Adapt to be adept
THE WEEK|November 29, 2020
How hospitals in India took on the many challenges that came their way during the pandemic
POOJA BIRAIA JAISWAL

Scary yet humbling. That is how the health care community in India describes its experience of the Covid-19 pandemic that affected more than 80 lakh people and took more than a lakh lives. The novel coronavirus in itself was a challenge, an enigma that kept unravelling at a breathtaking speed. We were clearly unprepared, and it showed—from supply chain disruptions and lack of personal protective equipment and ventilators to staff shortages and exhausted caregivers.

But the crisis forced hospital administrations to come together and rise to the challenge of treating an overwhelming stream of patients. This, while trying to understand the virus, even as routine surgeries and elective procedures got cancelled, leading to a major occupancy drop and significant revenue losses. As public hospitals were converted into Covid-19 centres, patients who depended on them were lost. Unnecessary delays in non-Covid treatments led to a surge of preventable emergencies and non-Covid deaths, thereby compounding the panic.

“The pandemic has been quite a teacher for hospitals and health care institutions across the country,” says Dr Ramesh Bharmal, dean of T.N. Medical College and B.Y.L. Nair Charitable Hospital and director of medical education and major hospitals, Mumbai. “We have learnt our lessons early on and have emerged stronger than ever,” he says. In April, the civic-run hospital got converted into the city’s biggest Covid-19 facility with more than 1,600 beds. Over time, it treated more than 6,000 Covid-19 patients and aided delivery of close to 1,000 babies, born to coronavirus-infected mothers. But the journey was anything but smooth. Heaps of biomedical waste in yellow bags were reportedly seen lying unattended outside its premises. There was an acute shortage of Remdesivir when more than a hundred of its critical patients needed the life-saving drug. Another civic-run hospital faced enormous challenges in disposing of unclaimed dead bodies of Covid-19 patients and acute staff shortages. But these hospitals managed to keep their head above the water.

Most hospitals went through the same experience. “Resilience is one of the foremost lessons we learnt through the pandemic,” says Dr K. Hari Prasad, president of Apollo Group of Hospitals, Hyderabad. “It has only been because of the relentless and selfless service put in by the health care staff, not just in Apollo but across the country, that we are presently in a better situation. It is easy to criticise hospitals but the community must acknowledge that these institutions have been at the forefront of the fight.” Almost 2-3 per cent of Apollo’s more than one lakh staff across India contracted the disease. “Over a period of time, we started posting only our infected staff in Covid-19 wards because of their developed resistance to the virus,” he says.

Across India, both public and private hospitals were facing a desperate shortage of manpower from March to June. “Even with the government allowing us to recruit across levels, we were unable to get people,” says paediatrician Dr S.R. Lakshmipathy, nodal officer of Covid-19 at K.C. General Hospital in Bengaluru’s Malleswaram area. “They were demotivated, scared and some were aged and had co-morbidities.”

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