

“In March, there was only one local supplier when we were looking to procure ventilators. We took an approval from the (Covid) task force and ordered 130 from Skanray Technologies. So far we have received 80. We have also procured 28 ventilators off the shelf as emergency measure, their price varying from Rs 11 lakh to Rs 18.20 lakh (per machine).”

The 80 Skanray Technologies ventilators, procured at Rs 5.60 lakh each, have cost the state Rs 4.48 crore, while the 28 high-end ones have been obtained at a cost of Rs 3.33 crore, Karnataka Drug Logistics and Procurement Society’s director N Manjushree said.

Akhtar said more supplies are in line, and once completed they should be adequate to handle the Covid-19 situation in the state.

The 640 ventilators supplied from PM Cares scheme are a mix of Agva Healthcare and BEL Skanray Technologies, health officials said.

At present, the state is leaning heavily on medical colleges and private hospitals to meet the requirement for high-end ICU ventilator beds. The Medical Education Department, which is separate from the Health Department, has additionally procured 140 high-end ventilators. Received from Germany, these machines have been installed already, and another 85 ventilators will come, Medical Education director Dr P G Girish said.

The Karnataka government has insisted that availability of ICU beds with ventilators is a non-issue since only one percent of active cases need them. “The situation may be manageable at present, but if cases hit 50,000 or 1 lakh in the coming days in Bengaluru, where are the ICU beds with ventilators,” a health official asked.