As COVID-19 cases surge, the health system, including the private sector, is feeling the pressure of increased demand for hospital admissions and critical-care facilities.
Three weeks ago, people who tested positive for SARS-CoV-2 had the freedom to opt for a private hospital of his/her choice, whether he was asymptomatic or had mild symptoms. However, it is no longer easy to walk in to a private hospital seeking admission, because beds are getting filled up.
Home care advised
“Availability of beds is indeed becoming a problem now that more people are testing positive day by day. We are also now counselling our asymptomatic patients to opt for home care so that the hospital beds can be saved for those patients with comorbidities or respiratory issues. We have a home-care package wherein patients are tele-counselled and followed up regularly so that they have nothing to fear,” says A. Rajalakshmi, senior consultant in Infectious Diseases and Infection Control, KIMS.
Thiruvananthapuram has the advantages of a well-equipped hospital network, both private and public, as well as a well-streamlined district health administration. Despite recording around 1,000 cases a day, the district is holding up well, with only 1.5% of the cases reaching ICUs.
With the exception of Kozhikode and Ernakulam, other districts would just fold up if cases surged further and the State crossed the 10,000 cases a day mark, it is feared.
Public health experts point out that more attention should be on the 60% of asymptomatic patients and those with mild symptoms who are now pushed to either home care or COVID-19 first or second line treatment centres to prevent them from going into complications.
“Earlier, all positive patients were immediately hospitalised. Now, doctors are trying to send as many as possible to home care or first-line treatment centres (FLTC). But this is a process which needs to be done with much more care and diligence or else there could be unnecessary deaths,” cautions a senior doctor.
Category C patients with serious symptoms alone are now referred to medical college hospitals. All asymptomatics and those with mild symptoms are assigned to home care or FLTCs, while Category B (patients with co-morbidities) are send to second- line treatment centres.
FLTCs are the weak link in the system right now because the facilities in most are hardly adequate.
“Now that beds at both public and private sector hospitals are getting dear, people are opting for home care just to avoid FLTCs and that could lead to unforeseen problems,” he said.
“The government should come out with district-wise lists of ICUs and beds available in hospitals and FLTCs. There should also be some agency or call centre at district-level for real-time monitoring of available beds and to coordinate its distribution. Or else, a COVID-19 patient who requires medical attention will end up going from hospital to hospital in the eleventh hour,” points out A.V. Jayakrishnan, chairman, IMA Hospital Board of India.