India’s surging COVID-19 infections is testing the health infra once again — beds added during lockdown aren’t enough

• Earlier this month, a 42-year old journalist Pandurang Raikar succumbed to COVID-19 in Pune after the hospital delayed admission over advance payment.
  
• There have been many cases where even affluent patients have failed to find space in hospitals.
  
• The benefits of the lockdown i.e. adding beds before infections spike have fallen short of the requirement.
  

Harshad Sanghvi, a builder from Ghatkopar, couldn’t get admitted to a hospital after suffering from a heart attack at 7.30 pm on 11 September. The reason was simple — there were no empty ICU beds, reported Mumbai Mirror.

Soon after he had the stroke, his family rushed to Zen Hospital in Chembur, where the doctors suggested he had contracted COVID-19. His family was advised to admit him to a COVID-19 dedicated hospital. After struggling for around 7 hours, they were finally able to get a hospital bed. Sanghvi was among the lucky ones who could get a bed.

However, in the past few months, there have been numerous reports of people dying because of lack of ICU beds. Earlier this month, a 42-year old journalist Pandurang Raikar succumbed to COVID-19 in Pune after the hospital delayed admission over advance payment. Pune has registered over one lakh coronavirus cases, and is fast emerging as the newest epicentre of coronavirus in India.

“All this while, Pandurang was feeling uneasy and breathless and required urgent hospital admission. However, the hospital refused to admit him. They asked him to pay Rs 40,000 as advance fees. They told him that it will take a while to make the payment as other patients were in the queue,” Kunal Jaykar, a close relative, told the media.

For the last 14 days, India has reported more than 1000 deaths. Every single day

The Indian government, on September 16, told Parliament that there are 62,979 intensive care unit (ICU) beds and 32,862 ventilators available in COVID-19 dedicated government and private health facilities across the country. Maharashtra has the maximum number of ICU beds at 14,447, followed by Tamil Nadu, which has 8,439 ICU beds.

However, the situation on-ground suggests they may not be enough.

Mumbai, the only city in the country to have registered more than 4 lakh coronavirus cases, ran out of beds in May when it had only 25,000 coronavirus cases. As of September 12, only 6% of ICU beds in Mumbai are available, according to an IIFL report dated September 14.

New Delhi — which has 28,641 active coronavirus cases — is also facing a shortage of ICU beds. The Kejriwal government has 2,201 ICU beds for COVID-19 patients against a population of over two crore. Only 35% of the ICU beds are available in Delhi currently, according to the IIFL report.

The Delhi government recently asked private hospitals to reserve 80% of the hospital beds for coronavirus patients. It had only 4,750 beds for severely ill COVID-19 patients.

Poor bed availability is an issue that has plagued India

India is the second-worst hit COVID-19 country in the world and has registered over 5 million cases with 80,000 deaths so far. Over the past few days, India has been adding over 90,000 coronavirus cases daily, the highest any country has ever recorded globally.

The crucial reason for the shortage of beds and other glaring concerns is India’s lower health budget.

For several years, India had been spending less than 2% of its GDP on healthcare, making it one of the lowest investors in the sector globally. Notably, Brazil, Russia, South Africa spend about 8.3%, 7.1%, and 8.8% in the public healthcare sector respectively. The World Health Organisation in 2019 placed India’s healthcare spending behind Iraq and Venezuela.

Between 2014 and 2017, India’s bed per population ratio changed by merely 0.60%. Also, there are regional disparities at every level. For instance, urban hospitals in India have more beds than rural hospitals, according to the National Health Profile.

Change in Population-Doctor-Bed Ratios between 2014 and 2017
Source: National Health Profile

The lack of beds isn’t the only problem that India’s overwhelmed hospitals are facing. There’s a lack of oxygen cylinders and medical staff too.

“With the country working round-the-clock to expand COVID-19 care facilities, the increase in the number of ICU beds will facilitate the early transfer of severe cases to ICU and faster action on severe cases. Apart from increasing the number of ICU beds, the training and skill development of the staff and crew set to work on COVID cases is very important, Dr Hardik Ajmera, Deputy Medical Director, Saifee Hospital, told Business Insider.
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Moreover, according to Dr Vanita Mande from Suasth Hospital, India should have a COVID-19 Essential Supplies Forecasting Tool in place as recommended by WHO.

According to a recent government estimate, India needs to spend ₹25 lakh crore to fight the epidemic — that’s five times the health budget and about 166 times more than what the government is currently planning to spend.


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