80 percent COVID bed reservation in Delhi: AHPI demands immediate rollback
AHPI is questioning the order on the plea that will not just expose non-COVID patients to the risk of COVID but also undermine the right of other patients, who are in serious need of surgeries/ other treatment, to access urgent heathcare.
New Delhi: In a press conference held here Tuesday by the association of Healthcare Providers of India (AHPI), Dr. Girdhar J. Gyani, Director General, AHPI expressed serious reservations against the order issued by the Delhi Health Minister, Satyendar Jain, instructing 33 big private hospitals in the national capital to reserve 80 percent of ICU beds for COVID-19 patients, due to shortage of such beds at some facilities.
AHPI is questioning the order on the plea that this will not just expose non-COVID patients to the risk of COVID but also undermine the right of other patients, who are in serious need of surgeries/ other treatment, to access urgent healthcare.
Speaking at the conference, Dr. Girdhar J. Gyani said, "The order has been issued without any prior discussions with private hospitals to understand the current demand-supply situation of critical care beds. While we fully support the augmentation of infrastructure for treatment of COVID patients, ignoring the needs of other sicker patients requiring critical care and ICU management at these tertiary care facilities is gross injustice. We have already made representations to the Union and Delhi Health Ministries against the order and may even consider exploring legal options against it."
In view of the fact that private hospitals routinely get 20-30% patients in their Emergencies involving strokes, heart attacks, grievous injuries, acute pulmonary disorders, complex fractures, and even other conditions like cancer, transplant and cardiac patients which require urgent interventions and critical care, reserving 80% beds in the ICU, will deny urgent care to seriously ill patients, requiring vital surgical interventions and critical care. All these patients will have to face prolonged waiting time (some resulting in loss of life) if ICUs are not available.
Adding to his arguments against the order, Dr. Gyani said, "In tertiary care hospitals, ICUs include surgical, medical, pediatric and neo natal ICU's. Management of COVID patients requires trained intensive care specialists, surgical ICU doctors and nurses cannot be deployed for COVID positive patient care. Since, any COVID ICU requires 2.5 times the manpower (owing to rostering and quarantine guidelines), most hospitals will not be able to meet such demands. Also, almost all large hospitals in the city have medical programs catering to pediatrics and obstetrics & gynecology, so a significant part of their critical care beds capacity is in terms of PICU, NICU etc. These beds, which may constitute 15-20% of overall ICU bed capacity in some of the hospitals, are not usable for COVID patients since very rarely does a COVID patient of that age require critical care."
Another aspect of the order, which will lead to the patients taking a beating, is that as per government orders, 60-80% of beds in hospital wards could be used for Non-COVID patients, however, now there will be only 20% of total ICU capacity available for these non-COVID patients. This will mean that for 20-40% COVID patients in wards, hospitals will be expected to reserve 80% of ICU beds. This total mismatch may lead to non-COVID patients suffering, while ICU beds may lie vacant for want of seriously sick COVID patients.
Sample data of ICU admissions collected from some of the leading private hospitals in Delhi, over the last 2 months, clearly shows that more than the COVID patients, it is the non-COVID patients who have been in dire need of ICU services. In one of the Super Speciality hospitals, of the total number of admissions, only 15% were COVID positive and the rest were all related to other conditions during the months July to August. In another Tertiary and Quaternary Care Hospitals the numbers requiring admissions in surgical ICU stood at 1605, during the period June to August. These surgeries included Cardiac, Gastroenterology, Obstetrics & Gynaecology, Urology, ENT/Head & Neck, Oncology, Paediatrics, Orthopaedics, Transplants and General Surgeries.
Also commenting on zero checks in place for demarcating COVID and non-COVID ICUs, Dr. Gyanisaid, "By not allocating dedicated Covid facilities and given the highly contagious nature of the disease, the government has also totally disregarded the fact that cohorting COVID positive patients with non-COVID patients in ICUs will spell disaster. This will scare away other patients, and obviously push ahead several planned surgeries and life-saving procedures by months, leading to adverse consequences."