City’s Covid surge chokes NCR of hospital beds

Noida-resident Bhanupratap Singh stood in queue for hospital admission at Sir Ganga Ram hospital on Saturday. His friend’s mother had tested positive for coronavirus disease (Covid-19) and was brought to the hospital emergency when she started having difficulty breathing.

“She is still in the hospital emergency. There are no beds in the hospital; we are waiting for beds to free up so she can be admitted. I have called several private as well as government hospitals but was told that even they did not have beds. In fact, the corona app shows that there are beds available in these hospitals but when I called, I was refused,” said Singh, wishing not to give the name of the patient.

“My friend’s brother had also tested positive in September and there was no problem in getting him admitted to a hospital at that time,” he added.

The situation was the same for Akriti whose 65-year-old father and 62-year-old mother had both tested positive for the infection earlier this week. On Thursday, when her father’s oxygen saturation started dropping suddenly, she took him to the emergency department of a big private hospital in the city. He stayed in the hospital emergency for over 24 hours because they were unable to find an ICU bed.

With Delhi reporting over 6,500 cases for five days, hospital admissions in the city have shot up. Over 81% of all the intensive care unit beds available in Delhi were occupied as of Sunday evening, according to data on the Delhi Corona app. Almost 86% of the ICU beds in five big government hospitals were occupied and 93% of those in the five big private hospital chains, according to the data.

As for the total beds earmarked for the treatment of Covid-19, around 50% of 16,067 were occupied as of Sunday evening.

“Over the last week or so, the Covid-19 admissions have shot up. And if you see the big hospitals, almost all of the patients need oxygen support, non-invasive or invasive ventilation. Those with mild symptoms are choosing to stay at home. There is a very small proportion of patients admitted to the general wards – those who are very old or have several comorbid conditions and are at a high risk of the disease taking a severe course,” said Dr Atul Gogia, senior consultant of internal medicine at Sir Ganga Ram hospital.

Unlike in August, when several of the Covid-19 patients were from neighbouring states, most patients in the hospital are from Delhi, he said.

However, several hospitals in Delhi NCR say that many of their in-patients are from Delhi.

Of 670 Covid-19 patients admitted in Gurugam hospitals, only 300 are city residents, while 144 are residents of Delhi.

Dr Virender Yadav, chief medical officer, Gurugram, said spillovers from Delhi and neighbouring regions had been anticipated earlier. “There is no cause for alarm because so far we are able to absorb this spillover… In certain hospitals, availability of beds is an issue, but there are plenty of beds available in other private and government facilities. There are no curbs on admitting patients from elsewhere,” he said.

A spokesperson with a major private hospital in Gurugram, who did not wish to be identified, said that a significant number of patients from Delhi are elderly with comorbidities like diabetes, hypertension and past cardiac events.

“They typically opt for one of three major multi-specialty hospitals in Gurugram that offer Covid-19 treatment, but are also equipped to deal with any complications arising from specific comorbidities. Many also happen to be residents of south and west Delhi, since Gurugram is easily accessible from there…,” the spokesperson said.

Private hospitals in Ghaziabad have also reported increase in bed occupancy, and say that they have been admitting Covid-19 patients from Delhi as well.

“Our occupancy till last week was about 65-70% and it has now gone up to about 90%. We are now getting patients from Delhi, Noida, Meerut and Bulandshahr besides the ones in Ghaziabad. It is also expected that spike in Delhi and upcoming festival season will surely lead to increase in number of cases,” said Dr Sangeeta Garg, chief medical superintendent of Yashoda Super Speciality Hospital at Nehru Nagar.

Apart from the 13 private hospitals with 900 Covid-19 beds, there are 576 beds dedicated for Covid-19 patients in government hospitals in the district.

District officials said they were getting 1,100 beds readied, and have made arrangements for 43 ventilators in government and 45 ventilators in private sector hospitals for the expected surge in cases in coming weeks.

Noida and Greater Noida in Uttar Pradesh have enough Covid-19 beds to meet the current demand say officials, however, they are preparing for a surge in demand for ICU beds.

“As of Saturday, the district has a total 64 patients in ICU of which eight are on ventilators. The average mortality rate so far for the district is 0.4%. Since there are about 1,500 vacant beds, it seems there is so far no need to increase them, but the department has already asked several private and public hospitals to keeps a few beds in reserve, just in case,” said Dr Manoj Kumar Kushwaha, district surveillance officer, state health department, Gautam Budh Nagar.

To increase the number of beds, the Delhi government on Friday directed 22 hospitals to reserve more beds for Covid-19. This will add 1,185 more beds to the city’s then total 15,800 Covid-19 beds. The government has also been trying to challenge a Delhi high court decision that scrapped its September order to reserve 80% ICU beds in 33 big private hospitals.

The problem is likely to get worse, with a committee headed by NITI Aayog member Dr VK Paul estimating that Delhi might see up to 15,000 cases a day during the winters. “Aggressive contact tracing and testing is a part of the reason for the current increase in the number of cases, the number of hospitalisations show that the infection is on the rise in Delhi. The third wave is the worst. Our committee had suggested creating pre-hospital facilities in banquet halls that can support patients who need some oxygen support, but with the increase in the number of patients needing intensive care, ICU beds will have to be increased in the hospitals,” said Dr Arun Gupta, a member of a committee set up by Delhi government in June beginning to help it in estimating and planning scale-up of infrastructure needed to manage Covid-19.

He said the government ordering 80% reservation of ICU beds is one way to do so.

“If infrastructure gets overwhelmed and people do not receive appropriate care at the right time, the mortality is likely to go up. Apart from what the private sector is doing, there are several free beds in government hospitals that can be upgraded to become ICU-like,” said Dr Sandeep Budhiraja, group medical director, Max hospitals. The city is likely to see a further rise in cases for now, he said.

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