Panic, greed, sleaze, underreporting reasons behind shortage of beds
Only five per cent of patients affected by Covid-19 require hospitalisation, Indian Council of Medical Research Director-General Balram Bhargava said on March 22.
The Union Health Ministry slightly revised the figure on May 21. At a Press briefing, Joint Secretary in the Health Ministry Lav Agarwal said out of the total number of active Covid-19 cases in the country, 6.39 per cent needed hospital support. Out of these, about 2.94 per cent needed oxygen support, three per cent intense care units (ICU), and 0.45 per cent required ventilator support.
On June 6, Delhi had a 27,654 active cases. If we go by the ICMR assessment of five per cent hospitalisation requirement, Delhi should need around 1,400 beds. If we follow the national trend of hospitalisation of 6.3 per cent, then Delhi should need around 1,700 beds.
On June 5, Delhi Health Minister Satyendra Jain claimed that Delhi has 5,000 hospital beds, nearly six times more than what the State required, going by the assessments of the ICMR and Health Ministry. That raised the all-important questions: Why crowding in the hospitals when so many beds are on offer?
Now take the case of Mumbai. According to a daily Covid-19 report published by the State Government, 16,801 coronavirus patients were admitted in hospitals across Maharashtra on Friday last when the total number of cases in the State stood at 80,000. It means around 20 per cent of the patient required hospitalisation in Maharashtra.
In Mumbai, which had 37,500 positive cases on Friday, of the total bed capacity of 9,092 in dedicated units, 8,570 beds were occupied whereas of the 1,097 ICU beds, except 20 all beds were occupied. In addition, 378 patients were on ventilators. That means around 10,600 hospitalisations, which comes to more than 30 per cent of the confirmed cases.
In Haryana, around 30 per cent of the total Covid-19 patients were admitted in 12 health institutions as on Friday. Of them, 12 patients, constituting less than 0.6 per cent of the total active cases, are critically ill and have been put on the ventilator and oxygen support.
The reports from these affected States make a mockery of the ICMR estimate of the hospitalisation requirement. The figures also show that in all these three States, four to five times more patients have landed in hospital as against the national average.
What could explain such a mad rush to hospitals in the last few weeks? Panic of the patients, the greed of hospitals, connivance between labs and hospitals, and a possible underreporting of cases.
A senior official of the ICRM told The Pioneer on the phone that 5-6 per cent hospitalisation is a universal trend. He felt that throwing the hospitals open for all patients was the reason behind the highly inflated figures in these States.
“It’s not for me to comment on this issue. Hospital authorities will better speak about it. But I do feel that not all cases require hospitalisation. In Japan and several other counties, they never admitted mild or asymptomatic cases in hospitals. Why are we doing it in India?” he asked.
Not surprisingly, the Delhi Government has directed hospitals to discharge all mild and asymptomatic patients and not admit such cases in the future.
“Fever and coughing would fall under mild symptoms. If a person’s breathing rate is more than 15 counts in a minute, it indicates moderate Covid-19 infection whereas over 30 breathing counts in a minute would fall into the severe category,” the Delhi Health Minister said at a Press conference on Saturday.
It’s shocking that the hospitals kept admitting such cases when the Union Health Ministry on May 14 issued a set of revised discharge guidelines which said Covid-19 patients with mild and moderate symptoms need not be tested before discharge.
The guidelines said all mild and moderately-ill patients should be discharged without testing from hospital 10 days after onset of symptoms — if there is no fever and no oxygen support needed for three days. In the case of the severely ill patients, negative testing is must after clinical recovery.
Before these guidelines, two consecutive negative tests within 24 hours was a must before a patient could be discharged.
It’s obvious that Delhi hospitals willfully flouted the Healthy Ministry’s discharge policy because they treated the Covid-19 pandemic as a windfall. That’s why States such as Maharashtra, Kerala, and Tamil Nadu have fixed a cap on the fees the hospitals could charge from the patients for their stay.
There is another interesting side to this crowding of hospitals. A Covid-19 testing lab in Thane has been accused of changing negative reports into positive ones and sending the patients to a particular hospital. The Thane Municipal Corporation has sent a notice to the lab and asked why its license should not be revoked.
Social media is abuzz with audios and videos clips showing doctors and hospital officials taking advantage of the panic to fleece the Covid-19 patients.
In fact, it’s panic more than anything else that’s driving people to hospitals even in cases where a homestay is enough for healing.
Conflicting guidelines and statements from the authorities on the need for hospitalisations have not helped the matter, either.
A spate of media report has also shown that hospital beds are empty but kept as a reserve for VIP patients. The common man can die in a corridor!
There are serious reasons to believe that the actual numbers of cases are at least tenfold more than shown by testing. In that case, the number of people who require hospitalisation is bound to be proportionately higher.
Victims of panic, greed, and sleaze, and possible underreporting of cases, Covid-19 patients have a harrowing time running between hospitals and home.
