Hospitals turn to pre-Covid biz as patients prefer home quarantine

The sudden spike in positive cases across many states is not making too many hospitals change their plans yet on winding down infrastructure exclusively linked to Covid-19. Hospitals and health care centres had begun freeing up space dedicated to Covid when cases went downhill. Even as cases have risen recently, home quarantine seems to be the preferred health care option for a large majority, according to health care executives.

The scene at Manipal Hospitals, which has the country’s second-largest hospital network in terms of beds, captures the new reality. The hospital has re-converted its Covid intensive care units into regular ICUs. These ICUs have an isolated section where Covid-19 patients can be kept, if necessary.

Dilip Jose, MD and CEO of Manipal Hospitals, said of the total Covid-19 patients, almost 70 per cent are now in homecare. Also, much less than 10 per cent of those hospitalised need intensive care. 

Consider the numbers:  From average occupancy levels of 70-75 per cent, the overall occupancy fell to 30-35 per cent during the peak of the pandemic last year. Of this, more than 50 per cent came under Covid-19 admissions. Now, the occupancy levels (including Covid-19) are back to 70-75 per cent, but Covid-19 cases are just about 10 per cent of this.

The trend is the same at the country’s largest hospital network — Apollo Hospitals. The number of Covid beds dropped to 1,600 during the third quarter, and further dropped to 800 in January. While Covid bed occupancy dropped to 48 per cent in December from 73 per cent earlier, the non-Covid occupancy has risen to 67 per cent.  In fact, hospitals are busy re-purposing their Covid capacities to cater to the growing non-Covid treatment demand.

Across the three hospitals in its network with 2,400 beds, Hyderabad based Yashoda Group was treating around 1,000 Covid patients daily during mid-2020. This came down to around 100 patients in December, and fell further to 50-60 in January. Dr Pavan Kumar Gorukanti, Director, Yashoda Hospitals, Hyderabad, said Covid-19 ICUs had been converted into regular ones. "We had scaled up our ICU capacities during the pandemic to 350 beds from a regular 250 beds. Each hospital in our network only had one non-Covid ICU, which has reversed to one Covid ICU in each hospital," he said. The group now runs 75-100 Covid ICU beds, of which only 40 or so are occupied.

Occupancy levels are only 5 per cent in Covid beds in Ahmedabad and the city civic body has thus reduced private beds to 2,500 from 6,000 earlier. Number of Covid patients on ventilation has also almost halved in the whole of Gujarat — from 50-55 in mid-January to less than 30 now.

Govt hospitals no different

Government hospitals too are cutting down on Covid infrastructure. The Lok Nayak Jai Prakash Narayan Hospital (LNJP), Delhi’s largest dedicated Covid facility with over 2,000 beds, has brought down the number of Covid beds to 300. This has been done on government directive. Currently, the hospital is a designated spot for those who have been detected with the UK strain of the virus.

“All of the patients with the UK strain are mild cases. A lot of patients coming to us have severe Covid and are admitted in the ICU. Those with mild symptoms are usually going for home quarantine,” said Ritu Saxena, chief medical officer, LNJP hospital.

Government-backed jumbo Covid centers too are shutting down. The Defence Research and Development Organisation (DRDO), which was operating a Covid facility with 1,000 beds, wounded up its structure in Delhi earlier this month with cases in the national capital on a steady decline, a senior official said. The makeshift hospital was set up within 12 days, to provide treatment free of cost to patients at a time when Delhi was struggling with rising cases.

Similarly, in Mumbai, the civic body shut down nearly 450 small Covid care facilities. These have been kept on standby mode and can be operational within 48 hours. The Mumbai civic body was running five jumbo Covid care centers. In December, the authorities had said these would be shut down phase-wise within three months.

However, after the recent case spike in Maharashtra, there’s an effort on getting the manpower in place to run these facilities if the need arises. "Civic officials spoke with us on Monday and have asked us to be on standby mode, and not reduce our Covid19 beds for now," said a senior official in a city-based hospital. The positivity rate in Mumbai is over 10 per cent now, and daily case additions have spiked to over 1,000 cases.

Joy Chakraborty, COO of Hinduja Hospital in Mumbai, pointed out that from a 20 per cent occupancy in January and early February, the Covid bed occupancy has suddenly risen to 40 per cent in the last two weeks.

Other civic bodies claimed they were ready to ramp up fast. Om Prakash, deputy municipal commissioner at Ahmedabad Municipal Corporation, said ramping up wouldn’t be a problem but people are preferring homecare to hospitalisation now.