MUMBAI: As covid-19 cases mount in Mumbai and patients struggle to get beds in hospitals, the city’s civic authorities are considering a change in strategy such as allowing patients with mild or no symptoms to recover at home.
The administration also mulls upgrading lower rung covid-care centres to treat patients with serious symptoms. These steps will help reserve hospital beds exclusively for the critically ill.
Following the massive surge in new cases in Mumbai, the city’s civic authorities had created a multi-tier system for patient management. Lowest in the hierarchy are Covid Care Centres (CCCs), which are reserved primarily for patients who are positive but are asymptomatic or have mild symptoms. Mumbai has nearly 56,000 beds in such facilities. Dedicated Covid Health Centres (DCHCs), with about 10,000 beds, which are reserved for moderately ill patients. Dedicated Covid Hospitals (DCHs) are for the critically ill who need serious medical intervention.
Under the new system, patients who test positive and have minimum symptoms or are relatively young and can practise social distancing at home, instead of being admitted to a CCC, will now be asked to stay home and recuperate. The CCCs will now be used to monitor patients with moderate symptoms, where they will be provided supplementary oxygen so that their condition does not deteriorate. This will restrict the number of patients who can be admitted to DCHCs and DCHs to only those who have severe symptoms and need active medical care.
“The main hospitals are getting full and we need the right approach to deal with a changing situation," Sanjay Oak, who heads the government-appointed medical taskforce to curb the spread of the pandemic in the state, told Mint. “We need to medically upgrade the facilities we have created so they can provide help to patients with more severe symptoms. Patients with mild symptoms who live in flats can practise social distancing and proper quarantine."
Many western countries have adopted this strategy. The UK has a person doesn’t need hospitalisation until his/her pulse oximeter reading is in the 80-85 range. A pulse oximeter is a small instrument that clips onto a patient’s finger and can read the pulse and the oxygen saturation levels in the blood. A 95-100 oxygen saturation range is safe.
“We’re making optimal use of the facilities we have and we will medically upgrade about 4000 beds, for instance at the new facility at the Bandra Kurla Complex," Oak said. “The hospital beds will be reserved for the critically ill."
Mumbai has so far reported over 41,000 covid-19 cases, of which 27,789 are active. The city has reported 1,319 deaths so far while nearly 17,000 patients have recovered and been discharged from hospitals.
“Only simple CCCs can be set up within 10-15 days, not full-fledged hospitals," Shivkumar Utture, president, Maharashtra Medical Council, told Mint. “So what we need to do is reduce the number of patients going into a DCH... Our infrastructure and supply of instruments is struggling to keep up with the increase in patients and ventilators and hospital beds are a scarce resource."