How Seven Hills Heroes are fighting COVID-19 in Mumbai

By Dr. Aarthi Kannan

MCGM and Reliance Foundation Hospital have joined hands in transforming Seven Hills Hospitals into the largest COVID-19 hospital in Mumbai. Dr. Aarthi Kannan in an interview with the officials.

Several factors complicate the outcomes of COVID-19— population density, level of public adherence to social distancing, lockdown measures and hand hygiene, pre-existing health preparedness in a system for a pandemic are only some of them to name. Availability of manpower and infrastructure to care for patients is a significant global challenge that influences this pandemic. As healthcare workers courageously step forward to care for COVID-19 patients, we are increasingly seeing that the highly contagious and infectious nature of the virus leads to a temporary and sometimes a permanent loss in available healthcare workers due to the risk they carry of being infected by their patients. Yet, healthcare is seen as an indispensible resource committed to its ethics and dedication in providing continued care to all patients, COVID and non-COVID, especially in time-sensitive and emergent cases even in the middle of this pandemic. Battling several catch-22 situations, hospitals are emerging with new strengths and developments every day to ensure care towards their COVID-19 struck population. One such hospital is Seven Hills Hospital, Mumbai.

Picture courtesy: Dr. Ramaswami, MCGM

The hospital has emerged as an important COVID-19 hospital in the last few weeks, while carrying the potential to rapidly upscale to 1500 COVID-19 beds with requisite infrastructure, which makes it the only current hospital with this capacity to care for COVID-19 patients in Mumbai. COVID-19 beds managed by MCGM, beds run by the Reliance Foundation, and some beds whose staffing is co-managed by MCGM and Reliance. From MCGM and Reliance maintaining free-of-cost care for COVID-19 patients at Seven Hills, to having an excellent nurse to patient ratio of 1:1 in the ICU and 1:6 in the ward in the Reliance-Foundation managed beds, Dr. Ramaswami and Dr. Tarang Gianchandani discuss the importance of negative pressure isolation in COVID-19, supporting their healthcare workers and some universal challenges that hospitals like Seven Hills currently face.

Picture courtesy : Hospital spokesperson, RFH

How MCGM manages the COVID-19 Facility

Dr. Ramaswami, IAS, Former Assistant Municipal Commissioner, Navi Mumbai, oversees the MCGM-run COVID-19 beds at Seven Hills. He says, “I have been handling the preparation of Seven Hills hospital from the MCGM side for COVID-19 since the last twenty-two days. This is a major hospital earmarked for COVID-19 in Mumbai. So far, we are handling 422 COVID-19 patients on MCGM side. We currently have the potential to manage 800 beds, which includes 10 Intensive Care Unit (ICU) beds managed by MCGM. I anticipate an additional 300 beds to open up by the end of this month, with another 32 ICU beds will soon be allocated here to MCGM. We can scale up to accommodate 1500 patients. Dialysis is a major issue that we need to handle in COVID-19, for which we procured dialysis machines and will scale up as needed. PPEs and medicines are adequate. This hospital is equipped with negative pressure isolation for COVID-19 patients, which is a necessity during a contagious respiratory pandemic, in order to reduce risk of transmission to others. As far as Seven Hills is concerned, all the staff present here are well-trained and receive a comprehensive coaching on management of COVID-19 patients and personal protection. I am overseeing their training with a committee formed by deans of all four Brihanmumbai Mahanagar Corporation (BMC) hospitals. Hands-on training for handling ventilators is also being given, as it is necessary. I ensured a tie up with Thyrocare laboratories to support the requisite lab test work for our patients and we have what we need.”

Support from Reliance Foundation Hospital

Reliance Foundation Hospital manages a significant number of beds at Seven Hills hospital. Dr. Tarang Gianchandani, CEO, Sir HN Reliance Foundation Hospital, says, “In a two-week span, RIL and RFH came up with 107 beds at Seven Hills Hospital. This includes 40 ICU beds and 67 isolation beds all of which are with negative pressure and HEPA filtration units. 66 of these 107 beds have been operationalized by the time of this interview and the remaining beds are ready for operations. Some of our beds are co-managed with MCGM. Negative-pressure isolation rooms with HEPA filters developed to treat COVID-19 positive patients are essential in preventing cross-contamination and help in infection control. All beds are equipped with the required infrastructure, bio-medical equipment such as ventilators, pacemakers, dialysis machines and patient monitoring devices. At the moment, 222 beds are built and we will ramp up to 250 beds.

Limited information on the virus with research still evolving posed as challenges in creating a plan of action. We rolled out infection control protocols and communication campaigns to ensure curbing the spread of COVID-19. Our Medical Task force has developed clinical treatment guidelines based on national and international evidence-based guidelines in order to manage COVID-19. Our teams have been working round-the-clock to procure ventilators, beds, medical equipment and devices, amidst the restrictions that the pandemic and lockdown have created. Reliance India Limited is enhancing its production capacities to produce 100,000 face-masks per day and a large number of personal protective equipment to continue to safeguard the nation’s healthcare workers.”

Obtaining manpower : The global challenge of the hour

Dr. Ramaswami and Dr. Gianchandani strongly concur that obtaining manpower is a major challenge especially with rapidly ramping up number of beds. Despite the COVID-19 challenge the world is up against, RFH strives to maintain a nurse to patient ratio of 1:1 in ICU (a ratio amongst the best in the world) and 1:6 in the ward for its allocated Seven Hills COVID-19 beds.

“We are conducting interviews to add more intensive care specialists and physicians as we scale up beds. 600 nurses have been given appointment and 150 of them have already started work. The initial shortage of ward boys and attendants are being overcome by inviting personnel from various outsourcing agencies to join and incentivizing employees with a pay that is well above their usual pay grade.” – Dr. Ramaswami

RFH : Going above and beyond for its Seven Hills healthcare staff

Dr. Gianchandani notes that uncertain times are always typically characterized by confusion and fear for one’s own well-being and that of family. RFH has gone above and beyond to increase safety and comfort with measures such as providing their Seven Hills healthcare staff with accommodation; safe travel solutions to mobilize the entire workforce across an our city under lockdown, complimentary meals and groceries, best available personal protective equipment for their emergency room healthcare staff and all other staff working with the COVID-19 confirmed and suspected cases at Seven Hills.

“So far our patients have responded very well to our protocols and the outcomes are very motivating.” – Dr. Gianchandani, RFH

“Personally, I am sure people that people are getting proper treatment and proper services at Seven Hills.” – Dr. Ramaswami