COVID-19 chaos in Delhi: Govt app reveals over 4,000 vacant beds as patients complain of shortage, eye-popping charges at private hospitals

At 10 am on 10 June, Delhi government’s Corona Dashboard showed a total of 9,021 COVID-19 beds, of which 4,873 were occupied and 4,148 were vacant. Four hundred and ninety-four ventilators were available: 262 being used and 232 lying idle.

These figures are updated by the Central and Delhi government and private COVID-19 treatment facilities. This dashboard has been showing around half the beds as unoccupied for many weeks.

Yet, recent days have seen an outpouring of stories on social media about patients going from hospital to hospital and being turned away because no beds were available.

Many social media posts alleged some hospitals were willing to give beds only for a hefty amount.

In a country notorious for hoarding and black marketing everything consumable, activist-turned-politician Chief Minister Arvind Kejriwal did not mince words as he openly accused a few private hospitals, without naming them, of black marketing COVID-19 beds. The chief minister also appealed to people not to visit hospitals unless "absolutely necessary."

There is clearly a massive mismatch between the government’s corona app, which claims to provide real-time information on hospital-wise bed availability, and the experiences of patients. The hospitals — government and private — are required to update the status as and when beds become available.

The surge in COVID-19 cases, however, has stunned the Delhi government which was, until a few weeks ago, confident of its ability to manage the virus. At the end of May, it even supported the idea of relaxing lockdown restrictions.

The rising numbers of positive tests led to the testing protocol being altered to leave out asymptomatic cases in order to manage scarce resources. Kejriwal also tried reserving beds for Delhi residents only, but was overruled by the Lt-Governor Anil Baijal.

Scene outside Delhi's Covid designated Lok Nayak Jaya Prakash hospital. Pic Archana Dwivedi

Delhi needs 1.5 lakh beds by end July

The reality is that the Delhi government’s efforts to manage healthcare in the face of the pandemic is proving a tough proposition. It may not yet have lost the COVID-19 battle, but could well be close to doing so. With around 18,000 active cases, things are not looking good.

Deputy chief minister Manish Sisodia projected 5.5 lakh cases by the end of July, when the bed requirement will stand at 80,000. This projection was presented at a 9 June meeting of the Delhi Disaster Management Authority (of which Baijal is chairman). But just a couple of days later, Kejriwal said the requirement is likely to be over 1.5 lakh beds by the end of July.

Baijal had on 7 June scrapped the Kejriwal government’s order reserving all beds in hospitals under the Delhi government exclusively for the residents of Delhi.

The reservation order was based on the need and fears that people from the National Capital Region (comprising 23 districts of Uttar Pradesh, Haryana and Rajasthan) in addition to Delhi would rush for the free treatment that government hospitals provide.

Baijal cited “the constitutional right to equality and right to life, which includes the right to health” as he trashed the reservation order.

A maze of numbers

Dr Randeep Guleria, director of the premier All India Institute of Medical Sciences (AIIMS), described Sisodia’s projection of 5.5 lakh cases by July end as “one of many mathematical models throwing up different numbers.”

“Whatever the numbers may be, there is a shortage,” a senior AIIMS doctor, on condition of anonymity, said. “More so when people suspect they have symptoms and want to go for tests. And when asymptomatic people go for tests just to be doubly sure.”

Dr Arvind Kumar, chairman of the Center for Chest Surgery, Sir Ganga Ram Hospital, denied allegations of patients being turned away when beds were available. “At this moment, we have 300 COVID-19 positive patients” he said.

Health minister Satyendar Jain, speaking on hospital authorities who raised doubts that they'd be able to manage both COVID and non-COVID patients, warned that the government would simply declare them dedicated COVID-19 hospitals.

Yet, the harsh truth is, beds are simply not available!

Dr Naresh Dang, senior consultant at Max Super Specialty Hospital, Patparganj, confirming the acute shortage of hospital beds in the National Capital, painted a grim picture of the future. “The number of patients is increasing so rapidly there aren't enough beds,” said Dr Dang.

“It is not about the money. Patients are running from pillar to post for beds. Even doctors testing positive are finding it difficult to get a bed. My own patients are running from one hospital to the other for a bed, and it is not as if they want to be treated for free. But if all the 400 beds in a hospital are occupied, where will they go?”

High treatment costs

A doctor at a private hospital who also did not wish to be identified explained the non-availability of beds thus: “When patients arrive, a few things are required. First, they have to have a COVID-positive report to get a bed. They then ask about the cost and are told the rates depending on how much each hospital charges. Shocked, many of them bargain, want very low rates, and are told no beds are available at that rate.”

The high cost of treatment at private hospitals, which have packaged the costs, has only added to the woes of patients. Post Kejriwal’s charge that some private hospitals were indulging in profiteering, Saroj Hospital, one of six private hospitals that the Delhi government has converted into a dedicated COVID-only facility, issued a circular of its treatment costs:

• A minimum bill of Rs 3 lakh even if the patient is in the hospital for less than a day
• Advance payment of Rs 4 lakh for a shared room
• Rs 5 lakh for a single room and Rs 8 lakh for ICU
• The treatment charges are in packages, from Rs 40,000 a day in a shared room to Rs 75,000 a day in ICU and Rs 100,000 a day for ICU with ventilator.

“In the ICU, attending to every patient means five to six PPE kits, each costing at least Rs 1,000,” said Dr Arvind Kumar of Sir Ganga Ram Hospital justifying the high costs. “So around Rs 10,000 is spent on PPEs alone. Then there are charges for ventilators and ICU beds.”

The hospital, he pointed out, runs on money from patients, and 5,000 employees have to be paid. He underscored the fact that the Delhi government does not fund the hospital.

For those who think it is the capital’s VIP culture which possibly makes hospitals block beds for the ministers, politicians, bureaucrats, judges, senior lawyers and corporate biggies, it is scant consolation that they too, like senior Congress leader Manish Tewari, have sad stories to share.

In a heart-wrenching tale, 52-year-old Anil Goyal of Shahdara in east Delhi knocked at the high court doors on 3 June, seeking directions to the Centre and Delhi government to provide a bed and a ventilator in a government facility for his 80-year-old father Moti Ram Arya, who tested COVID-19 positive on 31 May. By the time his plea was listed for hearing on 5 June, Arya was dead.

Amarpreet, who works for Gates Foundation, too had a terrible experience. She took her father, who was running a high fever and had serious breathing trouble, to Lok Nayak Jaya Prakash Hospital, a Central government-run dedicated COVID-19 hospital, where they refused to admit him. He died later that day.

On the evening of 4 June, Varun Vats, a resident of Rohini in west Delhi, shared on Facebook the travails of trying to get himself tested for COVID-19 as he had come into contact with his cousin who had tested positive on 1 June and who had developed fever, cough, cold and headache.

He was bounced from hospital to hospital, and lab to lab, including private labs, with all of them telling him the same thing: there were no testing kits, so he would have to wait for a couple of days. At Dr Lal Path Labs, the woman who took Varun’s call said: “Sir, these are government orders. There’s no testing at least for the next two to three days.”

This correspondent has learnt that the embassy of a central European country attempted to block 10 hospital beds and offered up to Rs 1 crore per bed. But it failed to clinch a deal.

Building capacity: Short-term plans

All this only highlights the fact that providing for the rapidly increasing need for hospital beds given the projected exponential surge in COVID-19 cases is going to be a Herculean task for the Kejriwal government.

For now, the government is looking to convert four and five-star hotels in the neighbourhood of big hospitals into treatment centres.

“The health department is extending COVID-19 hospitals by linking big hospitals and nearby five and four-star hotels with an upper price cap of Rs 10,000 per day per bed,” according to a press release issued by Baijal’s office. “The hotels would provide beds, housekeeping, food as well as medical services.”

The government has, so far, linked eight hotels to hospitals, to act as extended COVID-19 hospitals and is in the process of similarly linking 19 more hospitals with hotels to tentatively add another 2,000 beds by 15 June, even though two hotels have moved the courts against this order.

It does look like a minuscule number in the face of the massive requirement. So, the government is exploring the possibility of creating additional bed capacity in its sporting facilities. For now, they are considering making Pragati Maidan, Talkatora Indoor stadium, Thyagaraj Indoor stadium, Indira Gandhi Indoor stadium, Jawahar Lal Nehru Stadium and Dhyanchand National Stadium into makeshift hospitals.

Sources in the AAP said they could “swiftly convert these into hospital beds, including beds with ICU facilities” if the need arises.

As Dr Dang said, “It is not just about creating beds somewhere. A patient needs doctors, oxygen, nursing care… just because you declare a hotel a hospital, it will not become one. A stadium will not become a hospital just by putting beds in it. They need to do a lot of things. Can all the required arrangements be done fast enough? Delhi is going to go the way of Italy.”

This article was first published in Citizen Matters, a civic media website and is republished here with permission. (c) Oorvani Foundation/Open Media Initiative.