India’s health infrastructure under pressure as covid-19 burden swells

With daily covid-19 cases crossing the grim milestone of 1 lakh surpassing the previous year’s peak, several hospitals across the country are stretched beyond their capacities in handling the rising burden of the highly infectious disease.

States such as Maharashtra, Delhi, Chennai along with Punjab and Karnataka bearing the maximum load of the pandemic are already falling short of health infrastructure and equipment ranging from oxygen to ventilators.

India’s daily new cases continue to rise with 1,03,558 (1.03 lakhs) new cases were registered in the last 24 hours. Eight States including Maharashtra, Chhattisgarh, Karnataka, Uttar Pradesh, Delhi, Tamil Nadu, Madhya Pradesh and Punjab have shown a steep rise in the covid-19 daily new cases. 81.90% of the new cases are reported from these 8 states.

Mumbai remains one of the worst covid-19 hit cities in India. The Brihanmumbai Municipal Corporation (BMC) last week decided to discharge asymptomatic patients at the earliest to vacate beds for the patients with more serious symptoms.

The Mumbai civic body also said that it will place the order for procuring 1.5 lakh injections of antiviral drug Remdesivir and other medical equipment to avoid any potential shortage of medicines at the city hospitals. BMC commissioner IS Chahal said that all admissions should be routed through the ward level war rooms to avoid any chaos experienced during the first wave of coronavirus when several patients ran from the pillar to post to get a bed.

Maharashtra reported the highest daily new cases at 57,074 in last 24 hours. Private hospitals are witnessing rise in hospital admission of covid-19 patients. “We have witnessed a sudden surge in the number of COVID admissions and new infections. It is a major task to prioritise and allocate the equipment and infrastructure, while not compromising on the safety and quality of the treatment for large tertiary and quaternary care medical facilities,” said Dr Deepak Patkar, Medical Director Nanavati Super Speciality Hospital, Mumbai.

However, it is further more challenging to address the high demand of not only doctors, nurses and paramedical staff but non-medical support staff that plays an equally vital role in the seamless operation of any medical facility,” he said.

Prime Minister Narendra Modi in a review meeting on Sunday said that mortality under all circumstances should be avoided by ramping up healthcare infrastructure, availability of oxygen, ventilators besides required logistics, and ensuring that clinical management protocols are followed across all hospitals as well as for those in-home care. Concerned over the rising burden of the pandemic, states are now revamping their health infrastructure in order to tackle the rising number of patients.

“The situation in Odhisha is yet to be alarming as in States like Maharashtra, Kerala, Punjab and Madhya Pradesh, however, we have not only increased our testing, tracing, isolating and treatment but also speeded up vaccination. We have also started re-organizing our covid centres and hospitals in preparation for possible spurt,” said Dr Amar Patnaik, national spokesperson, BJD told Mint.

Uttar Pradesh shared the same concern. “There’s no shortage as on date, but if we go beyond 7000-8000 cases per day, we will have tough situation. But we shall prepare before that,” said Alok Kumar, secretary to Uttar Pradesh chief minister Yogi Adityanath.

Delhi hospitals’ real time bed availability on Sunday was showing that in at least 24 private hospitals and one state run hospitals, there was no ICU (without a ventilator) beds available. As the positivity rate is looming around 3% in Delhi, the state government has increased testing capacity along with boosting the health infrastructure amidst the surge. "We have issued orders to add 230 ICU beds in private hospitals. Along with this, 842 normal beds were directed to increase. In Delhi government hospitals, enough beds are vacant. Overall Occupancy rate inclusive of private and government hospitals is 25%. It is a comfortable situation but there were instances of shortage of beds in 2-3 hospitals, therefore, orders were issued to increase 220 ICU beds in 33 hospitals,” said Satyendar Jain, Delhi Health Minister.

India’s total Active Caseload has reached 7,41,830. It now comprises 5.89% of the country's total Positive Cases. A net incline of 50,233 cases recorded from the total active caseload in the last 24 hours, according to the union health ministry data. Private hospital chains across north India are fearing to run short of beds shortly with the rising burden of active cases. “Due to the fact that there is no lockdown as such currently and also, there are no completely dedicated covid hospitals, unlike last year. The pressure on the hospitals will be that much higher because they are dealing with routine cases, routine surgeries as well, and addition to the recent second wave of covid infections. So, it will be a tough fight to make sure that we treat all the patients,” Dr. Shuchin Bajaj, Founder Director, Ujala Cygnus Group of Hospitals said. The chain has hospitals in Delhi, Haryana, Uttar Pradesh and Uttarakhand.

“If the cases keep increasing it will be a tough fight for the healthcare infrastructure which has already been put under peak strain last year and it will be tough for the doctors and staff to again go through that stress once more as the cases rise in Delhi and north India,” said Bajaj.