Large hospitals in the city have been receiving several calls daily, seeking to admit critically-ill patients, who need intensive care support. Such is the load that at some large hospitals, admission of at least 10 critical patients to the ICU are being refused daily as authorities are having an increasing waiting list of such patients.
At Bharati Hospital, there are 75 ICU beds, and 58 people with critical illness are on ventilation. “We are refusing at least 10 new ICU admissions daily. Pune on April 9 witnessed the highest number of 7,000 new cases. Some patients get moderately or severely ill within a week. How do we admit the other critically-ill patients when those already admitted need ICU support? In such a scenario, we are witnessing least eight to nine deaths daily,” said Dr Jitendra Oswal, deputy medical director at Bharati Hospital.
At Noble Hospital, all 55 ICU beds are full. The hospital’s Executive Director Dr H K Sale said they are getting at least 50 calls daily from politicians, NGOs and doctors among others, seeking admission for Covid-19 patients. “Doctors from smaller hospitals also call us, seeking admission of their critical patients. We are trying to manage the situation but it’s been extremely difficult. Ventilators are being procured but each costs Rs 12 lakh,” Dr Sale added.
Symbiosis Hospital’s CEO Dr Vijay Natarajan said there is a deficiency of Remdesivir, oxygen and bed. “We have more than 200 occupants and 24 ICU beds with 10 on ventilation. If we can stop the disease’s progression by using Remdesivir at the correct time, then we can prevent ICU admissions,” he said.
However, the drug’s shortage has compounded the problem. “We are administering the limited vials hospitals get only to a few patients,” Dr Natarajan said. Some patients deteriorate quickly, while others need high flow of oxygen. The next two to three weeks will be extremely challenging,” Dr Natarajan said.
“We are getting 8-10 patients waiting in the emergency room for critical care beds. We are stabilising them and also asking hospitals if beds are available,” said Dr Avdhut Bodamwad, medical superintendent at Ruby Hall Clinic.
According to the Sancheti Hospital administration, the situation is becoming stressful. “We have admitted 40 Covid patients, of which 18 are in the ICU. We were waiting for our supply of Remdesivir till yesterday and got limited vials. Oxygen supply is also a challenge. We are feeling totally helpless. I am unsure about tomorrow’s supply,” Manisha Sanghvi, executive director at Sancheti Healthcare Academy, Sancheti Hospital, said.
Prior to the lockdown in the state, an analysis by the state health department had anticipated that there would be 1.8 lakh active cases in Pune by May 2 and estimated that there would be a shortfall of 2,240 ICU beds, while another 518 ventilators would be required in Pune district.
“The lockdown has given us some time to upgrade the health infrastructure and meet the demands for Remdesivir and oxygen. New hospitals with oxygenated beds are being identified and this is a daily process,” a district health official said.
‘Activate unutilised oxygen plants: State health secretary’
On April 24, a letter was sent by State Health Secretary Dr Pradeep Vyas to the district collectors on exploring the possibilities of establishing oxygen generation plants.
“We are struggling to augment supplies of oxygen and even re-purposing PSA plants for nitrogen. There are PSA plants for oxygen, which are lying unutilised. One such plant is being reactivated at Satara to generate oxygen and fill 2,400 jumbo cylinders per day. These need to be reactivated to meet the shortfall in the state,” Dr Vyas said. While new oxygen generation plants will take three to four weeks to install, retrofitting existing PSA plants for nitrogen can be achieved in less than a week, he added.
