The state of Goa, on Wednesday, saw the highest single-day spike so far with 3,101 fresh infections reported. The number of active cases rose to a staggering 18,828, putting an immense load on the state’s already crumbling healthcare infrastructure. With 24 deaths, the state’s toll rose to 1,111.
Of the 24 deaths reported on Wednesday, 12 died at the South Goa district hospital, eleven at GMC, and one at a private hospital in South Goa. A 35-year-old woman from Aquem was the youngest among the deceased. She was obese and tested positive a day before she was taken to South Goa district hospital on Tuesday, and diagnosed with acute respiratory distress syndrome (ARDS). Margao’s active tally surged past the 1,800-mark, while Candolim’s was 1,436 and Porvorim’s 1,291. The state’s recovery rate dropped to 76%, and 839 people were cured in the past 24 hours.
The state’s fledgling healthcare infrastructure is on the verge of collapse as the healthcare system is unable to deliver even the basics like accessible testing, results on time, and adequate monitoring of patients in home isolation. A deluge of patients far outnumbered the available beds at most of the state’s hospitals.
Goa Medical College (GMC) dean Dr. S M Bandekar said that the hospital sees 60-70 admissions a day, and that on Tuesday, over 50 patients were on trolleys as there were not enough beds.
“We shift them on beds as and when they become available, or transfer them to another hospital, depending on the case,” he said. In hospitals across the state, patients had to wait for hours whether for testing or any other service, as most establishments saw Covid-19 cases increase drastically over the past few days.
The state also witnessed a shortage of oxygen beds in government-run hospitals and a three-day backlog in releasing RT-PCR test results. Under severe stress, the government roped in the private sector to provide at least another 250 beds within a week and ordered the cancellation of all non-Covid elective surgeries for a month, barely a day after the chief minister assured residents that there was no “shortage of medical facilities and expertise”.
A reality check shows that while non-oxygen beds were available in Covid-care centers, oxygen beds in government-run establishments had run out. The Goa Medical College, which set aside 185 non-ICU (intensive care unit) beds for Covid care, was dealing with a patient load of 242. At the ICU, only five of the 20 beds were available as of Monday night.
In the interim, the private hospitals have been requested for additional beds since official records showed that several patients at the overstretched premier Goa Medical College and Hospital were left lying on stretchers. State health minister Vishwajit Rane said Goa’s private hospitals agreed to help when approached on Tuesday.
“The representatives (of private hospitals) have voluntarily decided to increase their bed capacity… by reserving 250 additional beds in their respective facilities. My sincere gratitude to them for this gesture,” Rane said on Tuesday.
With an average of 20 daily deaths and infections spreading across the state, health experts raise serious questions about the state’s preparedness in handling the pandemic. “People don’t get a report for five to seven days. So, we have cases rising and mortalities going up at an alarming level,” a government doctor said.
Hospital beds are full, and the waiting period at the casualty of the South Goa district hospital can go up to six hours. People who can’t afford to test at a private facility either visit a government hospital or wait till the nearest government primary health center opens. Health centers are closed for testing on Sundays. Only the flu OPD is open 24×7 which gets crowded with people without even masks or social distancing.
“We were not prepared for the second wave to hit in such a severe way. The virus is very virulent and has been progressing faster. The worry is healthcare workers collapsing, getting infected, and being morally down,” said senior pulmonologist and past IMA president Dr. Anil Mehndiratta.
Dr. Praveen Bhat, a senior pulmonologist and director of Horizon hospital, Margao, said the message must be “loud and clear” that people should get themselves tested at the earliest. “Patients with non-classic symptoms like backache or body pain or just feeling unwell delay getting tested. Having Covid-19 does not necessarily mean cough and fever,” Bhatt, who was part of the expert committee chaired by Dhawan, said.
Another expert said that “estimating a possible rise in cases during the next three weeks, the state should not only break the chain of infection but on a war-footing make oxygen beds available along with adequate manpower”.
GMC dean and in-charge of the state’s Covid hospitals, Dr. S M Bandekar, said that they’re aiming to open the super-specialty block with 500 beds for Covid patients on May 1. Bandekar said that they would “manage” the manpower shortage by posting doctors from other departments, while more nurses will be hired on a contract basis.
Meanwhile, the government has finalized a new standard operating procedure for Covid patients, after health secretary Ravi Dhawan had a meeting with health experts on Saturday, where it was decided that treatment of a patient who got tested will be started without his test result. But this new protocol is yet to come into force.
Pathologist Dr. Anan Jaiswal said that everyone took things casually after the first wave ended. “Only the mask will protect, and the government should have dealt with defaulters with an iron hand. Instead, the government was sending out mixed messages to people, trying to protect tourism,” he said.
“As I see it, things have spiraled out of control,” said Sunil Borkar from Usgao. He had been visiting his nephew at GMC’s pediatric ward and tested positive. “It is depressing to see the plight of people and the overworked doctors and other staff,” Borkar said that patients were pleading with doctors to save them. “Despite the presence of security, it is not easy to maintain social distancing at GMC,” he said.
“I saw a doctor asking a patient’s relatives to leave the premises immediately lest they also be infected.” He said. “I would tell them the same, even if my brother came here. Please leave, the doctor told them,” he said. “Visit the hospital pharmacies and you will see how people crowd without bothering to maintain social distance,” he added. “The same scenario is seen in canteens. People behave very irresponsibly.”
Although hospital authorities made it clear that not more than one patient attendant would be allowed, inevitably, many of the patient’s relatives and well-wishers visit the hospital, leading to difficulties in maintaining social distancing.
However, chief minister Pramod Sawant sought to explain the surge as a mere “clearance of backlog”. “The increased number of Covid-positive cases is due to the clearance of backlog, and the same is expected to continue for the next two days,” he said.
Goa Pradesh Congress Committee president Girish Chodankar said that the COVID-19 situation in the state is worsening day by day and hospitals are working beyond their capacity. “COVID situation in Goa is worsening day by day. All hospitals are working beyond their capacity. Patients are put on floors, stretchers, and chairs as there are no beds available. What is next? Is Goa Chief Minister Dr. Pramod Sawant preparing for pyres and graves now?”, questioned Chodankar.
“The entire system has collapsed. The Health Minister and Chief Minister are busy scoring political brownie points on each other. People are suffering. Government is clueless and has no plan of action in place. How will COVID infected patients survive, if there is no treatment facility available? The only option left to them is to die as the insensitive BJP government failed to create adequate medical facilities last year despite knowing that the second wave of COVID may hit anytime”, he added.
CM Sawant’s handling of the Covid-19 resurgence has been criticized, especially his persistent refusal to screen tourists. Sawant claims screening will affect tourist arrivals—bad news for a state-dependent on tourism for economic survival. His government has also not heeded to constant demands to impose lockdown or seal the borders to curb the spread of the virus.