MUMBAI / NEW DELHI (Reuters) – When Manit Parikh’s mother tested positive for the new coronavirus, she was rushed by ambulance to Bomba’s private Lilavati hospital, but officials told the family that no beds with critical care were available.
FILE PHOTO: Men wearing protective masks enter the premises of a hospital where a special ward has been set up for the coronavirus disease in Mumbai, India, March 17, 2020. REUTERS / Francis Mascarenhas / File Photo
Five hours and dozens of phone calls later, the family found a bed for her at the private Bombay hospital. A day later, on May 18, Parikh’s 92-year-old diabetes grandfather had breathing difficulties at home and was taken to the city’s Breach Candy Hospital, another highest private facility, but there were no beds.
“My dad asked for them,” Parikh told Reuters. “They said they didn’t have a bed, not even a normal bed.” Later that day, they found a bed at Bombay Hospital but his grandfather died hours later. His test results showed that he was infected with the virus.
Parikh said he believes the delays contributed to his grandfather’s death. Officials at Lilavati and Bombay Hospital refused to talk to Reuters. Representatives of Breach Candy hospital did not respond to the request for comment.
For several years, India’s thriving private hospitals have taken some of the strain on the country’s underfunded and overdue public health networks, but the trial by Parikh’s family suggests that when coronavirus cases explode in India, even private facilities run the risk of being overrun.
India on Sunday reported 6,767 new coronavirus infections, the country’s biggest increase in a day. Government data shows the number of coronavirus cases in the world’s second-most populous country doubles every 13 days, even as the government begins to reduce the restrictions on locking. India has reported more than 131,000 infections, including 3,867 deaths.
“The rising trend has not gone down,” said Bhramar Mukherjee, professor of biostatistics and epidemiology at the University of Michigan, citing India’s fall. “We haven’t seen a smoothing of the curve.”
Mukherjee’s team estimates that between 630,000 and 2.1 million people in India – of a population of 1.3 billion – will be infected in early July.
More than a fifth of the country’s coronavirus cases are found in Mumbai, India’s financial hub and its most populous city, where the Parikhas struggled to find hospital beds for their infected family members.
India’s Ministry of Health did not respond to a request for comment on how it will deal with the predicted increase in infections, given that most public hospitals are crowded at the best of times. The federal government has said in media briefings that not all patients need hospitalization and that they are making rapid efforts to increase the number of hospital beds and provide health facilities.
The federal government’s data from last year showed that there were about 714,000 hospital beds in India, up from about 540,000 in 2009. But given India’s growing population, the number of beds per 1,000 people has only grown during that time.
India has 0.5 beds per 1,000 people, according to the latest data from the Organization for Economic Cooperation and Development (OECD), up from 0.4 beds in 2009, but among the lowest countries surveyed by the OECD. By contrast, China has 4.3 hospital beds per 1,000 people and the United States has 2.8, according to the latest OECD figures.
While millions of India’s poor rely on the public health system, especially in rural areas, private facilities account for 55% of hospital admissions, according to government data. The private health sector has grown over the past two decades, especially in India’s major cities, where a growing class of prosperous Indians can afford private care.
Mumbai’s municipal authority said it had ordered public officials to take control of at least 100 private hospital beds in all 24 zones in the city of nearly 20 million people to make more beds available for coronavirus patients.
There is still a waiting list. An official at a helpline operated by Mumbai’s municipal authorities told Reuters that patients would be notified of the availability.
It is not just beds that are defective. On May 16, Mumbai’s municipal authority said it did not have enough staff to operate beds required for patients critically ill with COVID-19, the disease caused by the new coronavirus.
As a result, resident physicians will receive less leave than prescribed by the federal government, the authority said. Some doctors told Reuters that they are already overloaded and treat patients without adequate protective equipment and expose them to a higher risk of infection.
Several hospitals in Mumbai, the western state of Gujarat, the northern city of Agra and Kolkata in the east have in recent weeks been partially or completely closed for several days as some medical personnel were infected by the virus. The federal government has not reported any deaths of medical personnel as a result of the virus.
“In our country, health care has never been given priority,” says Dr. Adarsh Pratap Singh, director of the 2,500-strong National Medical Association at New Delhi’s highest public hospital, All India Institute of Medical Sciences. “The government now realizes reality, but it’s already too late.”
In recent weeks, the AIIMS group has been protesting against the lack of health equipment and publicly rejecting Prime Minister Narendra Modi’s call for doctors to donate some of their salaries to his coronavirus fund.
Some health experts say India’s struggle to treat viral patients is the result of chronic under-investment in healthcare. The Indian government estimates that it spends only about 1.5% of its GDP on public health. That figure is higher than it was – about 1% in the 1980s and 1.3% five years ago – but India still ranks among the world’s lowest spending in terms of percent of GDP.
This year, Modi’s federal government raised its health budget by 6%, but it is still short of the government’s own goal to raise public health spending to 2.5% of GDP by 2025, according to the New Delhi-based think tank Observer Research Foundation.
“Too many patients”
Keshav Desiraju, a former Indian health secretary, said that more investment in the health system before the outbreak of the virus may have made the health system more resilient. “At the times of the crisis, all holes are popping up,” he told Reuters.
Dr Chaitanya Patil, an elderly resident physician at King Edward Memorial Government Hospital, one of Mumbai’s largest, said the facility had a shortage of medical staff and the 12 coronavirus departments serving about 500 patients were nearly full.
“There are just too many patients coming in,” Patil said, “It’s a lack of preparedness or a lack of insight about those who are planning.”
Last week, Rajesh Tope, health minister in the state of Maharashtra, which includes Mumbai, said the lack of hospital beds for critically ill patients will not last long.
“Over the next two months, more than 17,000 vacant positions by doctors, nurses, technicians and other healthcare professionals will be filled,” he said in a public address.
India’s United Nurses Association, which represents 380,000 doctors, took a list of 12 issues they said they are facing – including lack of protective equipment and housing – to the Supreme Court in April. The court told them they could file a complaint on a state helpline.
Some nurses leave the big cities. Earlier this month, about 300 nurses working in hospitals in Kolkata city left their hometown 1,500 km (930 miles) away in India’s remote northeastern state of Manipur. A group that represented them said they had left because of irregular wages and inadequate security equipment, among other issues.
“We love our profession,” said 24-year-old Shyamkumar, who quit his nursing job at one of Kolkata’s hospitals and plans to return to Manipur. “But when we’re going to work, give us the appropriate equipment.”
Reporting by Abhirup Roy in Mumbai and Devjyot Ghoshal and Aditya Kalra in New Delhi; Additional reports from Rajendra Jadhav and Shilpa Jamkhandiker in Mumbai, Sumit Khanna in Gujarat, Subrata Nagchoudhury in Kolkata, Zarir Hussain in Guwahati; Editing by Euan Rocha and Bill Rigby