Gated communities gear up for the third wave

Should we invest in oxygen concentrators? Should we establish COVID care centres on our premises? RWAs in the FOMRRA fold debate such questions

June 12, 2021 11:10 am | Updated 11:52 am IST

New Delhi: Health workers wearing PPE kits arrange oxygen concentrators at Yamuna Sports Complex Covid care centre, in New Delhi, Wednesday, May 19, 2021. (PTI Photo/Kamal Kishore)(PTI05_19_2021_000155B)

New Delhi: Health workers wearing PPE kits arrange oxygen concentrators at Yamuna Sports Complex Covid care centre, in New Delhi, Wednesday, May 19, 2021. (PTI Photo/Kamal Kishore)(PTI05_19_2021_000155B)

Coronavirus variants come with the predictability of the roulette wheel. There is no telling what the virus would mutate into. Nor how disruptive the next dominant variant would be.

Thankfully, it is not blind man’s bluff either. There is reliable data to show what to expect of the virus. It is such data that gives the possibility of a third wave in India, the stamp of certainty. The Principal Scientific Advisor to the Government K Vijay Raghavan has in fact called the third wave “inevitable”.

So unsurprisingly enough, the talk is more around the preparation for it than the likelihood of it. Of course, there is speculation about its intensity. However, wanting to be found on the side of caution, a good number of gated communities are counting the investments they need to make to manage the wave effectively.

Early this week, the Federation of OMR Residents Association had an online discussion on just this subject, with three doctors — Dr. Saranya Narayan from Neuberg Diagnostics, Dr. Guganath Sivakadaksham from Siva’s Cardio Diabketic Care Clinic and Dr. Naveen Tummala from Swaram Hospital — sitting on the experts panel.

Worse case scenario

A couple of issues that came up were particularly pertinent to RWAs of gated communities. “Should residents’ welfare associations invest in oxygen concentrators?” asked Harsha Koda, a FOMRRA coordinator and the moderator of this discussion.

Dr. Guganath based his answer on the following premises about how the third wave would play out. “Given our vaccination status, it is predicted that it is going to be 1.8 times more intense than the second wave.” He cited the virus’ mutating ability and India’s population density as other important factors.

He came up with a battlecry — “Expect the worst and be prepared”.

“For every 100 people testing positive, ten will require hospital admission,” began Guganath, adding that RWAs could play a role in ensuring that a hospital bed is not occupied by someone who needs it the least.

“So, if you are living in a big apartment space, convert your general areas — such as the activity spaces — into quarantine centres. So, it should be equipped to quarantine at least 10 for every 100. In other words, for every 100 people, 10 beds. It can act as a buffer. You have to have a tie-up with hospitals in your region. You should have a doctor visiting and attending to the COVID-positive on a daily basis, and assessing their symptoms, blood samples and other test results, and looking into the progression of the disease. This way, anyone testing positive and immediately going and occupying a hospital bed can be avoided. That is the number one benefit,” he says adding that after monitoring those needing hospitalisation can be identified, and they alone can be sent to the hospital.

It may be pertinent to recall how the model of gated communities running COVID care centres on their premises with guidelines and support from Bengaluru Mahanagara Palike, was tried out in that city, during this wave. How successful these attempts proved to be are a moot point though.

Breathe easy

The next issue that came up during the FOMRRA discussion was about whether RWAs should invest in oxygen concentrators?

“Out of the ten requiring hospitalisation, two or three would require oxygen support. Five-litre oxygen concentrator would do, but a 10-litre concentrator would be ideal. So, two 10-litre concentrators for every 100 individuals. This is purely based on the predictions. Predictions can turn out right or wrong. If the third wave is going to be 1.8 times more severe than the second, it is going to be definitely necessary to invest in good concentrators,” remarked Guganath, adding that necessary oxygen support can be extended to those who need it till they get a hospital bed.

“Going for cylinders is not logical because they have to be refilled,” he added.

Dr. Naveen painted a picture of how the demand for oxygen cylinders can shoot up in the event of a wave being severe.

“Earlier, in the operations that we used to run, we would need 8 to 10 cylinders in a month. But once this Covid thing started we required about 18 to 20 cylinders a day. The requirement had shot up 60 times” — Dr. Naveen on the experience of running the COVID-19 treatment at his hospital in the second wave.

Harsha called attention to practical problems that go with making a huge investment in oxygen concentrators, particularly those that come with 10-litre capacity and a bigger price tag.

He pointed out that an STP, WTP or a generator was a straightforward investment. Their longevity and RoI were assured. Once put in place, “we do not have to think about replacing them for the next 30 years.” Oxygen concentrators were an altogether different kettle of fish.

Eye on the future

First of all, there is the question of whether oxygen concentrators should take up storage space at an gated community. Consideration two: How much of shelf life do they come with? And three, how long would they be required?

Dr. Guganath pointed out that being “an influenza-type of virus”, the Coronavirus would lingering around, those its virulence would likely diminish with time, though at a rate that cannot be predicted at this point of time.

“There will be a percentage of people who would be affected by this Coronavirus. I cannot predict for a decade. The warranty period for any oxygen concentrator is two to three years — until that time, there will definitely be a requirement for them.”

Earlier, as part of her opening remarks, Dr. Saranya had also given a two-to-three year time frame in which the Coronavirus will continue to be a strikingly noticeable problem affecting our social life and behaviours.

She emphasised that people had to be prepared for a life of “PMS” — Physical distancing, Masking and (hand) Sanitising — for the next two to three years. “These waves are going to happen. Already, the United Kingdom is having its third wave. It is just a matter of time before we are going to have it here. We have to act very proactively with the government, NGOs and corporates to ensure this does nor get out of hand again,” she cautioned.

Harsha sought to know the nitty-gritty of using and maintaining the oxygen concentrators, particularly on how they could be shared in a safe manner. Said Dr. Guganath: “The tube that runs from the machine to the mask has to be changed before it is used by a new patient. Getting a new oxygen mask and the tube would be fine. You can put the oxygen concentrator on an AMC with whichever company you have bought it from.”

Post-discussion, feeling the pulse of leaders at RWAs on Old Mahabalipuram Road, communities are working out how to give themselves the benefit and peace of mind that comes from having an oxygen concentrator or two parked in their utilities room.

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