Ahmedabad: As the summer sun raised temperatures Tuesday afternoon, as many as 24 ambulances were lined up outside the Ahmedabad Civil Hospital, the city’s largest government Covid facility. Inside each of them, a crisis was unfolding.
In ambulance number 15, Falguniben, a 27-year-old local resident whose mother is a Covid patient, said she had been waiting for their turn to enter the hospital. As of 9.30 pm on 13 April, she claimed, they had been in the ambulance queue for three hours.
All the while, her mother was struggling to breathe, even though she had been administered oxygen by the ambulance staff.
Not too far behind them was Bhavin Mehta, 27, with his 80-year-old aunt, another Covid patient. According to Mehta, his aunt’s blood oxygen level had dropped to 60 per cent in the morning, hours after she tested positive.
An oxygen level that low is critically dangerous, with doctors advising medical attention for any reading below 90 per cent.
They had to wait three hours for an ambulance, Mehta said, even as he resigned himself to waiting longer still outside the hospital.
It was a fact even Nirav Dave, a 50-year-old Ahmedabad-based businessman based, has swallowed as a bitter pill. However, troubled by the sight of his sister gasping for breath, he was furious.
While Dave said he had been waiting outside the hospital for three hours, an ambulance driver who did not wish to be named told ThePrint that Covid patients looking for a bed at the civil hospital were waiting up to eight hours for admission.
A nurse present in a 108 ambulance van said they often wait outside the hospital late in the night, so they can make a run for it whenever there is scope for a patient to get in.
All the Covid-19 patients waiting outside the facility find themselves in this position because the 1,200-bed civil hospital is out of oxygen and ventilator beds amid a surge in infections. Several patients have reportedly been diverted to the hospital because of a shortage of oxygen at smaller designated Covid facilities.
The whole of Gujarat witnessed a spurt in cases Monday too, reporting its highest single-day total of 6,021, up from 5,469 Sunday.
The surge has helped highlight what local residents describe as the city’s crumbling healthcare infrastructure. It is not just the lack of hospital beds — some residents alleged that the Ahmedabad Municipal Corporation (AMC) also seems to be going easy on contact tracing, magnifying the risk of Covid transmission.
The authorities at the civil hospital say they are aware of the ambulances waiting outside, but claim to be doing their best. Dr Rajnish Patel, the Additional Medical Superintendent of the civil hospital, said they working on a war footing but cited the virulence of a new variant to explain why all oxygen and ventilator beds are occupied.
If the Ahmedabad Municipal Corporation opens up its hospitals to Covid-19 patients, the situation is likely to ease, he added.
ThePrint reached AMC medical officer Bhavin Solanki for comment, but he didn’t answer to the calls and texts.
Request for Modi
Exasperated and in despair, Falguni said Ahmedabad’s grim Covid-19 situation is headed for worse days.
“If (PM Narendra) Modiji doesn’t do anything soon, half of the population of Ahmedabad will die of Covid-19, I am telling you,” she added, speaking to ThePrint outside the civil hospital. “Does he not care about our plight? We are, after all, the first citizens who made him our chief minister. Will he abandon us now that he is the prime minister?”
On the hot summer afternoon, with temperatures reaching 42 degrees Celsius, Falguni comforted her mother as she recounted their travails getting medical attention.
Falguni said she and her brother Mahesh had to make incessant calls to get an ambulance for their mother. They got one after 12 hours, she added, only to face another hours-long wait outside the civil hospital.
Mehta spoke of a similar ordeal. He said he called for an ambulance Monday night, after his aunt tested positive. “But we were told there aren’t any available. We managed to get one this morning after a three-hour wait,” he added, speaking to ThePrint Tuesday. By then, his aunt’s oxygen saturation level had dropped to 60 per cent. However, his wait for a bed continued.
“None of the private hospitals has vacant beds nor can we create a set-up at home. There is no option but for us to wait in this queue,” he said.
“We have already been waiting for an hour now. My aunt’s blood oxygen is at critically low levels. She has finally calmed down a little and her blood oxygen has risen to 75 after the ambulance gave her the oxygen cylinder. We have requested the hospital to consider our case urgent and arrange for a bed,” Mehta added.
Dave, meanwhile, said he knew his wait was far for over even as he told ThePrint that he had been outside the civil hospital for three hours.
“We have been waiting in this heat for the past three hours but to no avail. My sister clearly needs oxygen, her blood oxygen level has dropped to 85 per cent but doctors are not even sending nurses to aid or check the condition of patients waiting outside,” he added.
Visibly agitated, he said, “There are so many ambulances waiting outside and an additional 10-15 inside the hospital gate. We have been told my sister will get a bed only once beds are available. When will that be?”
An ambulance driver who joined the queue with a patient Tuesday evening said they are guided by the AMC on what hospital to visit.
“The minute we reach the house of a patient, we take their vitals and inform the Ahmedabad Municipal Corporation. The AMC then guides us on which hospital to take them to. In case private hospitals are occupied, we bring them here,” he added. “Doctors take requests from families whose Covid patients are in critical condition. In order to accommodate new patients, patients whose condition has improved or is stable are shifted to other wards.”
‘On war footing’
Dr Rajnish Patel of the Ahmedabad Civil Hospital said they are trying their best to deal with the influx of Covid patients.
“We have increased our bed capacity to 2,500 beds by including beds from other departments in the hospital. The problem is that not all our beds are oxygen-supplied beds; it is very rational to believe that 400-500 beds have ventilators, about 570 beds have oxygen supplied by central lines and about 400 beds are regular beds,” he added.
“So, when we say all our beds are occupied, we mean all our special beds with ventilators and oxygen supply are occupied. This is because the patients coming in need these special beds and not regular beds. About 20-30 per cent of our regular beds are still unoccupied,” he said.
According to Patel, the hospital has stopped “all planned work and is running our emergency department with skeletal staff”. “All the doctors have been pulled in to work in Covid wards,” he said. When asked about the number of doctors, he added, “We have a sufficient number of doctors working 12-13 hour shifts for now.”
Keeping up with last year’s trend, Patel said, 60-70 per cent of the patients coming in are above 40 years of age.
The situation, he added, is so challenging because of the “virulence of the new variant”.
“The mutant variant of the virus is affecting the patients in such an aggressive manner that patients need to be on oxygen beds. The cycle is such that the patient tests negative after 13-14 days, so the patient stops spreading the disease after 14 days. After that, what happens is that the complication in the lungs exists for three months. Though the patient is RT-PCR negative after two weeks, their lung capacity is deteriorated or completely destroyed to such a level that they will need oxygen support and supervision for three months,” he added.
Emphasising the strain on the hospital, he said, “The Ahmedabad Municipal Corporation has yet not opened up their hospitals for Covid patients. These include hospitals like VS Hospital, Shardaben Hospital, SVP Hospital and LG Hospital. If the corporation permits these hospitals to be turned into Covid facilities, then another 2,000 beds can be available to the city.”
Asked about the delay in opening them up for Covid patients, the doctor said, “The reason given for this is that these hospitals are still in the process of setting up facilities. What is surprising is that we weren’t given the luxury of time, we had to start our operation on a war footing immediately.”
‘Contact tracing lags’
Meanwhile, caught up in the struggle to get their relatives to a doctor, many people say they have not got themselves tested for Covid-19 yet. One such person is Tirth Joshi, a teenager whose mother has tested positive for Covid-19.
Waiting outside the hospital, Joshi said he will get himself tested only once his mother is admitted.
“I cannot leave her waiting here, I have to stick around. Only when she is able to get a bed in the hospital will I be able to find some time and space to get myself tested,” he added.
No one from the corporation, he said, had approached him for a Covid test.
“Even after my mother tested positive, nobody from the corporation contacted us. Everybody in the society knew she was positive,” he added.
Akash Goswani, a disgruntled relative of yet another Covid patient, said he was fed up of the “failing healthcare infrastructure”.
“I have been running from one urban healthcare centre to another since morning,” he added. “Forget contact tracing, they don’t even have spare RT-PCR kits to test relatives of COvid patients. The government keeps saying they have increased RT-PCR testing, where is it happening? They don’t even have the basic facilities to do it. The government is simply bluffing.”
Edited by Sunanda Ranjan