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Wednesday, October 21, 2020

Tripura’s Covid fight — From unused ventilators to lack of death audit: Central team flags issues

With 24,918 cases and 270 deaths till September 27, the state currently has the highest Covid mortality rate in the Northeast.

Written by Sourav Roy Barman | New Delhi | Updated: September 29, 2020 8:37:03 am
Tripura’s Covid fight — From unused ventilators to lack of death audit: Central team flags issuesGovind Ballabh Pant Hospital in Agartala.

Unutilised ventilators, dysfunctional X-ray and CT scan machines, no audit of deaths and non-existent waste management are among observations made by a three-member central team assessing the Covid-19 situation in Tripura after a visit to the lone designated Covid hospital in the state.

With 24,918 cases and 270 deaths till September 27, the state currently has the highest Covid mortality rate in the Northeast.

National Centre of Disease Control’s consultant epidemiologist Dr Daisy Panna, Lady Hardinge Medical College’s associate professor (respiratory medicine) Dr Pushpendra Verma and Union Health ministry’s senior regional director (Kolkata) Dr Satyajit Sen were members of the team that visited Govind Ballabh Pant Hospital, toured all the districts and reviewed the home isolation strategy between September 10 and 18.

At GBP Hospital, the team found 289 patients against 240 beds set aside for Covid patients, including three patients on ventilator and 50 on oxygen support. “10 BiPAP NIV (non-invasive ventilators) and 19 ventilators were unutilized and not installed,” the team said in its report.

Read | One RT-PCR lab, one Covid hospital, Tripura fights surge

Out of the 240 beds, 25 were equipped with oxygen supply and nine were ICU beds fitted with ventilators.

The committee’s report said X-ray and CT scan (chest) machines were not functioning at the time of its visit to GBP. “Death register was being maintained but records were incomplete, especially the columns on date of admission, comorbidity, diagnosis… There was no death audit/review committee,” the report said. Following the committee’s submission, a death audit committee has been formed.

The report also suggests the state continues to lack facilities such as a strong ambulance fleet. “A robust transport (dedicated ambulance with oxygen support with bag and mask with trained staff) and a sound referral system needs to be formulated as only one dedicated hospital is catering to the whole state…,” it said.

The report also flagged “no designated donning and doffing area for PPE” at the emergency Covid care ward; “major issues” involving biomedical waste management and lack of communication between the hospital and patients’ relatives.

The team has directed the state government to strengthen the oxygen supply systems at remote district hospitals as critically-ill patients have to spend hours travelling to Agartala.

Additional Chief Secretary (health) S K Rakesh told The Indian Express, “What the central team pointed out on unused ventilators and other equipment is true but that was due to mismatch of sockets of the devices. The person who could install it had to come from Guwahati and there was a delay. Most issues we are facing are due to remoteness of the state. We are getting the ventilators installed.”

On X-ray and CT scan machines, Rakesh said, “For non-Covid patients, we made arrangements at the adjoining cancer hospital. However, Covid patients could not be taken out. Again, getting repair staff was a problem as they had to come from Delhi or Kolkata.”

The senior official said August saw a spike in cases and deaths, but the situation was stabilizing now. He said, “There were rumours that the state government would declare even negative cases positive as it was getting Rs 1.5 lakh per patient as funds. That made people hesitant to get tested. Many reached the hospital very late. Also, there were around 3,000 marriages and political activities too.”

The state government is looking to add another 250 beds at GBP by October 15, he said.

Facing criticism for the Covid situation, Chief Minister Biplab Deb recently said he “won’t forgive” sections of “overexcited media” for “misleading people”. Since then, at least four journalists have been assaulted, allegedly by workers of the ruling party.

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