NEW DELHI — As the omicron variant blazed through the Indian capital this week, Naresh Gautam’s intensive care ward, inside one of India’s largest public hospitals, went from half empty Monday afternoon to almost full by Tuesday morning.
Eight months after a delta surge ravaged India, a shortage of medical staff is posing a looming problem as authorities seek to avoid a repeat of last spring, when the health-care system buckled, leading to hundreds of thousands of deaths. While health-care workers and government officials say they have learned lessons and have prepared far more hospital beds and oxygen tanks ahead of the current wave, hospitals are facing a pinch in personnel as authorities in several cities begin a soft lockdown to slow transmission rates.
On Tuesday, New Delhi ordered private-sector offices and restaurants to close as India reported nearly 170,000 new cases. Other cities, including the financial hub Mumbai, are enforcing curfews and also keeping schools closed.
At Safdarjung Hospital in the heart of Delhi, Gautam said front-line workers treating covid-19 are having to work shifts of up to 16 hours as their colleagues test positive or stay at home with the onset of symptoms. Gautam’s hospital is converting more ICUs dedicated to covid patients — and possibly even its 100-bed overflow facility built last year on campus, though he doesn’t expect a shortage of beds.
“A lack of doctors, that’s what’s causing a real crisis,” said Gautam, an anesthesiologist.
While many countries, including the United States, have reported staffing difficulties, India’s problem has been exacerbated by a dispute between trainee doctors and the government, which has delayed roughly 45,000 recent medical graduates from joining the workforce.
The incoming batch of residents will register for placement at hospitals this week, government officials said Sunday after a Supreme Court ruling settled a conflict over quotas. But hospitals across India won’t receive their incoming residents until mid-February, said Anuj Aggarwal, a Delhi-based radiologist who serves as secretary of a national union representing medical residents.
“It’s better than never, but it’s already too late,” said Aggarwal, who estimated that about a third of residents at Delhi hospitals are home sick.
In a memo Monday, Rajesh Bhushan, the Indian health secretary, ordered hospitals to “conserve” their staffs and summon retired health-care workers and students to assist in phone consultations. Many hospitals have already cut elective procedures to funnel staff to covid wards, according to media reports. This week, India began administering vaccine boosters to health-care workers and people over age 60 with comorbidities.
Despite omicron’s rapid spread, Indian officials say they are not worried yet about hospitals overflowing. While some of the country’s top urban hospitals are seeing a spike of patients, many are not: Officials in Delhi and Mumbai are touting an abundance of empty beds this week. Other jurisdictions have reported that they have makeshift clinics ready to be opened in case demand soars.
A team of Indian modeling experts at the Indian Institute of Technology in Kanpur, which advises the government, has projected that cases will continue to grow and peak at the end of January — and exceed the record numbers set in India during the second wave.
K. Srinath Reddy, president of the Public Health Foundation of India, said the government should have paused all political, social and religious events until April. Omicron, like a “fast-racing car,” was likely to spread from major cities to small towns and the countryside, he said.
“I’m concerned that as a society we aren’t taking note and protecting ourselves with appropriate behavior,” Reddy said. “We’re giving an opportunity to the virus to spread very fast.”
According to India’s genome-sequencing body, data from December showed that the delta variant of the coronavirus was responsible for 39 percent of infections. Now, many experts believe the current wave is being powered by the omicron variant, even if delta remains in play.
The rapid rate of cases doubling and the phenomenon of the virus infecting vaccinated people or those who had covid in the past suggest omicron is now the dominant variant in India, said Shashank Joshi, a member of the coronavirus task force for Maharashtra state, which includes Mumbai.
Joshi said the country was “not past” the point at which the situation was worrying, but he remained “cautiously optimistic” that omicron will not send an overwhelming flood of patients to hospitals in the coming weeks. The government’s preparedness plan should have a clear communication strategy, a home isolation policy so that hospitals and workers are not too stretched, and measures to focus treatment on high-risk, vulnerable patients, he said.
Still, one major reason for concern has been data showing a high proportion of tests returning positive in major cities, including Kolkata, where the rate is nearly 40 percent. That suggests infections are more prevalent than what test results show and could still rise sharply, experts warn.
The positivity rate in the next 10 days will be a key signal to “how the infrastructure will take the pressure,” said Shiv Kumar Sarin, the vice chancellor of Delhi’s Institute of Liver and Biliary Sciences.
Many hospitals have already begun to enact contingency plans. At the All India Institute of Medical Science in Delhi, Savrankar Datta, a radiologist, said the institute’s directors announced a plan two weeks ago to quickly vacate beds as cases rose. The hospital in recent days converted two buildings, the trauma and burn centers, to exclusively house covid patients as they began to stream in. Many departments, he added, have halted elective procedures and funneled staff to treat covid because doctors were falling ill, and it was not possible to continue normal operations.
“It’s wrong to say this is not going to be a challenge for the health-care system,” he said. “The sheer numbers will be so high that even a small percentage of hospitalizations is going to test limits.”
But at the very least, he said, “we’re not going to allow bed shortages to occur.”
Anant Gupta contributed to this report.