Amid govt efforts to increase COVID bed numbers, hospitals face shortage of health workers

By Saloni Bhatia

New Delhi, Jun 25 () As the number of beds in private hospitals for COVID-19 patients is being increased, there are complains of acute shortage of manpower -- doctors, nurses and other paramedical staff - to treat coronavirus patients, putting further stress on the city's health infrastructure.

Private hospitals say the shortage is due to lack of experts to treat coronavirus-related complications and because a large number of healthcare staff has to undergo quarantine. Many medical professionals have quit the jobs due to fear of infection or family pressure, while others have demanded more money and insurance.

Demoralised staff, lack of government support, infection among healthcare workers, reluctance of families to allow their loved ones to work in COVID wards, patients preferring private facilities over government hospitals are also some reasons why private hospitals in the national capital are facing a shortage of staff.

Amid a surge in coronavirus cases and the government's impetus on increasing beds by turning banquet halls and hotels into COVID facilities and attaching them with hospitals, the managements of these hospitals are faced with their own internal crisis.

At the Delhi Heart and Lung Institute (DHLI), a quarter of nurses had quit even before the hospital was converted into a COVID facility while another 15 percent nurses quit after it was turned into a coronavirus facility, citing reasons like parental pressure and personal fears and anxieties, according to hospital officials.

Similarly, at Saroj Super Speciality Hospital in Rohini, 40 to 50 per cent nurses stopped reporting to work citing reasons such as lack of transportation and refusal of families to let them be on COVID duty, said an official.

"There is a shortage of doctors. Our hospital has a cardiac unit and our doctors are trained to handle those cases. But with a disease that is hitherto unknown, you need many kinds of specialists, like internal medicine, respiratory medicine specialists, etc. They are not available," said Dr KK Sethi, chairman, DHLI.

"The resident doctors who handle emergency units are refusing to work. Nobody wants to join the hospital if you tell them they will have to work in COVID wards. Those who are willing to work are asking for exorbitant salaries, almost three to four times of what they would usually get," he said.

The Delhi government is increasing bed capacity in the national capital to tackle coronavirus cases, which are expected to touch 5.5 lakh by the end of next month, but experts feel it's being done without keeping in mind the human factor.

Dr RK Mani, Medical Director & Chairman, Critical Care & Pulmonology, Batra Hospital, said it is important to maintain an optimal doctor-patient and nurse-patient ratio.

"Increase in bed without appropriate increase in staff is not ideal. There is a greater chance of infection to healthcare workers and among patients. There are the issues of loss of morale, exhaustion and burnout. They may get aggravated to the point that people may choose to leave their jobs," he said.

Explaining the optimal ratio, he said in ICUs there should be one nurse for not more than three patients and outside the ICU, the ratio should be one nurse for not more than six to eight patients. Similarly, a doctor cannot see more than eight patients in the ICU.

"Expanding capacity means that the human factor is not in the picture. Not looking at care to the caregiver is a fatal mistake we are making," he opined.

Preference of patients to visit private hospitals over government hospitals is another reason that is burdening the private healthcare system.

According to Dr Chander Prakash, president of the Delhi Voluntary Hospital Forum, in government facilities 60 per cent beds are vacant.

"In private hospitals, staff was being given perks like vacations, pick and drop facilities, and other allowances. Now the government has capped the charges. From where will the hospital pay?" he asked.

Prakash also rued that there has been an increase in the cost of PPE kits, sanitisers and masks.

Sethi complained of the increase in use of disposables, masks and other items which has burdened hospitals.

Adding to the list of problems is the rising number of healthcare workers being infected. As many as 313 healthcare workers have been infected at Sir Ganga Ram Hospital till now. On Tuesday, two nurses and three doctors tested positive at Saroj Hospital. Nearly 2,000 health workers including doctors and nurses have contracted COVID-19 in Delhi so far.

Such is the scenario at DHLI that the staffers who have come in contact with other staff members who have tested positive are being called to work.

"They are allowed to come but we monitor them and see that they are not developing symptoms. Two doctors, two nurses, and a receptionist have tested positive recently. The people at the front desk face the brunt as patients fight with them, cough at them. It's a very tough situation," said Sethi.

Wearing PPE kits for six hours leads to exhaustion and not accessing washrooms has led to low immunity levels and burnout among healthcare workers, opine experts.

On Wednesday, the Delhi government had directed all state-run hospitals to extend the terms of senior resident and junior resident doctors, who are going to complete their tenures, by six months to meet the shortage of doctors in view of the spike in coronavirus cases.

Dr Girish Tyagi, president of Delhi Medical Association, said they have suggested to the government to rope in nursing students or interns.

He also suggested that states where the number of coronavirus cases are less can also be asked for help by the government.

"The city government can ask them to transfer some doctors and nurses here. Then there are homeopathic doctors and dental surgeons who can be utilised," he said. SLB RDM RDM