Elective surgeries in hospitals may again take a hit amidst the Omicron-driven third wave of COVID-19 with government’s focus shifting more towards COVID care. In a bid to avoid a repeat episode of the perilous second wave in April-May 2021, central government has asked states to restrict elective surgeries to keep manpower dedicated for COVID care as the hospitalisation has reached 5-10 per cent of the active coronavirus cases.
Union Health Secretary Rajesh Bhushan in a letter written to the states noted that a rise in COVID-19 cases, accompanied by an increase in positivity rate, is being witnessed in various parts of the country. This rise, it appears, is being driven by the new variant of concern -- Omicron -- along with the continued presence of another variant, Delta, in large geographies across India. In this context, augmenting human resources, particularly healthcare workers, for COVID management assumes critical importance, Bhushan said.
The government noted that during the second surge of COVID cases in the country, it was seen that the percentage of active cases that needed hospitalised care were in the range of 20-23 per cent.
“In the present surge, 5-10 per cent of active cases have needed hospitalisation so far. The situation is dynamic and evolving, therefore, the need for hospitalisation may also change rapidly,” said the health secretary.
“While various States/UTs have initiated steps for establishment of jumbo health facilities, field hospitals, temporary hospitals, etc., it must be appreciated that both infrastructure and human resources have their limitations. Therefore, it is important to conserve healthcare workers by initiating staggering wherever possible and by restricting elective procedures in the hospitals,” Bhushan argued in the letter.
All States/UTs are advised to keep a daily watch on the situation of total number of active cases, cases under home isolation, number of hospitalised cases, cases on oxygen beds, ICU beds and on ventilatory support. Based on this monitoring, requirement of healthcare workers and their availability, health facility wise, must also be reviewed on a daily basis as was done during the second surge, the health secretary said.
Private hospitals are also recording a dip in elective surgeries due to the rising Omicron threat.
“With a constant surge in numbers of COVID-19 patients across India, we have observed a significant drop in number of patients opting for elective surgeries at our facilities. This is similar to the trends observed in past two waves of the pandemic. This is an obvious trend that will increase in the few weeks with progression in COVID-19 numbers. It will help hospitals to divert more manpower in care of COVID patients as and when admissions increase,” Dr Sandeep Budhiraja, group medical director, Max Healthcare told Business Today.
The elective surgery segment in the hospitals was rising until November 2021. According to Bhudhiraja, patients were coming for elective work in orthopedics, spine surgeries and cardiology until November. An increase in day care specialties like ophthalmology and paediatric surgeries also saw an increase before Omicron.
According to Gautam Khanna, CEO, P. D. Hinduja Hospital, surgeries form a major source of hospital revenues and hence hospitals revenues were hit hard due to reduced surgeries, reduced patient inflow, the additional cost of building the infrastructure for COVID treatment and protocols and increase manpower costs.
“We saw a 50 per cent jump in non-COVID bed occupancy in the first seven months of 2021 when compared to the non-COVID bed occupancy in 2020-2021. However, we continue to maintain our COVID bed capacity as before, due to government regulation, even though our COVID beds occupancy is 10-15 per cent. If we look at the percentage increase in surgeries performed in the first seven months of 2021-22, we are sure that by the end of March 2022, our hospital should be able to achieve or even exceed the pre-COVID levels,” said Khanna.
Khanna maintained that during the lockdown months, April to Aug 2020, average surgeries per month dipped to 20 per cent of pre-COVID levels.
“It started increasing from September and for FY 20-21, we were at 45 per cent of pre-COVID levels. In the last four months of this FY, we have reached an average of 80 per cent of pre-COVID levels,” he said.
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