In Gujarat, hospitals fret over beds as Covid cases surge

Banaskantha, which had been reporting cases in single-digits on most days in March, reported 30 new cases on Friday. Mahisagar reported a new district high with 38 new cases. Mehsana touched mid-December levels (of last year) with 43 new cases and Patan reported over 40 new cases for the second time in the past seven days.

GVK EMRI (Emergency Management and Research Institute), which provides emergency ambulance services, has seen a new challenge crop up in the smaller districts. An official said, “We usually have designated Covid-19 ambulances but we saw that with the rising cases spread across the district, area coverage was becoming difficult. So now we are also deploying non-designated ambulances with provisions of PPE kit and disinfection for ferrying Covid-19 patients.”

While Gujarat has seen a rapid increase in daily new cases since mid-March, the emergency ambulance service official said trips have gone up significantly in the past five days or so.

However, compared to the post-Diwali surge when Ahmedabad was reporting nearly two-third of the state’s daily caseload, resulting in transfer of Covid patients from Ahmedabad to neighbouring districts, the latest surge has not seen such a requirement yet, says the GVK EMRI official.

Across the state, GVK EMRI is ferrying nearly 800 patients (782 as of Thursday) of which 210 were in Ahmedabad with 85 per cent of these patients being taken to either Asarwa Civil Hospital in Ahmedabad and Gujarat Medical Education and Research Society (GMERS) Sola.

Ahmedabad Civil Hospital, where its 1,200-bed facility was scaled down in mid-February with 200 beds reserved for Covid-19 patients at the time while reopening the remaining beds for regular paediatric, gynaecology and obstetric procedures, has had to scale up again. Superintendent Dr JV Modi said at present 920 beds are reserved for Covid-19 patients with 596 beds occupied. Apart from this facility, Institute of Kidney Diseases Research Centre (IKDRC) has 50 beds reserved for Covid-19 patients at present. “Even after Diwali, the maximum occupancy in Ahmedabad Civil Hospital was upto 800 patients or so. We have 85 patients critical with 10 on ventilators and 75 on bipap… About 60 per cent of our overall patients as well as critical patients are aged 60 years or above.”

However, Ahmedabad-based pediatrician and neonatologist Dr Mona Desai, who was also the ex-president of Ahmedabad Medical Association, said that this surge is seeing higher infections in children including neonates to those aged upto 10-12 years. Ahmedabad Hospitals and Nursing Homes Association president Dr Bharat Gadhvi added that Covid-19 deaths have seen a marginal trend with a younger group – around 50 years – turning out to be more critical, compared to the post-Diwali surge. Criticality profile too appears to have changed, adds Dr Desai adding that newer symptoms include diarrhea, high-grade fever of up to 103 degrees with rigor and absence of cough or cold.

Of the 769 ICU beds across 90 private hospitals in Ahmedabad city, 72 per cent beds are occupied at present. Overall bed occupancy across these 90 hospitals stand at over 70 per cent at present. On March 7, overall occupancy was at 12 per cent, which then increased to 20 per cent by March 15 and 54 percent by March 29, indicating a steep rise in the past three to four days.

As Surat city reported a total of 506 cases, Surat Municipal corporation (SMC)-run SMIMER hospital parking area has now been converted into a Covid care centre and the Surat Municipal Commissioner on Friday announced that all leaves for employees of SMC now stand cancelled for the month of April.

The SMIMER hospital has 650-bed facility and additional 400 beds facilities have been made in the multilevel parking area of the hospital. Apart from SMIMER, Unique hospital in Surat, is also overflowing with patients resulting in converting its basement area to install 15 beds as a Covid care centre facility. Similarly, other private hospitals designated for Covid treatment in Surat city have been flooded with Covid patients. Of the total 1,266 Covid patients admitted, 466 are in private hospitals while 800 others are being treated in government and municipal corporation hospitals.

Deputy Municipal health commissioner Dr. Ashish Naik said, “At present 291 patients are admitted in New Civil hospital and 362 in SMIMER hospital. NCH has bed capacity of 2225 beds and SMIMER has bed capacity of 650 beds.”

Vadodara administration urges home-based isolation

With Vadodara recording 376 Covid cases on Friday, taking the tally to 29,156 and 2,130 active cases, the administration has decided to encourage home-based isolation for patients not requiring hospitalisation. On Friday, apart from a training workshop of 200 teams of Sanjeevani Abhiyan — the health teams that will attend to home isolated Covid-19 patients in the city — the administration also held a meeting with private empanelled Covid-19 hospitals and warned them against over-charging patients or admitting those who do not need to be hospitalised.

A day after the administration released the protocol for admission of Covid patients for private hospitals, Officer on Special Duty Vinod Rao held a meeting on Friday with the stakeholders to emphasise the need to only admit those patients who need it. Rao said, “We held a meeting with about 75 leading private hospitals of Vadodara and reviewed the situation. We have asked them to strictly follow the notification for Covid Admission, and divert the rest for Home Based Covid Care under Sanjeevani Abhiyan. We have warned the hospitals about complaints of overcharging the patients and to strictly follow the guidelines of charges as well as discussed issues regarding increasing ICU beds, Oxygen beds, Supply of medicines, Cashless Insurance coverage and so on.”

The protocol includes criteria that must be met to admit patients – the patients must be above 60 years of age or younger with comorbid conditions such as diabetes, Ischemic heart diseases, morbid obesity, asthma, renal or liver failure, hypertension, immunocompromised patients with diseases like HIV or those taking steriods or suffering from malignancy.

The protocol also enlists that patients with Oxygen saturation under 94 per cent can be admitted as well as those with breathlessness, continuous fever for more than three days, respiratory rate of more than 20 per minute, hypotension with systolic blood pressure of less than 100mm/Hg, tachycardia, bradycardia and those who have induced oxygen desaturation after six minutes of walk test. The protocol also enslists other criteria to be followed with laboratory and radiology tests.

(With inputs from Kamaal Saiyed in Surat and Aditi Raja in Vadodara)