Investigation: Here's why COVID patients in Mumbai are struggling to find ICU beds
With data showing that the city has only a handful of ICU beds, ventilators available, insiders say reasons from suppression of data to lack of staff to blame
As the death rate and cases continue to increase in the city despite the efforts of the civic body, access to healthcare remains the biggest problem for COVID-19 patients, as the struggle to find a bed has worsened. Six private hospitals mid-day called this week said they had no ICU beds available; only one said it had isolation beds and was ready to accept a COVID-19 patient.
The state has mandated that private hospitals should allocate 20 per cent of their beds for COVID patients and 80 per cent of this 20 per cent is to be allocated by the civic body. The BMC has set up a live dashboard in May to manage allocation, but senior civic officials say there are very few ICU beds available.
On June 11, out of 1,164 ICU beds in all the government and private healthcare facilities, only 11 were vacant. Out of 515 ventilators, only 35 were available. Among the city's 8,100 isolation beds, only 935 were available.
mid-day called Jaslok, Lilavati, Kokilaben, Somaiya, Breach Candy and Nanavati hospitals for a COVID patient. While all six discouraged us from bringing the patient to the hospital, Somaiya said there were no ICU beds available but they would allot the patient an isolation bed.
Rizwan Khan, whose sister died at a Dongri hospital
A civic official said most private hospitals have no more than one or two ICU beds at any given time. Requesting anonymity, a senior doctor from a top private hospital who has been treating COVID patients said most private hospitals are under-reporting the number of vacant beds.
Govt-private sector row
"The private sector won't take a loss and since routine surgeries are currently not happening, hospitals are not making any money," said the doctor. "There is high-handedness on the part of both the government and hospitals and as a result, patients are lining up and dying while they wait for a bed."
People line up at Nair hospital for a COVID-19 test. File pic/Ashish Raje
He added that there is a need for both sides to find a middle ground since there is resentment over the way the state regulated the fees for COVID patients without consulting private hospitals. "Around 80 per cent of the ventilators are in private hospitals and the number of patients is growing. Perhaps the government could offer some concessions for electricity charges for the next three months as incentive for the hospitals to cooperate," he said.
Staff crunch adds to woes
Dr Gautam Bhansali, consultant physician with Bombay Hospital, said the situation is also partly due to the staff crunch at private hospitals. He said in almost all private hospitals, only 40 per cent to 50 per cent of the staff are reporting to work. Due to exams, some doctors are not coming either.
"Lack of transportation is also a big problem since employees end up travelling for three to four hours to reach the hospital," he said. "A request has been made to the civic chief, the chief secretary and chief minister to allow a few trains to run in the morning and evening only for essential services so that more staff can report to work."
On June 6, the state government had appointed five IAS officers to resolve complaints against private hospitals. B Radhakrishnan, an officer who is handling seven hospitals including SL Raheja, Seven Hills, Lilavati, Holy Family and Sushrusha Hospital, has received more than 50 complaints related to bed availability so far.
No way to verify
The civic body has also allotted two auditors in every hospital to resolve billing issues and update the dashboard. One auditor pointed out that the figures of beds are given by the hospital management and there is no way to verify the numbers.
"Since the ICU beds are for critical COVID patients, it is not possible for us to check all the beds through the day. We tried asking the hospital management to share the list of patients who are occupying the ICU beds so that we can verify the numbers. But the hospitals refused to share details, citing privacy concerns," said the official.
After failing to find a bed, the next option for people is to approach political leaders, who feel the ground reality is not improving. Samajwadi Party MLA Rais Shaikh said private hospitals are trying to profit from the pandemic and that the state is turning a blind eye. "The allocation of beds in private hospitals is just a farce by the BMC. Private hospitals have been given concessions in terms of property tax. Members on the task force includes doctors from the private sector and there is a vested interest here. The government is allowing this loot of the common man. A law needs to be imposed and hospitals have to be penalised," he said.
Not at full capacity
Congress MLA Amin Patel said the live dashboard does not give a real picture of the reality and that it was introduced too late.
"Private hospitals say their beds are full because they are not working at their full capacity. None of the hospitals are honouring the government order and are all charging above the government's rates. The public needs some kind of relief during such difficult times and the government needs to be stricter," he said, advocating cancellation of licences of violators.
Suresh Kakani, additional municipal commissioner, said there is no shortage of beds and while there are 1,400 to 1,500 cases reported daily, only a small percentage is critical.
"We are doubling the number of ICU beds from 100 at Seven Hills, GT and St George hospitals, with each setting up 100 additional ICU beds," he said. "We encourage people who need a bed to take the help of the ward control room, which will make the necessary arrangements. We have also asked the ward offices to display the control room numbers at various locations." He said the BMC has ramped up the number of oxygenated beds to offer the emergency medical intervention that patients need.
A patient being handled at KEM hospital. File pic/Suresh Karkera
Among the 80 per cent beds managed by the civic body, most private hospitals have reserved beds for quarantine, isolation and ICU.
Kokilaben Hospital, however, has reserved only 34 ICU beds and when asked why, Santosh Shetty, Chief Operating Officer said, "We have allocated the maximum number of beds for critical patients and ICU beds are the need of the hour. We are treating critical patients referred from other hospitals as well and we have a step-down unit for patients who have recovered. While the discharge policy is 10 days, the subset of patients who require ventilation are those suffering from cardiac issues, diabetes and dialysis. They take longer to recover and their turnover time is not as quick as other patients," said Shetty.
Ajaykumar Pande, vice president of Lilavati Hospital said, "When a patient is admitted to the ICU, there is no definite time when they will recover. Once patients are admitted, until their recovery over the next 10 days, the ICU beds are occupied. We are also facing an acute shortage of staff since they can only work in six-hour shifts, which means we need four times the strength of staff we need for regular patients. Some staff have also been infected and in quarantine."
Currently, Shetty said that more than 100 staff members are taking care of patients admitted in the ICU at Kokilaben Hospital. The Jaslok and Nanavati managements chose not to comment. When contacted, Saifee, Nanavati and Jaslok Hospitals were unavailable for a comment.
Total beds in private hospitals: 2,467
Total ICU beds in private hospitals: 460
As on May 26: (numbers may have marginally increased)
Total number of ICU beds in civic facilities: 644
'My sister died hours after we found a bed'
Rizwan Khan, 28, had a harrowing experience trying to get his sister, Asma Shaikh, 36, admitted after she tested positive on May 31. "We tried Saifee Hospital and were told there is a long waiting list. Hospitals either said they had no beds, or asked for a deposit of lakhs. We tried to go to JJ Hospital and KEM and were told that there are no beds available," said Khan.
On June 1, Khan tried to get her a bed at a hospital in Chembur, but was asked for a hefty deposit. "They initially asked for R5 lakh but later settled for R1.5 lakh. After paying, when we took her to the hospital, the guard refused to let her in and the doctors said there was no bed available. My sister desperately needed a ventilator," said Khan.
With political pressure, Khan, a Govandi resident, managed to find a bed in a Dongri hospital on June 2. "We paid a deposit of Rs 50,000 and admitted her at 4 pm. Four hours later, the doctor said she had died. After her death, the hospital gave us a bill of R45,550 even though she was admitted for just a few hours. The government says they have made sufficient arrangements. Then why couldn't we find a bed anywhere on time?" asked Khan.
'Told no bed after waiting for six hours'
Kamathipura resident Balnarsaiah Donthula, 61, and his special needs diabetic son, 38, struggled for three days to find two beds in the same hospital. "My son can't communicate or take care of himself. I needed to be in the same hospital. I tried to find beds in private hospitals but none had beds," he said. Running a high fever and with severe weakness, Donthula waited for six hours before being told there was no bed at a Mumbai Central hospital. "I waited at the gate from 5 pm to 11.:30 pm. The guard wouldn't even allow me to enter. With the help of an MLA, I was finally able to get admission at Bhatia Hospital on June 7 and my son was admitted on June 9," he said.
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