In a letter to chief minister Uddhav Thackeray, Association of Medical Consultants (AMC) Mumbai, a body of specialist doctors in Mumbai, has said that unless the government controls the spread Covid-19, the healthcare infrastructure will be further challenged. With the influx of patients leading to stretching of the already inadequate healthcare resources they have raised concerns that resources of private hospitals are being strained.

AMC is a body of approximately 12,000 specialist doctors and medical consultants in almost 90% hospitalized healthcare in Mumbai and its suburbs and  practicing at corporate and non-corporate tertiary care referral hospitals (both government and private) and private consultants. The letter says that Covid patients have had to move from hospital to hospital due to lack of information of beds in Covid hospitals. The centralized government system needs to be revamped to display bed availability in real time. Due to non-availability of data in real time their doctors have not been able to guide Covid pregnant women and Covid patients requiring dialysis. Further the turnaround time of 2-7 days for a Covid report has resulted in immense delay in initiation of treatment as well as discharge of a Covid patient eroding their resources.

“In spite of government directives, hospitals dealing with non-Covid patients have often been wrongly sealed for 14 days by local health authorities, protocols of quarantining and testing of staff have not been uniformly followed by local health authorities and implementation of various government guidelines like protocols on admission and discharge of Covid patients protocols are also not uniformly followed by the concerned authorities,” says the letter.

The letter also states that healthcare personnel and establishments have been acquired without uniform memorandum of understanding. Save a few hospitals with a predefined MoU, others have been acquired forcibly without defined terms and conditions creating a sense of insecurity and except in the MMR region such no such MOU exists in other corporations.

“High end medicines towards treatment of Covid patients in public hospitals have been largely unavailable. Medicines and investigation (injection Tocilizumab with IL6 testing) have been arranged through donations and not been provided by the government. Available personal protective kits (PPE) are uncertified and are largely inadequate in number. There have been several complaints on the same from KEM, Sion, Nair and other hospital residents. Despite the central government notification, the state government has not put a cap on costing of N95 mask and complete PPE suits so far which has led to exorbitant charges by the vendors.”

The doctors’ body also states that no action has been taken against people involved in incidences of violence at Cooper and Lilawati hospitals or against security personal/superintendent for failure to register an FIR. “Our doctors, staff and technicians have often faced difficulties from local politicians (the Panvel case) as well as from society (the Nashik case).”

It further says that no provision has been made or facility provided to get private hospital staff and doctors tested or admitted at nominal rates nor are there any guidelines for managing private patients and hospitals once doctors are called for duty at Covid facilities.
 
“The present policy towards Covid testing by the government has led to confusion and labs have refused testing of admitted patients. Pregnant ladies, chemotherapy patients and dialysis patients who need to be admitted and tested are exposed to other patients in wards. Many doctors have been infected during surgeries. In absence of pre-operative Covid testing laparoscopic surgeries will not be undertaken which will lead to prolonged hospitalization. While requisitioning the services of specialist doctors towards Covid care adequate care needs to be taken so that non Covid patients do not suffer,” says the letter.