Are Delhi Govt Hospitals Ready for COVID 3rd Wave? The Quint's Ground Report
'We can build health infrastructure but how to deal with shortage of experienced medical staff,' said a doctor.
The COVID-19 third wave in India is inevitable, say health experts. But are our hospitals prepared for a COVID third wave? Especially if it is as horrifying as the second wave that cost thousands of lives due to lack of oxygen and our healthcare infrastructure's inability to cope?
The Quint visited some key Delhi government hospitals for a reality check on their preparedness in the event of a COVID-19 third wave.
Our focus was on whether the Pressure Swing Adsorption (PSA) Oxygen plants promised by the Centre and State had been installed at these hospitals. As we know, during the deadly second wave, Delhi depended on the Central Government for oxygen supply and saw acute shortages. But with the help of in-house PSA oxygen plants, the intention was for Delhi's hospitals to be able to generate their own oxygen.
We found that most Delhi government hospitals have installed or are in the process of installing PSA oxygen plants. But we also found that these plants would fall short in capacity in a crisis. Hence, the dependency on Liquid Medical Oxygen (LMO) would continue.
The biggest problem with LMO is transportation from source to the hospitals that need them. Unavailability of oxygen and gaps in transportation often led to loss of lives during the second wave.
Another major concern at all the hospitals The Quint visited was a shortage of experienced medical staff.
Raja Harish Chandra Hospital – 4 PSA Oxygen Plants
Our first stop was Raja Harish Chandra Hospital in Narela, North Delhi. This 200 bed hospital was a COVID-19 hospital during the second wave. It is supposed to have 4 PSA oxygen plants with an overall capacity of 930 LPM (Litres Per Minute). One plant funded by PM CARES Fund is up, another funded by France in May 2021 is also running. But two other PSA oxygen plants to be funded by Delhi government are yet to be installed.
Each oxygen bed requires 10 litres of oxygen supply on an average, so these 4 PSA plants will cover 90 beds. Our 70 metric ton LMO (Liquid Medical Oxygen) plant installation is already in process which will supply oxygen to the remaining beds in the hospital.Sanjay Kumar Jain, Medical Superintendent, Raja Harish Chandra Hospital
Medical Superintendent Sanjay Kumar Jain also said that the hospital is in the process of adding 200 to 400 beds, but hiring experienced medical staff could be a big challenge.
We have told Delhi government that we can move forward with increasing beds only if we get medical staff. The government has told us to hire medical staff, but there is a massive dearth of experienced medical staff.Sanjay Kumar Jain, Medical Superintendent, Raja Harish Chandra Hospital
'Oxygen Purity of PSA Oxygen Plant Is 93%'
Another challenge that hospitals relying on PSA oxygen plants will face is the purity of oxygen. As per experts, oxygen purity of PSA oxygen plants is merely 93% and not advisable for patients on ventilators.
We are increasing the ICU beds to 75. We plan to cover 100% ICU beds through the LMO plant. The remaining oxygen beds can be covered by the PSA oxygen plants. Patients on ventilator beds need 100% pure oxygen.Sanjay Kumar Jain, Medical Superintendent, Raja Harish Chandra Hospital
A senior hospital staff member, on the condition of anonymity, told The Quint that a single 1000 LPM capacity PSA oxygen plant instead of four plants would have been more cost effective, as it would have required fewer technicians to operate it.
Jain accepted that during the second wave they faced problems at multiple levels – from lack of oxygen to massive influx of patients. Even shifting patients with oxygen cylinders from one floor to another had been tough due to shortages of trolleys and staff.
We are trying to plug all the loopholes that we observed during the second wave. We hope that increased infrastructure will help us in future.A senior doctor at Raja Harish Chandra Hospital
Bhagwan Mahavir Hospital – PSA Oxygen Plant Yet To Be Installed
Our next stop was the 321 bed Bhagwan Mahavir hospital in Pitampura, North-West Delhi. As per hospital sources, the management plans to increase the number of beds to 744. But it is still uncertain by when.
During the second wave our hospital was a COVID hospital. We faced oxygen shortage and somehow managed. We had to transfer most of our COVID patients to another hospital.Alka Agarwal, Medical Superintendent, Bhagwan Mahavir Hospital
The hospital is likely to be declared a COVID-19 hospital in the third wave. A senior doctor at Bhagwan Mahavir hospital, on the condition of anonymity, told The Quint said that a 1000 capacity PSA oxygen plant and LMO plant are in the process of being installed in the hospital.
We hope the PSA plant will be installed before a third wave hits Delhi. We are just waiting for the delivery of the plant. But we are not sure by when the LMO plant will be installed.A senior doctor at Bhagwan Mahavir Hospital
The doctor also underlined the lack of manpower in the hospital. 'Merely oxygen plants are not enough, we need technicians and doctors to operate them,' said the doctor.
We have informed Delhi government about our manpower needs. Now it is upto the government to address it. Be it PSA oxygen plant or LMO plant, we need experienced people to operate them.A senior doctor at Bhagwan Mahavir Hospital
The doctor added that apart from PSA oxygen plants, the hospital also has oxygen concentrators and oxygen cylinders to cater to oxygen needs.
Jag Parvesh Chandra Hospital – Will Be a COVID Hospital in 3rd Wave
From Bhagwan Mahavir hospital we went to Jag Pravesh Chandra Hospital at Shastri Park in North East Delhi. The hospital's Medical Superintendent Dr. Adarsh Kumar spoke to us on the phone.
Kumar said that an 800 litre PSA oxygen plant is likely to be installed by the end of September 2021.
We were a non-COVID hospital in the second wave but we have been told that we are going to be a COVID hospital in the third wave.Dr. Adarsh Kumar, Medical Superintendent, Jag Pravesh Chandra Hospital
Jag Pravesh Chandra hospital is a 200 bed hospital. The Delhi government plans to convert 100 beds into oxygen beds and 100 beds into ICU beds during the COVID third wave.
'We have floated tenders for Liquid Medical Oxygen plant and very soon we will finalise the vendor,' said Kumar. The Delhi government has allowed recruitment of 25% extra medical staff so that it can function as a COVID hospital. Kumar said the hospital will recruit more medical staff soon.
I think we are well equipped to handle COVID's third wave.Dr. Adarsh Kumar, Medical Superintendent, Jag Parvesh Chandra hospital
Some of the other Delhi government hospitals that have installed PSA Oxygen plants are Maharishi Balmiki Hospital, Deep Chand Bandhu Hospital and Rao Tula Ram Memorial Hospital. While Dr. Hedgewar Aarogya Sansthan is still uncertain about the installation plant.
Though the Delhi government has installed PSA oxygen plants, the dependency on LMO or Liquid Medical Oxygen will remain. And that is a big worry.
And the other big question - How will Delhi government hospitals will deal with the acute shortage of experienced medical staff, which was acknowledged at all the hospitals that The Quint visited?
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