Hospital infrastructure may be stressed if Covid-19 infections rise further

Rate of hospitalisation low so far, at less than 2%, but doctors caution against dropping guard

India’s hospital infrastructure may be put to test again if the rate of infection rises during the Omicron-led third Covid wave sweeping through the country. So far, the rate of hospitalisation remains low, at 1.5 to 2 per cent — less that two out of 100 people with Covid currently require to be hospitalised.

The country added 159,000 fresh cases in the last 24 hours (as of Sunday morning).

Ritu Garg, zonal director, Fortis Memorial Research Institute, Gurugram, compares her experiences of the two waves. In mid-April, her hospital had 80 patients admitted when the case tally in Delhi was 1,500. Now, the hospital has 12 patients with daily cases crossing 15,000 in Delhi.

Mumbai’s civic body, too, pointed to a similar experience. “When Mumbai had a peak of 91,108 cases during the Delta-led second wave last year, 85 per cent of the oxygen beds and 96 per cent of the ICU beds were occupied. This time, 27 per cent of the oxygen beds and about 30 per cent of the ICU beds are occupied, even when the city’s active cases have crossed 91,000,” a civic official said.

Currently, of the total 2,150 beds in nearly 45 private hospitals in Ahmedabad, 30 are occupied for isolation, 14 ICU beds without ventilator support are taken and there are three patients in ICU on ventilator support. If the need arises, the number of beds can be ramped up to 6,000, said Bharat Gadhvi, president, Ahmedabad Hospitals and Nursing Homes Association.

Doctors, however, caution that the low hospitalisation at this stage is not a good enough reason to lower your guard, for things may go downhill from here.

Shuchin Bajaj, founder director of Delhi-based Ujala Cygnus Group of Hospitals, pointed out, “We are already seeing 100,000 daily cases in India now, and the number is expected to go up to a minimum of 500,000 cases per day. This means, 10,000 patients would need hospitalisations per day. It’s a huge number, and we really don’t have beds for that.”

Gopi Krishna Yedlapati, pulmonologist with Yashoda Hospitals Group in Hyderabad, added that the city starts to feel the pressure when patients from the adjoining districts start to pour in. “When cases in Maharashtra start to rise, people from bordering districts come to Hyderabad for treatment,” he said.

While each city may be gearing up to meet its daily load of cases, the imbalance in urban and rural healthcare infrastructure may become pronounced as cases spike, and more patients become critical.

Major cities are leaving no stone unturned. The Mumbai civic body has asked all private hospitals to restore their peak Covid-19 bed capacity (May 2021 levels) by January 10. Nearly 95 per cent of the cases in the city, which has reported 20,000-odd cases for three straight days, are from non-slum areas. So, the demand for private hospital beds would be higher. The Delhi government has recently instructed all hospitals with 50 or more beds to reserve 40 per cent (ward and ICU beds) for Covid-19 patients.

Tamil Nadu and Kerala have decided to focus on symptomatic patient treatment to ensure enough beds are available for those who need them. In the last one week, while the number of active cases in Tamil Nadu increased by 3 per cent, the number of hospitalisations increased 8 per cent and those in ICUs jumped by 10 per cent. 

Moreover, while hospitalisation demand has been low so far, medical experts are worried about more children calling in sick this time, and hospital staff catching the infection. Around 200 staff members of Christian Medical College, Vellore reported positive for Covid on Sunday.

“In Tamil Nadu, we have a total of around 100,000 beds available, including the private sector. What we are afraid of is a shortage of manpower in case a lot of health care professionals get affected. At this point, hospitalisation of cases is relatively less,” said J A Jayalal, national president, Indian Medical Association (IMA).

Another worry is the rise in sales of home test kits for Covid-19. While hundreds of thousands of kits are being sold daily, civic officials feel people many may not report the results immediately. Suresh Kakani, additional municipal commissioner of Municipal Corporation of Greater Mumbai, said that about 70,000 tests are done daily in Mumbai, of which the majority are RT-PCRs. “We expect people to be responsible and report their results. Hospital admissions are based on RT-PCR reports,” he said.

Vinay Umarji contributed to this report