Doctors have expressed fears for patients after the government ordered that 14 of Delhi’s biggest private hospitals be reserved exclusively for Covid patients for the first time, as the Indian capital’s healthcare system struggles to cope with a virulent second wave.
The announcement by the government came as the situation in Delhi grew increasingly dire, with 13,468 new cases reported on Wednesday, breaking all records since the pandemic began. The capital has overtaken Mumbai, previously Covid ground zero in India, in terms of the number of new cases reported every day.
In addition to the requirement placed on the top hospitals, a further 101 private hospitals will have to reserve 60% of beds for coronavirus patients.
Dr Girdhar Gyani, director general of the Association of Healthcare Providers India, said it was “absurd” and unfair that non-Covid patients should bear the consequences of what he called the Delhi government’s “failure” to adequately prepare the capital for a second wave, which has been battering Mumbai for almost a month.
“What about accident or trauma victims? Stroke victims? Heart attack patients? Treating Covid patients doesn’t require the top-level medical expertise of these specialty hospitals where complicated and very advanced surgeries are performed – yet you go and block all their beds? I presume it is OK then for stroke or accident victims to die in the cause of saving Covid patients?” said Gyani, who plans to challenge the Delhi government’s decision in the Delhi high court.
India’s healthcare system is a hybrid of free government-run hospitals and private hospitals and clinics. With the government hospitals underfunded, overcrowded and lacking in modern resources, particularly in big cities such as Delhi, private hospitals are seen as essential for those seeking more specialist treatment who are able to afford it. The 14 private hospitals designated as 100% Covid are among the most popular in the city.
“It’s the government’s responsibility in New Delhi to prepare facilities to cope with the pandemic. When they failed to do so, they dumped their responsibility on to private hospitals to cover their own deficiencies. That’s no solution,” said Gyani.
Suhel Seth, a Delhi-based analyst and lobbyist, was among those who expressed despair at the edict. His 78-year-old mother began chemotherapy at Delhi’s private Fortis hospital in February, after being diagnosed with cancer for the third time, but now her treatment is likely to be put on hold.
He called it the “stupidest decision in a long time”, saying that patients with cancer, kidney issues or those in need of transplants were being “thrown to the wolves”.
“The government should never have decommissioned all those huge Covid centres that were set up last year. It thought the virus had gone away. It failed to understand the virus,” said Seth.
Though the Delhi government insisted that beds and ventilators were still available in the city’s hospitals, according to the state’s hospital availability app, 90% of ventilators were occupied and most of the big government hospitals had none available at all on Wednesday.
The Delhi government said it also intended to convert hotels and banquet halls into Covid care centres to increase the number of beds. A night curfew between 10pm and 5am has been imposed on the capital, though the state government has not ruled out further lockdown-type restrictions.
Delhi chief minister Arvind Kejriwal warned that the second wave was particularly affecting younger patients between 20 and 40 years old and that 65% of the new cases in Delhi were people below 45.
“It’s very difficult and very unfortunate that the government was not properly prepared for this second wave, so now they are imposing on private hospitals,” said Dr Mahesh Mangal, a surgeon at Ganga Ram hospital.
“I know Covid is important, but equally important are non-Covid patients who are also suffering and dying and deserve to be treated. There are 300 doctors working in our hospital, many who are specialists in cancer and surgeries, and their patients cannot just go to another hospital. I have a lot of patients waiting for an operation – now they cannot have the surgery.”
Dr Amod Manocha, head of pain management at Max hospital in Saket, Delhi, said he was concerned that there would be a repeat, or even escalation, of the situation during the first wave, where “non-Covid patients came to harm because they could not come into the hospital, so many just stayed at home”.
But Manocha conceded that the situation was “about demand and supply”. “It’s a difficult situation, but the way the cases are rising, arrangements have to be made to treat these Covid patients,” he said. “It’s unfortunate, but the healthcare infrastructure is being matched with the demand and need of the moment.”