KASARAGOD: Health officials have decided to increase the oxygenated beds in the district to 1,000 from the 100-odd beds now. The decision comes against the backdrop of the rising number of COVID cases, with Kasaragod reporting, on an average, 763 cases every day for the past 11 days.
But the meeting was silent on proportionately bolstering the health workforce, including doctors and nurses, to care for the COVID patients.
In a meeting, chaired by collector D Sajith Babu, the health officials agreed to set up 300 new oxygenated beds in a week at the Tata Trust COVID Hospital at Chattanchal and COVID hospital run from the medical college building at Ukkinadka.
The rest of the 700 beds will be set up at the new block at Nileshwar Taluk Hospital, the yet-to-be-opened Mother and Child Hospital in Kanhangad, and the District Hospital.
District surveillance officer Dr A T Manoj said around 15% of the daily cases need hospitalisation. That is, every day around 115 to 150 COVID patients are admitted to hospitals. Of them, 10 to 15 persons will require oxygenated beds. "Some days we see a spike," he said.
Officials, however, are gearing up to increase the beds to be prepared for the worst.
Severe shortage of doctors
However, the same officials said the doctors and nurses attending to COVID patients are already stretched and the addition of beds without increasing the health workers may break the system.
In Kasaragod, posts of 64 doctors and 118 nurses are lying vacant. Of the 64 vacant posts of doctors, 34 are in the Tata Trust COVID Hospital, said the officials.
The hospital has 16 posts for specialist doctors (junior medical consultants) and 16 posts for assistant surgeons (MBBS graduates).
Officially, eight of the 16 posts of specialists and 10 posts of assistant surgeons are lying vacant. But in reality, the six assistant surgeons appointed in January have not yet reported for duty, leaving all the 16 posts vacant.
Among the 16 specialist posts, three of the six posts in General Medicine, two of the four posts in Pulmonology, one of the four posts in Anaesthesia, and both the posts in Paediatric are lying vacant. The hospital is now run by eight specialist doctors with no assistant surgeons.
Also, the six posts for casualty medical officers, one post of a resident medical officer, and one post of the superintendent are lying vacant.
No trained nurses
The bigger crisis unfolding in the district is the acute shortage of trained nurses to handle patients in ICU beds.
Officials said 118 posts of nurses are lying vacant in the district. Of them, 69 vacancies are for grade I nurses, who have experience of eight to 10 years. Of the 69 vacancies, 31 are in Tata Trust COVID Hospital. "We do not have trained nurses to manage our ICU patients," said a doctor in the hospital.
One senior nurse is required to attend to two ICU patients, and outside the ICU, one nurse can take care of six patients.
District health officials said temporary recruitment to senior posts is not allowed and posts of grade I nurses could be filled only through promotion by the Directorate of Health Service.
"We are hiring entry-level nurses on a temporary basis as part of the COVID Brigade but the attrition rate is high among them because of the disparity in salary," said an official.
For the same job, a nurse hired as a COVID Brigade staff is paid Rs 17,000 per month but if they are hired on an ad hoc basis under the National Health Mission, they are paid Rs 30,000 per month.
Officials said if the government filled the grade I posts, they could hire more nurses on an ad hoc basis, doubling the nursing strength in the district. "We are moving on a war footing to increase patient intake in hospitals. The government should also fill the vacant posts soon," the official quoted above said.
As of now, Tata hospital has 120 beds and nine ICU beds. In one week, officials said, the hospital will have 200 oxygenated beds and 100 normal beds, and 40 ICU units.
192 posts created in MH, half of them only for the record
The LDF government created 192 posts for the medical college with a rider that only 50% of the created posts should be filled. "It is time to lift the restrictions," said a top official in the district.
As of now, it has 161 beds and 40 nurses. "The 40 nurses are split into two batches. One batch of 20 nurses works for 14 days while the second batch remains in quarantine. Once the beds are increased to 300, we will require more nurses and doctors to keep the hospital running," said a doctor.
Of the 300 beds, 200 will be oxygenated, he said. The hospital also has 12 ICU beds and nine 'step-down' ICU beds.
No DMO or chief consultant
The chief consultant (respiratory medicine), the most senior post in the District Hospital, is lying vacant since September 2015 when Dr Cyriac Antony P retired.
Two posts of senior medical consultants in general medicine and general surgery in the District Hospital are also lying vacant since January 2020.
To be sure, the post of District Medical Officer -- the head of the district health department -- is lying vacant since March 2020, when the incumbent Dr A P Dinesh Kumar left with a transfer.
Dr A V Ramdas is in-charge of the post now.