Doctor In India: Emergency Room Is So Crowded 'It's Nearly Impossible To Walk'
Dr. Sumit Ray, critical care chief at a New Delhi hospital, is on the front lines of India's growing COVID-19 crisis. "As a system in different parts of the country, we have collapsed," he says.
Updated May 6, 2021 at 10:20 AM ET
India has been setting daily records for positive coronavirus tests — more than 400,000 people on Wednesday alone.
In New Delhi, the Holy Family Hospital is at 140% capacity.
"It's nearly impossible to walk sometimes in the [emergency room]," said Dr. Sumit Ray, the hospital's critical care chief. "Sometimes we have to keep the patient in the ER for hours, for a day or two, because we don't have a bed in the wards or in the [intensive care unit]."
"Many of the public areas, some corridors, etc., have been cordoned off right next to my office behind a wall," he said in an interview with NPR's Morning Edition. "There is about 30 patients in a common area, which used to be the outpatient department. We have used those rooms also and put beds there, monitors there, oxygen cylinders there."
"Individual hospitals are standing up and doing the best they could. But as a system in different parts of the country, we have collapsed," he said.
Below are highlights of the interview, edited for length and clarity.
On his hospital's shortage of ventilators and ICU beds
Our staff is stretched. They're working more hours, working harder, longer. ... We need more ventilators because as the timeline of COVID is such that once the peak of number of cases happens about two to three weeks down the line, a certain percentage of those patients become sicker and end up in the ICU. And that's what exactly we are seeing now. And the number of deaths are increasing now. And what we are now having a problem with is that we have many patients who need ICU beds, but we do not have ICU beds for them. So we are managing them in high-dependency units, on wards, etc. Obviously, the quality of care is not the same because the level of monitoring, etc., cannot be managed as it is needed in the ICU.
So these are the problems which we face now. We kind of predicted this a few weeks back because we know the timeline, how COVID behaves. And we had tried to tell the government that there has to be a surge capacity building so that patients who will need this may have to be shifted. And that cannot be organized by an individual hospital. It has to be built by the government. It's starting to happen, but it's not come through yet.
On how hospital staff are worried about COVID's impact on their own families even as they treat patients
While taking care of patients in the hospital, we are talking to family, messaging them what to do at home when they're down with COVID. And if they worsen, then where do they need to go? So actually, the situation has reached such a point that many of our staff are scared that even if their loved one becomes seriously ill with COVID, will they find a bed in our own hospital or any other hospital for that matter?
On how India misjudged the pandemic and what led to vaccine hesitancy
We celebrated too early, too much chest-thumping, saying that we had vanquished the virus. I think all of us underestimated the virus. But how we were proved wrong, we are paying for it. ... There was a vaccine hesitancy, the reasons being that there was some degree of data intransparency, if I may say, about the vaccines that were being used in India ... . So the hesitancy was partly expected, could have been done better in terms of giving more transparent data.
On the ER being far over capacity
Our ER is beyond [capacity]. It had 30 beds and we have at any point of time about 100-odd patients and there are patients sitting in chairs who are being given oxygen because we are not refusing. It's nearly impossible to walk sometimes in the ER. ... sometimes we have to keep the patient in the ER for hours, for a day or two, because we don't have a bed in the wards or in the ICU.
On the collapse of India's health care system
We have collapsed in a sense. I mean, individual hospitals are standing up and doing the best they could. But as a system in different parts of the country, we have collapsed. I mean, what would you say if people start dying in ambulances because they can't get in a hospital bed, if people die at home, if people die in the ER because there is no bed in the wards or in the ICU. So that is a collapse of the system. There's so many more deaths that could have been prevented.
Ziad Buchh, Lisa Weiner and Scott Saloway produced and edited the audio version of this story. Avie Schneider produced for the web. contributed to this story
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