Task Force says treatment protocol not being followed and patients not being referred to bigger facilities in time.

The state-appointed Covid-19 Task Force has identified small hospitals and nursing homes not following the prescribed treatment protocol and not raising the red flag early enough when a patient’s condition begins to worsen as one of the main reasons why Mumbai’s death rate continues to be high.

At a meeting of Task Force members with Municipal Commissioner Iqbal Chahal it was pointed out that an overwhelming majority of patients arriving at major government-run and private hospitals in a serious condition are from small nursing homes.

And nearly in every case, the Task Force observed that either the nursing home bungled up treatment or it took too long to refer the patient to a bigger hospital.

The municipal corporation has now asked its war rooms in each ward to keep track of all Covid-19 cases in smaller hospitals and make sure there is no delay in moving a patient to a bigger, better-equipped facility if the need arises. Mumbai’s death rate is currently hovering between 3 and 4 per cent and the municipal corporation has launched Mission Save Lives to bring it down to 1 per cent.

The BMC has identified 66 nursing homes – all less than 50 beds and not equipped with ICUs – that its officials need to keep a close watch on. A majority of these nursing homes are located between Andheri and Borivali. “These nursing homes are not supposed to admit critical patients and they must inform a major government hospital if a patient’s condition becomes unmanageable or transfer the patient to a big private hospital,” said a BMC official.

Task Force member Dr Shashank Joshi said patients are reaching hospital in such critical condition that it becomes difficult to save them. This when all major BMC-run hospitals and jumbo Covid care facilities have vacant beds is just unacceptable, he said. “These nursing homes should now stop admitting Covid-19 patients and focus on non-Covid cases,” he said.

Chahal on Saturday said that a majority of Covid-19 deaths in Mumbai involved patients brought in critical condition from satellite towns like Thane and Navi Mumbai or referred to BMC-run hospitals from small nursing homes. According to BMC’s data, 54 per cent of Covid deaths can be linked to delays in referring a patient to proper Covid facility.

Private doctors, however, believe that nursing homes are being made a scapegoat when all they are doing is what they were asked to. “The municipal corporation in its frenzy to add beds turned these nursing homes into Covid facilities. But these hospitals don’t have ICUs, nor do they have intensivists on their rolls. So, obviously they struggle when a patient turns critical,” said Dr Deepak Baid, president, Association of Medical Consultants. He said the truth is that the municipal corporation is still short of ICU beds and that is the main reason why the death rate is still high.

Dr Parthiv Sanghavi, former secretary of Indian Medical Association, said that the decision to turn these nursing homes into Covid facilities was wrong. “And now they are being compared to big hospitals. Big hospitals have CT scan, ventilators, dialysis machines and specialist doctors in every field. That is why they not only manage critical patients well, they can also tell early if a patient’s condition is worsening,” he said.

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