The four states that are the worst hit by the pandemic in India have been forced to consider out-of-the-box options as they find themselves struggling to cope with a surge in patients needing ever more doctors, nurses and paramedics
Rapidly rising covid-19 cases have stretched India’s frayed healthcare system, prompting government health authorities to turn to the private sector or even other states.
The four states that are the worst hit by the pandemic in India—Maharashtra, Tamil Nadu, Gujarat and Delhi —have been forced to consider out-of-the-box options as they find themselves struggling to cope with a surge in patients needing ever more doctors, nurses and paramedics.
Last week, Maharashtra ordered municipal commissioners and district collectors of the Mumbai Metropolitan Region to take charge of 80% of beds in private hospitals, while capping treatment costs till 31 August.
Additionally, the Brihanmumbai Municipal Corporation (BMC), anticipating a further spike in cases, said it is setting up 100,000 beds for coronavirus patients, and doubling the number of ICU beds to 1,000. And on Sunday, the state sought Kerala’s assistance in managing the pandemic in Mumbai, requesting 50 doctors and 100 nurses from the southern state to buttress the efforts of around 5,000 doctors called in to the capital from other districts of Maharashtra.
“A lot of hospitals did not have special facilities required for covid treatment, like negative isolation wards and ICUs with ventilators, quarantine facilities with oxygen supply and normal quarantine facilities. These had to be set up when the pandemic began," said Gautam Khanna, chief executive of PD Hinduja Hospital & Medical Research Centre, Mumbai.
“Setting up and increasing such capacities takes time and hence we are seeing hospitals being stretched beyond their capacities," he said.
Meanwhile, Kerala too is constrained, notwithstanding its enviable healthcare standards. It is considering helping not only Maharashtra but also the UAE—a favoured destination for people of the southern Indian state —as essential strategies to control the spread.
But in doing so, it faces a tough challenge to meet its own staffing needs, as the number of infections in the state shot up from just 16 to 322 in the last two weeks. In early May, Kerala, anticipating manpower shortages, decided to appoint nearly 1,000 doctors on a temporary basis.
It was the largest-ever direct public recruitment in Kerala, a hiring that would have normally have taken place over the course of years. In March, it had appointed 276 doctors to tackle the pandemic amid a staff shortage, another unprecedented step. The two spells of hiring were in response to a rise in infections resulting from the resumption of foreign and interstate travel.
On Sunday the Delhi government issued orders to 117 private hospitals to reserve 20% of their beds for covid-19 patients. Chief minister Arvind Kejriwal on Monday said as many as 509 of the 677 beds available in private hospitals in Delhi for covid patients are occupied as people seem to prefer getting treated in private hospitals.
“There were enough beds and human resources for tackling covid-19 when there were fewer cases in India, but the situation is different with cases reaching 150,000. The orders of taking over private hospitals for covid-19 treatment reflect that public sector hospitals across states are falling short of doctors and nurses, especially in high caseload states such as Maharashtra, Gujarat, Tamil Nadu and Delhi," said Girdhar Gyani, director general, Association of Healthcare Providers- India.
This a reflection of a wider healthcare gap. India has one doctor for every 1,445 citizens —below the WHO’s prescribed norm of one doctor for 1,000 people. And it has only 1.7 nurses per 1,000 people against the prescribed minimum of three.
“The country already had a very poor doctor-population ratio and this is even more acute for covid-19, since trained interventionalist and infection control specialists are very few. This has necessitated the government in some states to mandate doctors from other specialities to treat covid patients at public and private hospitals," said Khanna.
Nidheesh M.K. in Kerala, Kalpana Pathak in Mumbai and Pretika Khanna in New Delhi contributed to this story.
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