New Delhi: As the third wave of coronavirus in Delhi floods hospitals with patients, several Covid facilities around the capital find themselves grappling with a challenge that puts them in a precarious position amid a pandemic — a shortage of doctors.
From the Delhi government’s Guru Teg Bahadur (GTB) Hospital and Rajiv Gandhi Super Specialty Hospital, to the central government-run Lady Hardinge Medical College (LHMC), a similar resource crunch appears to be at play at all Covid hospitals in the capital.
While a shortage of staff is a difficult challenge for hospitals at any time, it is an even more fraught prospect during a pandemic.
Starved of breaks, some doctors, it is learnt, are handling as much as double their regular patient load during shifts that can stretch up to 14 hours.
A government official in Delhi Health Minister Satyendar Jain’s office told ThePrint on the condition of anonymity that a “couple of hospitals” had raised the issue of staff and doctor shortage at a meeting held by the minister Tuesday evening to review the situation across the city’s hospitals.
A second official in the Delhi government said these hospitals were “assured that adequate arrangements will be made” even though “no timeline was specified”.
An order issued Wednesday night by special secretary, Delhi health and family welfare department said Covid-19 hospitals under Delhi government have been permitted to engage 4th and 5th year MBBS students, interns and BDS (Bachelor of Dental Surgery) doctors to assist duty doctors at an honorarium of Rs 1000 (for an 8-hour shift) and Rs. 2000 (for a 12-hour shift) per day. For interns, honorarium would be over and above their stipend, the order read.
ThePrint reached Jain for comment through phone calls and texts but received no response from the minister.
A crushing shortage
The shortage of medical professionals at Delhi hospitals comes at a time when, according to multiple doctors, patients are increasingly arriving in hospitals at a critical stage of disease.
The nature of Covid-19 is proving a further challenge on the front lines as doctors on duty have to routinely quarantine themselves, while some others are forced off-duty after contracting the disease.
Talking about the lack of doctors, Dr R.S. Rautella, medical director at GTB Hospital, said “it is difficult to even put a number on it anymore”.
“We have been dealing with this from day 1 of the pandemic and the latest surge has only made it tougher because all our ICU beds are occupied, so it means more work for doctors but there is only so much the existing ones can stretch.” he added.
At GTB Hospital, Rautella said, shortage of senior resident doctors has been an issue for the past four years, with the hospital repeatedly flagging the matter to the administration.
As things stand, at least 62 of 253 posts for senior resident doctors are learnt to be vacant at the hospital, which was converted to a Covid-only facility in June.
“We had a shortage of 95 senior residents in July. We managed to hire some on contractual basis through interviews but the shortage prevails,” said Dr Rajesh Kalra, Covid-19 incharge at the hospital.
GTB is also short of 10 junior resident doctors against a capacity of 180.
At Rajiv Gandhi Super Specialty Hospital (RGSSH), there are only about 60-70 doctors, including junior residents, against a capacity of 200.
RGSSH medical director B.L. Sherwal said the shortage had been communicated repeatedly to the government. “The health minister called for a meeting yesterday (Tuesday) so we have demanded 20 specialists and another 60 senior resident doctors to begin with, since even our ICU ward is being expanded,” he added.
The pattern continues at Lady Hardinge Medical College (LHMC), also a designated Covid-19 facility.
“As per the mandate, one resident doctor should be deputed for six ICU bed patients, and one nurse for every ICU bed. In a regular Covid-19 ward, it can be one resident doctor for 10 patients and one nurse for two beds,” said Dr Mathur.
However, due to the shortage, each doctor is having to look at 20 patients, he added.
According to Mathur, what makes many hospitals’ situation worse is the absence of postgraduate students and junior resident doctors who are currently at home on account of the college shutdown imposed in light of the Covid-19 pandemic.
“We still end up getting several (students) from our facility since it is a medical college but many other hospitals face this problem,” he said.
At Saroj Super Specialty Hospital, a private facility for Covid-19, 45 resident doctors have been managing the entire workload amid the pandemic.
“The doctors have been on duty continuously, so they are exhausted. Given the shortage, we have been trying to manage by hiring from outside agencies,” said medical superintendent Dr Dhiraj Malik, adding that this adds to their expenditure. “Many doctors have tested positive themselves so they have to go into quarantine, leaving us with limited staff, but in such a situation their recovery is as crucial,” he said.
Lok Nayak Jai Prakash (LNJP) Hospital, which is among Delhi’s largest Covid-19 hospitals, issued ads this June for 30 doctors’ positions but received only three walk-in candidates, said a senior resident doctor at the facility.
However, LNJP medical director Dr Suresh Kumar said “things are better than June as the government did provide us with more doctors, and we also keep conducting interviews as and when we can”.
Over the course of the pandemic, 200 doctors and health workers at the hospital have tested positive for Covid-19, of which five doctors are currently admitted in the hospital itself.
“This is a never-ending worry right now. Sometimes cases will increase so the requirement for doctors also goes up, but there are times when we are comfortable. It is an evolving situation,” Kumar added.
In June, Safdarjung Hospital, another major Covid-19 hospital in the national capital, posted vacancies for 177 senior residents with Vardhman Mahavir Medical College.
According to results posted on the college website, only 41 vacancies had been filled till July end, including two in medicine and eight in anaesthesia. Dr Balvinder Arora, Director Professor, Department of Infectious Diseases, Safdarjung Hospital, told ThePrint, “We hired about 90 senior medical officers and senior resident doctors and another 100 nurses in September and the situation is slightly under control.”
For doctors and other healthcare staff, the shortage translates into long shifts that keep them on their toes for over half a day.
The standard shift for doctors lasts eight hours at most hospitals, but one doctor on Covid duty at Safdarjung Hospital said they have had to work “12 to 14 hours without a break for days on end”.