Key points:
- The Delhi high court allowed the state government on Thursday to reserve 80% of intensive care unit (ICU) beds in 33 private hospitals for Covid-19 patients
- On Thursday, new infections were at 7,053 and the city added 104 deaths — its highest one-day fatality — since the outbreak began in March.
The Delhi high court allowed the state government on Thursday to reserve 80% of intensive care unit (ICU) beds in 33 private hospitals for Covid-19 patients for two weeks, lifting its own legal hold after noting that the coronavirus outbreak was at alarming new levels in the national Capital.
The Delhi government first ordered private hospitals to keep ICU beds aside for critical Covid-19 cases in an order on September 12. A group representing some of these establishments challenged the order, resulting in a stay on September 22 by a single-judge bench that criticised the government’s distinction between Covid and non-Covid critical patients.
“In view of the present situation and the spiralling situation that has radically changed in the last three months, the order of September 22, passed by the single judge, is vacated,” a bench of Justice Hima Kohli and Justice Subramonium Prasad said on Thursday.
Figures from Delhi government’s hospital resources monitoring showed that as on Thursday morning, a little under 17% of the city’s ICU beds for Covid-19 patients were free. This came a day after the Capital recorded a peak of new cases at 8,593 on Wednesday. On Thursday, new infections were at 7,053 and the city added 104 deaths — its highest one-day fatality — since the outbreak began in March.
These numbers represent Delhi’s most serious wave of infections yet. In the last week, Delhi added 7,148 cases every day, up from 3,697 in the week ending September 12 when the government first tried to reserve ICU beds for Covid-19 patients.
The Delhi government’s legal representatives, additional solicitor general Sanjay Jain and additional standing counsel Sanjoy Ghose, accepted the court’s criticism that the September 12 notification seemed outdated and premature, but pressed on with the request since the situation had now become much more critical.
“Empower me (Delhi government) today to address the dynamic situation. Kindly let me enforce for 15 days. We will take steps to complete the deficiency,” the ASG said – a request that was eventually granted.
The government representatives faced questions on the preparedness and the timing of its responses on several accounts. “What is the rationale behind selecting these 33 hospitals? What is the density exercise that you have conducted? Is it a random selection? What is the density exposure and how many of the hospitals have been reserved in the Central district of the city with the fourth sero survey report showing increase in the cases? How have the beds been divided,” the judges asked.
Responding to these, the ASG said three factors had been taken into account while choosing the 33 hospitals: these had the largest chunk of ICU beds (a total of 2,217), they were popular among residents, and were better equipped to segregate Covid and non-Covid patients as well be able to increase the number of ICU beds if required.
Appearing for the Association of Healthcare Providers(India) (AHPI), which challenged the Delhi government order, senior advocate Maninder Singh and advocate Sanyam Khetarpal said the 33 private hospitals already reserved 67% of their ICU beds for Covid patients.
Girdhar Gyani, director general of AHPI, said reserving beds creates problem for specialised treatment. “The problem is these are some specialised treatments — like transplants and complex surgeries — that do not happen in hospitals other than these 33. Now, it is a fact that more ICU beds are needed and the government could have reserved the same number of ICU beds in 60 other hospitals easily. Treatment for Covid-19 is not that complicated. Now, with these hospitals being forced to reserve the beds, patients who need a liver or kidney transplant might have to travel outside Delhi to avail it,” he said.
Gyani hit out at the government, saying there are beds vacant in many government hospitals “because nobody wants to go there”. “The government should be punished for that. Instead, the private players are being punished,” he said.
Delhi government representatives did not respond to requests for a comment.
The court was also critical of some other aspects of the government’s preparations. “Have you set up helpdesks outside the hospitals? You say that you are running an ambulance facility but how many patients , who are Covid-19 infected, and cannot travel in the public transport, have been ferried and sent to the Radha Soami Beas Satsang facility,” the court asked, referring to one of the city’s largest Covid treatment centres.
After hearing the government’s submissions, the court said “no citizen with a health emergency should be made to run from pillar to post if there is a bed available in a hospital”.
Before Thursday’s lifting of stay, the matter of reserving beds for Covid-19 patients reached the Supreme Court. On Tuesday, the top court, while refusing to interfere with the Delhi high court’s order, asked the government to again approach the Delhi HC.
At the time, ASG Jain had said: “If possible, please understand my predicament. The city is facing an extraordinary situation. Lots of people from other states are coming into Delhi for better health care. A large number of people in the middle class segment in the city prefer to get admitted in private hospitals.”
To this, the top court judges said: “We are aware that the situation in city is worsening. Delhi has a problem, sometimes 5,000, sometimes 10,000, this is a fluctuating situation… You can bring this matter to the attention of the high court.”
“If the hospitals are overwhelmed and the beds get exhausted, naturally the mortality of the disease will go up. People who are in need of ICU care or oxygen support need it in a timely manner. Also, if we look at Covid-19 cases, most people are preferring to stay in home isolation. These days people also have the oxygen saturation monitors at home. So, chances are those who reach the hospitals are in need of immediate medical attention. If they do not get it, they are likely to die,” said Dr Shobha Broor, former head of the department of virology at AIIMS to Hindustan Times.
