How patients in Mumbai are losing crucial hours running between hospitals for ICU beds

Mumbai has over 25,000 active Covid cases and death toll has crossed 1,000 mark. Though not every patient requires critical medical attention, there is shortage of ICU beds across the city.

(Representational image) 1,200 beds with oxygen supply at Nesco ground in Goregaon | ThePrint Photo | Swagata Yadavar

Mumbai: When Andheri resident Avinash Kathare’s brother-in-law, Namdeo Waghmare, complained of breathlessness on 18 May, he was rushed to Mumbai’s Cooper Hospital around noon. Kathare waited at the facility with 60-year-old Waghmare for over 12 hours, but they weren’t able to get a bed.

“We took him home and arranged oxygen support. But his condition deteriorated and we rushed him to Kokilaben Dhirubhai Ambani Hospital where we were told that he could have Covid-19. But the hospital didn’t have an isolation bed,” Kathare told ThePrint.

Throughout the day, Kathare called “20 hospitals” only to be told there weren’t any available beds. He finally got one at King Edward Memorial (KEM) Hospital in Parel, and was able to take him there after nearly six hours in a private ambulance hired for Rs 7,500. His Covid-19 test came positive and Waghmare was shifted to an isolation ward on 22 May where he died on 25 May.

While Kathare alleged negligence on part of KEM, Dean Hemant Deshmukh said all patients admitted to the hospital “are given attention”.

He said no patient is admitted if they have mild or moderate symptoms, adding all Covid beds in KEM Hospital “are equipped (with oxygen and other accessories) as these are for serious critical patients”.

As of 25 May, there were 25,956 “total suspected patients admitted” in Mumbai hospitals — more than half of the total 36,881 active cases in Maharashtra. Though not every patient requires critical medical attention, the high number of cases has filled up the limited number of intensive care units (ICUs) across the city.

According to the Ministry of Health and Family Welfare, 5 per cent of all cases need critical care. Going by the number of active cases in Mumbai, 1,298 patients are in need of critical care beds.

The number of ICU beds available with the government authorities, however, is only around 530 — in the designated Covid hospitals functioning under the Brihanmumbai Municipal Corporation (BMC). While the number officially went up to 1,165 beds after the Maharashtra government Friday took over 80 per cent of beds in the city’s private hospitals, most of these additional beds were not free as of Tuesday.

Additional Municipal Commissioner Suresh Kakani said, “650 ICU beds from private hospitals are now under the state government, (but) many of them are occupied by patients. Out of these, 100 are available for allotment.”

He added, “As and when the beds are vacated by patients, they will be taken up by the government.”

Crucial hours lost running between hospitals

Mumbai is the country’s worst Covid-hit city and the shortage of ICU beds here is real.

“On the night of 22 May, I got 8-9 calls from politicians and other prominent people on whether there were beds in the hospital. Sadly, there weren’t,” Dr Akash Khobragade, medical superintendent of St George Hospital, told ThePrint.

Due to the shortage of beds, families like Waghmare’s end up losing crucial hours running between hospitals.

Samir Chavan, 35, died a few hours after he was admitted to the Hindu Hruday Samrat Balasaheb Thackarey (HBT) trauma centre in Jogeshwari Sunday, 24 May.

His brother, Sandip Chavan, told ThePrint that Samir was first taken to the Guru Nanak Hospital where he didn’t get a bed. After this, he was taken to the Seven Hills Hospital, and then to Nair Hospital, before a bed was finally found at the HBT.

As of 25 May, Mumbai reported 1,026 deaths due to Covid-19.

‘Jumbo facilities’ to come up in city

When a central government’s health team had visited Mumbai last month, it was predicted that the number of Covid-19 cases will surge to 42,000 by 30 April and 6.5 lakh by 15 May in the city.

While the numbers have been less, the state government has increased surveillance, screening, testing and treatment for the peak that is yet to come.

“Capacity enhancement of beds in dedicated Covid-19 health centres and hospitals and making the requisite medical manpower available to handle the additional surge of patients is a big challenge which is being overcome by various measures,” Ashwini Bhide, Additional Municipal Commissioner who formerly headed Mumbai’s metro project, told ThePrint.

The number of Covid-19 beds in Mumbai has increased from 3,500 to 6,500, said Bhide, adding there are plans to have a 100-bed private nursing home facility in each of the city’s 24 wards. She also said five to six “jumbo facilities”, with more than 8,000 beds having 50 per cent oxygen and 10 per cent ICU beds, will also get commissioned in the coming weeks.

The new discharge policy by the Indian Council of Medical Research (ICMR) allows patients to go home 10 days after the onset of symptoms, without two negative results. The move aims to free up more beds for the critically ill.

BMC chief Iqbal Chahal had earlier said there were about 35,000 beds for asymptomatic and mild patients in Covid-19 care centres in the city.

When ThePrint visited the state-run St George Hospital, two new 30-bed ICU wards were being set up. The facility began treating Covid-19 patients as early as 23 March.

“There are more moderate and critical patients so you will find that the beds are full,” said Mangala Gomare, Deputy Health Executive Officer, BMC. She also said augmentation of beds was under way.

Private beds, surge in Covid-19 care centres

Last week, the Maharashtra government took over 80 per cent beds in the state’s private hospitals and nursing homes, with regulations over treatment prices.

This would free up 4,400 beds in Mumbai and distribute patients among private and government-run hospitals. The private facilities treated only about 20 per cent of the city’s Covid-19 patients until now.

Meanwhile, BMC chief Chahal has announced that 1 lakh new beds would be arranged in the city to prepare for a surge in cases anticipated in a month or so.

Most of the beds planned, including ICU beds and those with oxygen facilities, are in the Covid-19 care centres, which can treat mild to moderate cases on large grounds, colleges and vacant buildings.

The Mumbai Metropolitan Region Development Authority (MMRDA) has also set up Covid-19 care centres in the Bandra Kurla Complex with 800 ICU beds, 1,200 beds in Goregaon’s NESCO grounds and another 1,200 beds at the Mahim Nature Park.

Jitendra Tandel, a health activist, however said, “Private and charitable institutes have not been giving the 10 per cent reserved beds for indigent patients for so long. How can we be sure that they will make 80 per cent of their beds available for patients, especially since most hospitals have been shut during the pandemic.”

He also said things are unlikely to change until the administration makes data of hospital bed availability public. The jumbo facilities may have more beds, he added, but how will the authorities cope when monsoon is likely to flood the grounds.

The BMC helpline of 1916 is supposed to be a one-stop centre for information related to Covid-19 care, including availability of hospital beds. Once a call is made to the number, the executives are expected to take down the details, give callers a coupon and get back to them about the availability of hospital beds.

However, the helpline executives do not have a real-time data about hospitals because information is updated only twice a day.

Shankar Mugalkhod, who runs a free ambulance service for Covid-19 patients, said, “Almost every day, I ferry patients from one hospital to another because there are no beds.”