A medical staffer checks a ventilator in an intensive care unit at a newly inaugurated hospital in Tamil Nadu state during a government-imposed nationwide lockdown. Photo: AFP/Arun Sankar

Manish Sisodia, Delhi’s deputy chief minister, wasn’t scaremongering when he said the number of Covid-19 cases in the state could double every 7-10 days until July 31 and the number of hospital beds needed would increase 10 times.

Delhi could need 80,000 hospital beds for half a million cases by the end of July.

He spelled out one of India’s worst fears – the scarcity of medical facilities. As of now Delhi is using only half its 8,821 hospital beds for the almost 30,000 Covid-19 cases, the third-highest number in India.

And Delhi is one of the privileged states with top-class hospitals, research institutions, an army of private and retired medical professionals and a large number of urban and educated citizens.

Part of the reason is the low spending on healthcare. India’s public health expenditure is only 1.3% of the gross domestic product. Along with out-of-pocket and public expenditure it spent 3.6% of GDP on health, compared with 17% for the US, 11.1% for Germany and France and 10.9% for Japan.

Ironically, state Chief Minister Arvind Kejriwal, who as late as May was confident that the existing facilities would be sufficient, is currently being tested for a suspected coronavirus infection. His deputy, Sisodia, is defending Delhi’s right to reserve the scarce hospital facilities for Delhi residents.

Every state is dealing with not only the challenge of containing the virus but also insufficient beds, intensive care units, ventilators and ambulances. This problem is further exacerbated by a shortage of doctors, nurses and medical support staff.

Maharashtra with 88,529 cases leads all 29 states, accounting for one third of all 267,000 cases in India. Mumbai, its state capital and the country’s main commercial center, has more than 50,000 cases, and along with suburbs accounts for 63,612 cases, or 72% of the state. About 7,500 Covid-19 patients have died so far in India.

Mumbai’s 6,099 beds at hospitals dedicated for Covid treatment for co-morbid and severe cases was 96% occupied as of May 27. Its 645 intensive care units were 99% occupied and 72% of its 373 ventilators were in service to save lives. Cases are only rising.

Experts fear that cases could surge with the easing of lockdown restrictions to restart economic activities and people rushing out without precautions. Prevention seems the best bet for most in India.

Sensing acute shortages, the state government took over private clubs, exhibition grounds and cricket fields to set up temporary shelters to quarantine high-risk contacts and patients with mild symptoms who wouldn’t require immediate hospital treatment.
Most of the beds are ready.

The government had to ask the southern state of Kerala to send in 50 doctors and 100 nurses to relieve the exhausted local doctors and medical staff.

An initial surge in cases saw doctors working all waking hours. At one horrific stage a government hospital had patient beds lined up on one side of a ward and corpses on the other, sparking public outrage.

To prevent a panic, the state government took under its control 80% of all private hospital beds for Covid cases.

The situation is no different in other states and large metros. While state-run medical facilities are seen as unhygienic and risky, patients patronizing swanky private hospitals often accuse them of malpractice, including over-charging and subjecting them to unnecessary tests and treatments to inflate their bill.

Scores of patients being turned away by Delhi-based private hospitals prompted Chief Minister Kejriwal to file a police report against one hospital and caution the others. He accused the hospitals of allotting beds to those willing to pay exorbitant sums.

This was one of the reasons he barred outsiders from Delhi hospitals. Yet, the fact remains that the poor get a raw deal.

India currently is the sixth worst-affected country after the US, Brazil, Russia, Spain and the UK. and could soon surpass Spain and the UK. General immunity to other illnesses has been low as well.

Then there’s the issue of dependence on China for some raw materials and medical equipment.

India is one of the cheapest sources of generic drugs for the rest of the world, but for a while its own production was disrupted when supplies of pharmaceutical ingredients from Wuhan in China were disrupted during the early days of the pandemic.

India is trying to reduce its dependency on China by increasing domestic production. Likewise, it rapidly ramped up its production of personal protective equipment and N-95 masks.