How Covid field hospitals can take weight off India’s overwhelmed healthcare system

by Latesh Sen and Chandrashekhar Jadhav

India is reeling under the second wave of COVID-19. With the daily count crossing two lakh it has already surpassed the US and Brazil.

State governments have had to impose curfews in various parts of the city to stem this tidal wave of infections. After Mumbai, which is currently under strict restrictions, Delhi, with a positivity rate of 20.22 per cent as on April 15, has imposed similar restrictions. Already hospitals in the national capital region are running out of beds.

This after the Delhi government directive to all the city’s top hospitals to reserve a majority of their beds for Covid patients. Last year, during the first surge of cases, it had taken over banquets halls and hotels to turn them into what it called “extended hospitals” and had attached them with hospitals to treat the rising number of Covid patients. It has adopted a similar treatment strategy during the current surge.

But will it suffice? The challenge this time is different and much more enormous. The surge is steeper, with more people requiring critical care. We believe India needs to look at the way field hospitals are being set up and operated in other countries. These hospitals have helped governments to treat critically ill Covid patients without burdening the regular hospitals.

We need to understand that with most beds in hospitals being dedicated to Covid patients, non- Covid patients — including those on dialysis, undergoing treatment for other chronic diseases such as cancer, and those who have to undergo an elective surgery — have had to pay a heavy price. These patients need regular medical care and any delay in treatment can have severe implications on their health.

Besides such patients have a weak immune system and are susceptible to catching Covid. There have been instances where cancer patients and diabetics caught the infection from the hospital and suffered serious health consequences.

Dedicated Covid field hospitals — which have emerged as an innovative, cost-effective solution to fight COVID-19 — can help avoid this situation. In fact, many governments in the Middle East, including the UAE, have successfully used field hospitals to treat Covid patients, ensuring that regular medical care is not disrupted.

A well-planned Covid field hospital can be set up within days in open spaces in the city or its outskirts. These hospitals are equipped with all medical modalities to provide quality care to Covid patients and can easily have a lifespan of over 10 years.

The last one year has helped us understand the ways in which coronavirus can affect human beings. We know that in most cases, the virus affects the respiratory system, causes pneumonia, and if not treated timely can cause irreversible damage to the lungs of the patients. Such patients require immediate intensive care.

These field hospitals in the UAE have full-time pulmonologists, internal medicine specialists, and intensivists, dedicated to treating Covid patients. Their ICUs are fully equipped; and they even have on-site oxygen concentrators, which is critical to managing seriously ill Covid patients.

However, many other aspects of Covid treatment, especially diagnostics, can be tackled using digital technology in the field hospitals. For example, portable bedside x-ray and ultrasonography machines can be deployed and the images be shared digitally with a radiologist. Similarly, blood, urine and other samples can be collected at the field hospital and transported to a nearby laboratory.

Such smart use of space, medical manpower and technology can reduce Covid care costs by 30-40 per cent. It is because in a regular hospital, per day cost to a patient is calculated keeping in account all the facilities — be it operation theatres, or radiology lab —available in the hospital whereas in a field hospital, Covid patients are charged only for the actual.

Setting up and running field hospitals requires expertise. The team — including doctors, nurses, other paramedics and technical staff — undergo a rigorous training. They know how to utilise the resources optimally and deliver high quality care to a large number of patients — something healthcare providers need to focus on during the pandemic.

The virus is affecting people across all sections of society. And it seems that the pandemic is here to stay longer than expected. Therefore, it is imperative to build a healthcare system that can ensure cost-effective, quality care to Covid patients and undisrupted medical care to all other non-Covid patients.

Original article in The Indian Express