Mumbai: The Covid bed occupancy in Mumbai’s private and public hospitals stood at 20%, with at least 17,784 beds — or 80% — vacant even as the daily caseload in the city rose to 10,606 on Monday. Civic authorities said most admissions were on account of an “abundance of caution” to break the chain of infections, and were made up of Covid-positive patients with co-morbidities, who fell within the high-risk category but had having mild symptoms.
“Hospital admissions are increasing but it is also because we are being abundantly cautious,” said Suresh Kakani, additional municipal commissioner and incharge of the Brihanmumbai Municipal Corporation’s response to the pandemic.
“Our jumbo centres are not shying away from admitting people with the mild disease but who are in the high-risk category. This not only helps in breaking the chain of infection but also keep a check on the progression of the disease and fatalities,” Kakani said.
The city has 22,205 Covid beds in both public healthcare facilities and private hospitals. Government facilities include tertiary hospitals like KEM hospital in Parel and BYL Nair hospital in Mumbai Central, as well as nine jumbo facilities spread across different wards of Mumbai. The total number includes beds that are attached to ventilators as well as those that oxygen support.
The city also has the capacity to expand the number of beds by another 80,000 beds.
Apart from this, Mumbai also has 227 Covid Care Centres (CCC) for Covid positive patients with extremely mild symptoms or who are asymptomatic but need to isolate themselves from their families on account of a lack of space in their homes. On Tuesday, there were 972 Covid patients in these facilities, up from 311 on December 20.
To be sure, Covid bed occupancy has seen a jump since December 20, when it was 6.25% (the number of Covid beds at the time were 13,830). However, according to Dr Shashank Joshi,a member of the state’s Covid task force, only a small percentage of hospitalised persons are patients with serious underlying conditions who need close monitoring. At least 20% of the hospitalisations are of international travellers who tested positive for Covid and are awaiting their Omicron reports.
At the beginning of December, the civic body issued a Standard Operating Procedure (SOP) on international travellers arriving from at-risk countries, including the UK, South Africa, Botswana among others, which included a strict seven-day institutional quarantine after an RT-PCR test to track the spread of the Omicron variant of concern (VOC).
“The first category includes patients who take mandatory Covid tests before undergoing other medical procedures. As the circulation of the virus has increased, nearly 70% of such patients are testing positive and are hospitalised before they can undergo their medical procedures. The second category, which accounts for about 20% of admissions, includes international travellers awaiting their Omicron reports. The last category is of patients who are highly vulnerable with other serious underlying conditions and need to be in the hospitals for close observation. These account for only 10% admissions,” Joshi said.
Currently, of the 4,491 hospitalised patients, 1,374 (30.59%) are on oxygen support; 507 (11.28%) are in ICU; 320 (7.12%) are on ventilators.
BMC chief Iqbal Chahal said that only symptomatic patients are being hospitalised as per the guidelines issued by the Indian Council of Medical Research at the start of the pandemic.
At jumbo centres, symptomatic patients are being admitted even if they have mild disease. “Many of these patients live in smaller houses and are directed to us by the ward war rooms. Some even walk-in directly because they are worried about spreading the infections to others in the family,” said Dr Neelam Andrade, dean of the NESCO jumbo facility in Goregaon.
Experts warn that while the hospital bed occupancy is low, people must follow Covid-appropriate behaviour by masking up and avoid crowds.
“Each hospital will have to assess their facility in terms of how many admissions they can take, and be in touch with the ward war rooms constantly to avoid any kind of chaos,” said infectious disease experts Dr Om Srivastava. “On the other hand, people should also play their part in fighting this surge by avoiding crowds, wearing masks and following Covid appropriate behaviour.”
More admissions in private hospitals
While the occupancy in public facilities is about 18%, private hospitals have a higher occupancy at nearly 30%.
For instance, Bandra’s Lilavati Hospital had full occupancy in its 100-bed Covid ward and 22 bed ICU. “We have been getting a lot of patients with full-blown symptoms who are getting admitted mainly because of their underlying conditions,” said Dr V Ravishankar chief executive officer of Lilavati Hospital. He said that all the patients are fully vaccinated. “Patients who are deteriorating are those who have very bad oxygen saturation levels,” he said.
Andheri’s Kokilaben Dhirubhai Ambani Hospital had an occupancy of 15 to 20 patients in the first week of December. The hospital began seeing a rise from December 20 and its occupancy was 50 on Tuesday. “The occupancy has been driven by two main categories of patients — those with concerning underlying issues like cancer, heart disease, lung ailments and those with persisting symptoms,” said Dr Santosh Shetty, chief executive officer of the hospital.
While the recent round of BMC’s genome sequencing has revealed that 55% of the samples were of the Omicron variant, doctors said that Delta and Delta derivatives could also be driving some number of hospitalisations.
The PD Hinduja Hospital in Mahim has been carrying out the RT-PCR tests with the help of the kits that look for the S gene dropout, which is an indirect way to detect the Omicron variant before the sample is sent for genome sequencing for confirmation. Dr Joy Chakraborty, chief operating officer of the hospital said that about 35% of the samples have the S gene dropout indicating the presence of Omicron. “This tells us that Delta still has a role to play in all these hospitalisations,” he said. The hospital has 70% occupancy of the Covid beds.
Dr Shashank Joshi said that patients with moderate disease, those in the high-risk category and those who have desaturating oxygen levels should be red-flagged for admissions. “There is definitely some panic due to the increasing numbers but unnecessary hospitalisations are very unlikely. In fact, most people want to avoid hospitals as much as possible,” he said.
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