Coronavirus Outbreak: States Scramble To Create Hospital Infrastructure

Given that the government infrastructure is inadequate to treat the influx of coronavirus patients from growing hotspots, state governments are scrambling to create the space for it by “taking over” private hospitals. In the past one week, Rajasthan, Madhya Pradesh, Chhattisgarh, and Andhra Pradesh have issued orders to take over private hospitals in some districts.

Hospitals that are built in public-private partnership mode in key cities, such as the Indraprastha Apollo in Delhi, have been told to be ready to be converted into a Covid-19 facility. This could not be independently verified from Apollo.

In Mumbai, the 500-bed Seven Hills Hospital in Andheri has been converted into a dedicated coronavirus treatment set-up. Reliance Industries is managing 100 beds in this hospital. “We are helping the government to set up the infrastructure for 100 beds in this hospital and also provide manpower,” said a group spokesperson. Reliance Industries has earmarked its smaller facility on an old Pune-Mumbai highway for a dedicated Covid-19 facility.

The crisis is deeper in districts where hotspots are likely to emerge once migrants returning home start showing symptoms. It is estimated that three of every 10 migrants who are going back to villages may be carrying the virus.

Maharashtra has more than 400 cases. As the city’s largest slum reports patients (including a death), the local administration is on an overdrive to contain community spread in this place of around 800,000 people.

Apart from three government hospitals in Mumbai, the Seven Hills and Covid wards in some private hospitals, Maharashtra is roping in district hospitals now. “The plan is to have over 2,000 dedicated beds in 30-odd government hospitals of Thane, Vashi, Kalyan-Dombivali, etc. We are working to create the necessary infrastructure in these hospitals,” said a senior state government official.

While no private hospitals have been “taken over” by the Gujarat government, around 131 of them have been asked to remain on standby. “When needed, we can either fully or partially take over these hospitals. For now, the government hospitals have enough isolation beds even as more are being readied in cities like Ahmedabad, Vadodara, Surat, and Rajkot,” said a health department official.

There are roughly 4,600 isolation beds available at public hospitals while the government is building the capacity for an additional 2,700. In addition, 1,000 isolation beds across the 131 private hospitals have been identified for immediate future requirement. Similarly, while public hospitals currently have 1,100 ventilators, an additional 1,700 ventilators across these private hospitals have been identified. “If required, more private hospitals can be roped in which can take the total isolation beds capacity to over 10,000,” the official further stated.

Karnataka, too, is working on a master plan where each district will have a dedicated Covid-19 hospital in the state and the patients of those hospitals will be shifted to other hospitals nearby so that chances of infection are minimised, said a top Karnataka Health and Family Welfare official. “Depending on the patient load we will keep increasing the number of hospitals. These will be in the public sector as well as the private sector,” he added.

The Raja Rajeshwari Hospital in Bengaluru has already been identified to be converted into a dedicated Covid-19 facility. Apart from this, 26 private hospitals in the Bengaluru urban district area, including Aster CMI, Apollo Hospital, Columbia Asia and Fortis Hospital, have isolation centres for Covid-19 patients in Karnataka.

West Bengal, too, plans to have one nodal hospital per district to tackle the cases. These nodal government hospitals would direct the other hospitals in the district on treatment etc.

Rajasthan has reserved about 84 private hospitals with over 9,000 beds in Jaipur district for Covid-19. In Assam, there are plans to set up brownfield hospitals too within the next two months that would be funded by Rs 80 crore fund generated from one day’s salary donated by the government employees.

Apollo said that with its network of 70 hospitals, it has the largest number of isolation and ICU facilities in the private sector, and are fully prepared for a stage where highly specialised treatment for the critically ill will be required. “We have over 250 beds which can be enhanced to 500, created only to treat the critically ill at any given time and 1,000 ventilators. We expect to give advanced care to over 2,000 patients a month,” the spokesperson said.

Another private hospital chain operator who has a vast network in southern states said that taking over entire private hospitals could be worrisome. “We are not sure how it works as there would be other critical cases coming in too,” said the owner.

Analysts said the outbreak has already taken a toll on private hospitals. “Large players like Apollo have seen a significant drop in occupancy levels to 40 per cent from 69 per cent amid restrictions on people movement and postponement of elective procedures. Fortis has also started seeing a decline in number of elective surgeries resulting in a sharp fall of around 65 per cent, 40 per cent in OPD, IPD volumes, respectively. Occupancy levels are down to 43-45 per cent from 68 per cent in Q3FY20. Narayana Hrudayalaya’s domestic in, out-patient volumes have fallen 30-40 per cent due to travel restrictions and deferral of elective procedures. The company had temporarily suspended operations at its Cayman facility for two weeks due to an undisclosed Covid-19 case,” noted an ICICI Securities report.-Business Standard