More on Covid-19

While several state governments have made dramatic announcements about taking over private hospitals to fight Covid-19 , it is clearly the public health system that is primarily tackling the epidemic, from identifying and tracking suspected cases to testing and treatment. What’s more, these services have been provided free to all without questions about insurance coverage or income certificates.Barring Madhya Pradesh, where private medical colleges and hospitals in Bhopal and Indore have more cases than government facilities, in most states that identified private hospitals to treat Covid-19 cases, barely a handful of patients have used them.In the last week of March, there was a spate of announcements, starting with the Bhilwara administration announcing the takeover of five private hospitals as the district reeled from a surge in Covid-19 cases. States announcing takeovers included Rajasthan, UP, Andhra Pradesh and Chhattisgarh.Others like Telangana, Bihar, Kerala, Tamil Nadu, West Bengal and Karnataka have depended almost entirely on government hospitals. The Tamil Nadu government identified 110 private hospitals where patients could seek treatment for Covid-19, but of the 1,173 cases so far, barely 20 have opted for the private sector.In Karnataka, out of 250 cases, just over 30 have been treated in the private sector.The record of private hospitals in dealing with Covid-19 has been patchy, with health workers getting infected and the hospitals themselves becoming hotspots. In Karnataka, two private hospitals, one in Davanagere and another in Bengaluru, had to be temporarily shut down after several among the staff were infected after treating a Covid patient. Similarly, in Mumbai, two private hospitals became hotspots after dozens of their health workers got infected.Within nine days of taking over Raipur Institute of Medical Sciences, a private hospital, the Chhattisgarh government had to roll back the decision due to insufficient infrastructure and medical facilities. Instead, the largest hospital in the state, Ambedkar Hospitals, became a dedicated Covid hospital to supplement AIIMS Raipur and district hospitals.Out of 2,300 plus cases in Maharashtra, more than 1,700 are in Mumbai. Of these about 400 are being treated in Seven Hills, a private hospital that had been shut down. The Bombay Municipal Corporation opened up the hospital and is paying for those treated in Seven Hills, but the ICU is managed by staff from HN Reliance Foundation Hospital. Pune, which along with Mumbai accounts for most cases in Maharashtra, also has the bulk of its patients in government hospitals.Madhya Pradesh is an exception with most patients in private hospitals. These include Chirayu Medical College hospital in Bhopal, and Index Medical College, Sri Aurobindo Institute of Medical Sciences, Bombay Hospital and Vishesh Hospital in Indore. The government has announced that it will pay for these patients, but details such as whether it will be payment per patient or monthly charges for the use of the whole facility have not been worked out.The UP government, too, has said it will rope in the private sector and is in talks with a few corporate hospitals. However, here too the terms have still not been worked out and all patients are being treated in government hospitals so far.Almost all states have identified private hospitals that might need to be requisitioned if the situation worsens and many have been advised to keep 10-25 beds for isolation facilities. However, so far, the weight of the fight against Covid-19 is almost entirely on public health facilities and staff.