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Maha COVID-19 crisis: Hospital beds and ventilators running short, scarcity in oxygen and Remdesivir supply, and inordinate delays in testing

While the labs in Maharashtra are already working beyond capacity, the state needs to increase testing by several folds as its test positive rate is very high

Maharashtra is in throes of a resurgent coronavirus outbreak that is on the brink of overwhelming the state’s health care system. The state on Tuesday reported 60,212 fresh coronavirus positive cases, taking the total tally to 35,19,208 while 281 fatalities pushed the death toll to 58,526. The state alone accounts for almost 44% of the total active COVID-19 cases in the country.

In the view of alarming rise in the coronavirus outbreak, Maharashtra chief minister Uddhav Thackeray on Tuesday convened a press conference and announced a 15-day long statewide curfew starting from 8 pm on April 14.

Patients struggle to get beds and ventilators as the coronavirus outbreak overwhelms hospitals in Maharashtra

The situation in Maharashtra is particularly dire, with cities across the length and breadth of the state reporting an upsurge in coronavirus cases. Hospitals throughout the states have been swamped with COVID-19 patients as the state government scrambles to get private institutes and other medical centres to admit coronavirus patients.

In Mumbai, the capital of Maharashtra and India’s financial nerve-centre, hospitals are on the verge of buckling under the pressure as new infections rise at an alarming rate. About 7,873 new cases were reported from Mumbai on Tuesday. Chaos has swept the hospitals in Mumbai as the hospital authorities are forced to send patients and their relatives back because there are no vacant beds left. Similarly, such grim situation at the hospitals pervades the rest of Maharashtra.

In Nagpur, the winter capital of Maharashtra, there has been an acute shortage of isolation beds, ICU beds and ventilators. About 6,826 people tested positive in the city on Tuesday. With a population of over 30 lakhs, only 33 isolation beds and 2 ICU beds are vacant as of April 13 in over more than 127 hospitals(government and private), including Covid Community Centres.

Likewise, the coronavirus outbreak situation in Pune, another major city in Maharashtra, is similarly bad. Pune on Tuesday reported 5,214 cases. Patients in the city are forced to run pillar to post in their search for the availability of vacant beds at the city’s numerous medical facilities.

Dire Oxygen shortage in Maharashtra

The surge in coronavirus caseloads in Maharashtra also meant that the state is facing acute shortages in the availability of supplemental oxygen. Maharashtra CM Uddhav Thackeray yesterday pointed out the scarcity of oxygen during his address to the state.

Besides requesting neighbouring states to provide Maharashtra with surplus oxygen, Thackeray also asked IAF assistance from PM Modi to airlift oxygen from other states.

Earlier yesterday, 19 patients in Thane’s Vasai allegedly died because of shortages in supplemental oxygen. The relatives of the deceased and local authorities alleged that the coronavirus patients who were admitted to the hospitals succumbed due to the alleged scarcity of oxygen. Today it was reported that the state will receive 100 MT oxygen from the Jamnagar plant of Reliance in Gujarat.

Apart from oxygen, the state is also facing shortage of Remdesivir, the drug used in treatment of COVID-19 patients. The shortage has resulted in black marketing of the drug for easy and quick profit. On 12th April, Maharashtra health minister Rajesh Tope said that companies manufacturing anti-viral drug Remdesivir should double the production and decrease its MRPs to Rs 1200- Rs1300.

Testing backlog across Maharashtra as COVID-19 cases rise at a frightening pace

Even testing capabilities are under tremendous strain due to the inexorable rise in number of coronavirus cases. Many testing centers have been witnessing serpentine queues as people suspicious of being infected are lining up to get themselves tested.

This has naturally created a backlog in testing at several laboratories across the state. The spike in Covid-19 cases precipitated by the second wave of the coronavirus pandemic and state guidelines mandating negative RT-PCR tests for those working in public transportation, home delivery services, film shoots, roadside eateries, and other categories have likely played a crucial role in exacerbating the testing backlog in the state.

Acknowledging the delay, Mumbai’s Municipal Commissioner Iqbal Singh Chahal on Monday this week asked all the laboratories to issue reports to the municipal body within 24 hours.

Another reason that may have contributed to this worsening testing backlog is the BMC’s decision of making negative RTPCR test mandatory for entry in the malls. Even as the cases were on the rise, the BMC allowed malls to operate, allowing entry only to those who carry a negative RTPCR test with them. This move seems to have backfired as testing laboratories across the city were swamped with people waiting to get their tests done.

The surge in testing across Mumbai can also be attributed to the positivity rate of infections reported in the city. In the week between April 5 to 11, the positivity rate in the city was hovering around 22 per cent, a 4 percentage point increase from the week before. As cases in Mumbai climb, more people are coming out to test themselves for an infection that has now become pervasive in Mumbai.

In their defence, the testing laboratories claim that they are already working at a stretched out capacity. Labs equipped to handle 2000-3000 cases a day have suddenly found themselves tasked with testing 15,000 to 17,000 samples a day. While they are building the capacity to cater to the growing requirement of testing, the inexplicable surge has undoubtedly contributed to the testing backlog.

The situation is not very different in Nagpur. The Nagpur Municipal Corporation on Sunday announced that there won’t be any RTPCR test conducted at any of the public testing or swab collection centres run by the municipal corporation. In the statement, the NMC said due to the increasing Covid cases, and a rush at testing centres, all the four public labs at IGGMCH, AIIMS, GMCH and Nagpur University have a huge backlog of results.

Instead, the NMC said only antigen test will be conducted at these centres. However, antigen tests are not the most reliable test for determining COVID infection and are known for giving false negatives and false positives.

Some private testing laboratories that are still conducting RTPCR tests are taking inordinate time to process the results. The results, which were earlier given in hours after the test, are now taking days for getting processed. This has naturally created a sense of fear and panic among people, who realise that such long delays could prove fatal.

“They are giving us results on the third or fourth day after the testing. We don’t get a bed in hospitals unless we furnish a positive report. Moreover, there is a shortage of beds and ventilators. Who is supposed to be responsible if the delay of 4 days cost us our lives?” a visibly anxious citizen asked while standing in a queue outside a testing centre in Nagpur.

For others who are travelling to other states, the delay in the testing results does not comply with the guidelines mandated by the governments.

“I have to travel to Gujarat on an urgent basis. The state of Gujarat has mandated negative RT-PCR test done within 72 hours before arrival. However, the testing centre says they can provide us with the result only on the 4th day. How am I expected to furnish the test result then?” a woman outside a testing centre in Nagpur asked.

More tests needed in the state

It is ironical that while that the labs in Maharashtra are already working beyond capacity, the state needs to increase testing by several folds to control the pandemic. At present the test positive rate in the state is more than 25%, which is almost double the national rate of around 13%. As the state is seeing high positive rates among the tested, it means it is not testing enough, and a large number of people are roaming around in public without getting tested, who may have the infection and spreading the same.

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Staff reporter at OpIndia

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