NEW DELHI: The number of COVID-19 patients in India who require intensive care unit facilities may exceed its existing inventory of about 32,000 dedicated ICU beds by July end if the current epidemic growth pattern continues and the proportion of patients needing ICU care remains unchanged.
A statistical analysis by researchers at the Institute of Mathematical Sciences in Chennai shows that India could have over 10 lakh active cases by July end or even sooner, considering the current reproductive factor of 1.22 for SARS-CoV-2.
Based on government figures which show that 3-4 per cent of active cases need ICU care in hospitals, the researchers have estimated that by July end, typically July 24, there would be 30000-40000 COVID-19 patients requiring ICUs in the country.
According to the latest figures shared by the Union Ministry of Health and Family Welfare, there are 32,362 ICU beds in total in the country dedicated for COVID-19 patients apart from 1,20,104 oxygen supported beds and 8,91,828 isolation beds.
"Since there is so much relaxation given in the lockdown norms now, the reproductive factor of the COVID-19 pathogen could go up and about a million active cases that we are expecting at current growth rate could actually happen sooner, maybe by mid-July itself," said Sitabhra Sinha, a biophysicist at the IMSc who has done the analysis.
As of Friday, the country has 2,97,535 confirmed cases of whom 1,41,842 are active cases.
Experts meanwhile said that that in a resource-constrained country like India, with very limited and unevenly distributed health infrastructure, the responses by the governments -- at both the central and state levels -- have been "sloppy".
"I have seen rather lousy response from both Centre and most states thus far," said Dr Shikha Panwar, a critical care specialist in a private hospital in Faridabad where dedicated ICU beds are full with COVID-19 patients.
"It's simply not possible to create advanced health facilities like ICU beds overnight and get trained manpower but even out-of-the-box ideas like converting unused public and private places into makeshift hospitals is not happening on the ground fast enough," she said. "We are seeing a large number of patients being refused treatment in Mumbai and Delhi-NCR with the surge in cases and my fear is that this lackadaisical response will cost the country dearly."
Sujatha K Rao, former Union health secretary too echoed similar sentiments.
"Every country has limitations and it is difficult to create ICUs in the short run. Also, it's not a question of beds alone but accompanying manpower and equipment as well," she said.
She cited the example of Delhi -- a badly hit state -- where the state government has projected that 80,000 hospital beds would be needed for COVID-19 patients alone as the total cases could go up to 5.5 lakh by July end, suggesting that states will have to focus on avoding a rapid surge in infections as catering to the deluge of patients could be simply impossible.
"It is essential to even out the spread of infections -- to create 80000 beds is ridiculously ambitious," she said. "Besides there are other equally deserving non-COVID patients and they can't be abandoned."
Her prescription included modulating lockdown norms as per outbreak status and ensuring strict lockdown in containment areas.
Dr Raymond Savio, an intensivist in Chennai, said that considering sick patients need longer time to recover, critical care units could soon be stretched to their capacity.
"While there is no need to panic at the moment, the real key to this lies in the hands of people. The so-called unlock should be observed with greater discipline than during the lockdown,” he emphasized.
Keshav Desiraju, who has also been a Union health secretary in the past, underlined that the governments -- at the Centre and state levels -- need to take full responsibility of the situation.
"There has to be a realistic projection of beds required across all categories and there should efforts to fulfill the need during the pandemic to the best of government's capabilities," he said. "I think governments should acquire private hospitals if the need arises."
The numbers that matter
* 958 dedicated COVID Hospitals with 1,67,883 isolation beds, 21,614 ICU beds and 73,469 oxygen supported beds
* 2,313 dedicated COVID Health Centres with 1,33,037 Isolation beds, 10,748 ICU beds and 46,635 oxygen supported beds.
* 7,525 COVID Care Centres with 7,10,642 beds
* Ventilators available for COVID beds - 21,494