The Delhi government issued an order on September 12, instructing 33 premier hospitals to reserve 80% of their ICU beds for Covid-19 patients. According to experts, the order created problems in these institutes as non-Covid patients, who had been waiting for their procedures, had started coming for treatment, and at the time more than 50% of ICU beds, in general, were occupied by them.
Another problem that the hospitals faced was how to separate 80% beds from the remaining 20%. Dr Girdhar Gyani, director general, Association of Healthcare Providers (India), said, “If an ICU with 40 beds has to keep 32 beds for Covid-19, then how do we isolate the balance 8 beds for non-Covid patients? This would mean that virtually all 40 beds would be used for Covid patients. The other important issue was that some of these 33 hospitals are undertaking quaternary care procedures like bypass heart surgeries, liver/kidney transplants, oncology, neuro/stroke surgeries, etc. Patients needing these procedures depend on these hospitals and the order passed by the Delhi government virtually shut the doors for them. It appears as if as per the Delhi government there are no non-Covid patients in Delhi.”
AHPI challenged the order in the Delhi High Court, and it was stayed on September 22. The Delhi government approached a double bench of the HC but this plea was stayed there as well. The government then approached the Supreme Court and there, too, it was referred to the double bench of the high court. By this time the number of cases had increased and the HC, on November 12, vacated the stay till November 26.
“After the stay being vacated, the Delhi government has gone into an overdrive and ordered all private hospitals to reserve 80% of their ICU beds for Covid-19. Further, the government has ordered 90 private hospitals to reserve 60% of their total beds for Covid. This is going to create a very serious situation for non-Covid patients, resulting in likely increase in morbidity and mortality of such patients. Unfortunately, fatalities due to non-Covid cases will not come on record,” Dr Gyani said.
“There has been a failure at the macro level. The Delhi government did announce at that time to set up Covid care centres in hostels, open shamianas, railway wagons, etc. Then came 10,000 beds at Radha Soami Satsang Sabha. Unfortunately, we depended too much on home isolation and did not set up or utilise the Covid care centres for mild cases. The government failed to educate the population on when to go for Covid tests and when to report to Covid care centres or hospitals. This compounded the cases and suddenly patients started approaching hospitals a little too late. This situation was further aggravated due to huge relaxations during festive time and adverse weather conditions,” added Dr Gyani.
AHPI says that what seems to be the tipping point is the fact that while the pandemic is a basic responsibility of the public health system, with the private sector acting as the second line of defence, the recent order makes the private sector the first line of defence. Elaborating on what could prove to be a viable a solution, AHPI says, “It is time that the government introspects and enters into a dialogue with the private sector and finds amicable solutions to earmark dedicated Covid hospitals/wards and at the same time keeps beds for life-threatening ailments like heart attack, stroke, kidney/liver transplant, cancer, etc. It is also time that we activate Covid care centres for mild cases including utilising the 10,000 beds at the Radha Soami centre and similar other centres to avoid patients rushing to hospitals. Finally, a comprehensive campaign is needed to educate the population on acting on time with respect to specified conditions as publicised by ICMR.”