Isolation facility at Kasturba Hospital too weak to handle tough cases, say doctors

Kasturba Hospital in Mumbai has quarantined eight patients.   | Photo Credit: Emmanual Yogini

A negative pressure room with frequent air conditioning cycle changes, high-efficiency particulate air (HEPA) filters, ultraviolet (UV) lights and an anteroom between the patient’s area and general corridor are some of the basic requirements for a good isolation facility dealing with patients who have contagious infections. But Mumbai’s only government-run isolation facility at the Kasturba Hospital, Chinchpokli, dedicated for infectious diseases, has none of these. With the ongoing deadly outbreak caused by a novel strain of Coronavirus (nCoV) in China, Kasturba Hospital has quarantined eight patients who are feared to have had an exposure to the virus. However, the hospital’s infection control capacity has now become a subject of debate.

Ward number 30 in the hospital has six glass cabins and four side rooms for isolating patients. The ward is equipped with four ventilators and an equal number of multi-para monitors. Officials also said there are adequate stocks of personal protective equipment, N95 masks, medicines and trained doctors and nurses. However, a team from the Centre that visited the facility recently pointed out many problems such as merely one metre between two cots, requirement of capacity building, training of staff and so on.

“A negative pressure room is a must in an isolation facility, and besides HEPA filters and UV lights, walls and floors have to constantly remain dry. This entire system is called an Air Handling Unit, in the absence of which it cannot be termed an isolation facility,” said a senior doctor.

The concerns about the quality of infection control were also raised by patients who have been quarantined for suspected nCoV over the past few days and their relatives. “They insisted that this was the only isolation facility where we could admit the patient. He hardly had any symptoms but we were more concerned that he would get some infection while at the hospital,” said a colleague of a 65-year-old UK citizen who was discharged on Thursday after two consecutive samples tested negative. Some quarantined patients and their relatives have pleaded with the hospital authorities to let them go, others have even quarrelled.

Built in the pre-independence era, Kasturba Hospital was among the few infectious diseases hospitals located in the midst of green areas, where a person with a contagious infection could recover as well as limit the spread of infection. However, over the years, isolated areas such as these have became part of the city centre. “The problem is with our policymakers. These hospitals come into the limelight during an outbreak and remain neglected otherwise. Why can’t these facilities be upgraded and maintained to be ready to face an outbreak?” said another doctor.

A 2003 editorial published in the Indian Journal of Medical Ethics said under normal circumstances the State shows very little interest in its infectious disease institutions. “For example, in Mumbai, the municipal corporation-run Kasturba Infectious Disease Hospital has been a victim of neglect for many years. It is ironical that the same system, which completely ignores the health needs of the common man, was remarkably energetic and efficient when dealing with Severe Acute Respiratory Syndrome, as it literally hounded every case with even the slightest suspicion of infection,” it said.

Additional Municipal Commissioner Suresh Kakani said it would be wrong to say that the isolation facility is not up to the mark. “There are two schools of thought when it comes to isolation facilities. One believes that central air-conditioning and closed premises may circulate the infection while the other believes in properly ventilated rooms at the facility located in an isolated area,” he said.

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Printable version | Oct 25, 2021 1:52:15 PM |

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