Though new cases of COVID-19 are decreasing in Nagpur, the authorities are working on preparedness in case third wave of the pandemic hits the city. The focus always lies on increasing number of beds. Everyone feels, if the beds are increased then those testing positive for coronavirus in large number can be accommodated. But the ratio of required staff as compared to the number of beds is always given less importance. If the ratio of frontline healthworkers to the number of beds is not maintained, it would play havoc.

 

The Residents, the nurses, the doctors in Government Medical College and Hospital (GMCH), Indira Gandhi Government Medical College and Hospital (IGGMCH) are working under tremendous pressure. In fact a few days ago Maharashtra Association of Resident Doctors (MARD) had warned administration that this ignorance would play with the lives of patients admitted in the hospital as they would not receive proper treatment. Now, the administration must give a serious thought to it else everything would go haywire. During his Nagpur visit, Public Health Minister Rajesh Tope had made an announcement that 1,000 beds would be added to the existing ones. He made that statement probably without taking the staff position into account. Increasing beds just in number can’t solve the purpose, because the person occupying bed is to be given the treatment wherein doctors, nurse and other elements are involved. Their number should be in proportionate with the beds. There is no uniformity in the ratio of number of beds to medicos or to nurses in the overall medical education in India. But approximately the ideal ratio of nurses is 1:3 which means one nurse should be there for three beds.

 

In general wards one nurse is expected to cater to six beds. But in Intensive Care Unit (ICU) the ratio should be 1:1. As far as doctors to patients ratio is considered, every ICU should have 1 senior doctor, 1 resident who can take care of 10 to 15 patients. It needs to be supervised by one intensivist. This is the ideal position. But that is never maintained. Take example of All India Institute of Medical Sciences (AIIMS). It has 350 beds which are managed by only five doctors from Medicine faculty. Of course, they are accompanied by medicos from Anatomy, Physiology, Biochemistry etc. Medicos from Anatomy, Physiology, Biochemistry etc are only the numbers. They are not expected to provide treatment to seriously ill patients. Now, AIIMS will have additional 200 beds for children and the institute has only five doctors in that specialty. Will they able to manage so many patients, if unfortunately so-called third wave of COVID -19 hits, is a million dollar question. Similarly, the inadequate staff at GMCH and IGGMCH, is finding itself helpless in handling the patients. GMCH has around 1,000 beds while IGGMCH has about 600 to 800 beds. Both these old institutes have good number of medicos and Residents. But this good number is not very good in terms of handling the COVID wards. As per rule and as a precautionary measure too, the doctors who render services in COVID ward are supposed to stay in isolation for three weeks.

 

Unfortunately, GMCH and IGGMCH are not able to follow it due to staff crunch. The Residents have to come back within seven or 10 days of rendering service in COVID ward. GMCH, IGGMCH and AIIMS have to divide their staff into two-- COVID and non-COVID. Secondly, all these premier institutes can’t say no to any patient as per rule. Obviously they can’t restrict the number of patients and have to treat them. GMCH and IGGMCH have failed to work in shifts, they did not succeed in maintaining rotation. Unfortunately, these all aspects remained neglected. Somehow, Nagpur was able to manage the treatment last year. But the load has increased now and if things continue like this then it would be difficult for healthworker to save the patients.