Staff shortage, mismanagement rattles Karnataka hospitals amid rising COVID cases

Even as the Karnataka government grapples with shortage of hospital beds amid rising COVID-19 cases, manpower shortage in both government and private hospitals has become another grave concern.

Several hospitals across the state were short-staffed with frontline workers — doctors, nurses, paramedics, and housekeeping staff — testing positive for COVID-19. Besides, the lack of additional benefits for private healthcare professionals to work in COVID-care centres made them stay away from work and avoid risk of infection.

On Friday (July 17) night, when Medical Education Minister K Sudhakar made a surprise visit to K C General Hospital in the city, one of the nurses complained that there were only two nurses to handle 112 patients.

“For every 10 patients, there should be a nurse. We are handling 112 patients. Besides, three of the five physicians are COVID positive. How can we manage?” the nurse asked the Minister.

Private Hospitals and Nursing Homes Association (PHANA) earlier this week noted that nearly 30 per cent of doctors and 50 per cent nurses and a few ward boys had either quit or stayed away from work over the past few months fearing infection.

Meanwhile, the Karnataka Medical Council estimated that hospitals across the state faced a 40-50 per cent shortage of healthcare workers.

“There is a fear factor among healthcare workers. First the government should boost confidence by announcing additional perks to these healthcare workers. The private hospitals cannot do that as they are constrained with dwindling profits in the wake of COVID crisis,” Dr Prasanna H M, President-elect at PHANA said.

“Also, the government needs to set up or set aside a dedicated hospital for treatment of healthcare staff,” he added.

The private hospital body said nearly 25 hospitals shut shop since the pandemic kicked in and that about 58 hospitals shut over the past year due to financial constraints and lack of medical resources.

Prasanna added that multiple requests to the government to allocate homeopathic and ayurvedic doctors for COVID care and requests for permission to use final-year nursing, MBBS, and pharmacy students to assist during the crisis times, have fallen to deaf ears.

Their demand comes amid the government saying strict action will be initiated against private hospitals denying admission to government-referred COVID-19 patients.

Another Bangalore doctor from the Apollo Hospital who did not wish to be named, said the government should initiate action against those resigning in these critical times. “Also, the Nursing Council of India should send strict warning to their members who quit jobs in the midst of a pandemic,” the doctor said.

He also opined that the government should offer the same benefit as government doctors to private hospital doctors assigned on COVID duty. “Except for the ₹50 lakh medical insurance, there is no additional benefit. Let them give some honorarium and transfer it directly to the staff accounts. That will boost their morale,” the doctor said.

In a hospital on the outskirts of Bangalore, the doctor at a mid-size private hospital (with less than 30 beds) said nearly 50 of around 60 staff quit over the past four months. The doctor said many of his nurses hailing from other states like Tamil Nadu and Kerala moved to their respective places since they believed those states fared better in COVID care.

“One of my partners tested positive and some of our staff are under home quarantine. Some quit fearing infection and some are not able to return due to logistical issues. Also, the ward-workers are stigmatised in their respective villages. So it’s a complete mess,” Dr Nagaraj of Srinivasa Hospital, Hoskote said.

Furthermore, the lack of proper healthcare facilities in hospitals and substandard PPE kits were other reasons behind healthcare workers staying away from work. “Though I have been running a fever clinic since the start, I had demanded the government to provide me with an enclosed cabin-type kiosk for testing. It’s been a month and my request is still pending,” Dr Nagaraj said.

Over the past couple of weeks, several healthcare workers took to streets demanding pay hikes. About 42,000 ASHA (accredited social health activist) workers went on a protest last week and demanded the honorarium be increased from ₹6,000 to ₹12,000. About 2,000 Ayush (Ayurvedic, Unani and Sidda) doctors too threatened to resign enmasse if the government did not raise their salaries to ₹60,000 from the current levels of ₹20,000-₹25,000.

The government, which hiked salaries for contractual MBBS doctors by ₹15,000, assured them that they would take up their demand to make them permanent employees in the next Assembly session. “With 2,000 doctors post being vacant, we assure to fill 600 posts by promoting these contractual doctors to permanent jobs after observing their performance. We will hire the rest of the 1,400 through direct recruitment,” Health Minister Sriramulu had said.

However, the government remained silent on hiking the salaries of ASHA workers and Ayush doctors.

With community transmission underway in several locations, COVID cases doubled at a faster pace, which in turn led to shortage of staff, resulting in a severe impact on COVID treatment in the state. In 15 of the 30 districts, cases doubled in less than 10 days, while the national average was about 20 days.

The state average positivity rate (number of people testing positive among those tested) remained at 15 per cent, but was high in places like Dharward, Bangalore, and Dakshina Kannada districts. In Dharwad district, one in three tests turned positive for COVID-19, while it was about one in four in Bangalore urban and Dakshina Kannada.

In Bangalore, nearly 45 percent of the cases are symptomatic, and for almost half the cases in the state, the transmission cause has not been identified yet.

While the total number of COVID cases stood at 55,115 on July 17, the total active cases in the state were 33,205, of which 20,623 (60 per cent) were in Bangalore. With 1,147 people succumbing to the disease, half of them in Bangalore, the crisis turned worse in the city.

Amid all of this, the state government transferred the city’s civic body (BBMP) commissioner Anil Kumar and replaced him with Manjunath Prasad, who was the Principal Secretary of Revenue Department.

Apparently, Kumar, going against Chief Minister B S Yediyurappa’s stand that the lockdown will (should) not be extended, said the lockdown in Bengaluru should be enforced for at least 15 days.