April 21, 2020
The Question: COVID-19 was declared as a global pandemic by the World Health Organization on 11th March 2020. While all countries are working hard to cope with the sharp rise in infections, the existing healthcare capacity even in developed countries appears to be falling short of the real need. India, home to over 1.3 billion people, has a fragmented health care system with an inadequate public health infrastructure and a large and growing private sector. The availability of data on inpatient care and critical care capacity in India is limited, creating uncertainty surrounding whether the country can accommodate mass hospitalization at the peak of the Covid-19 pandemic.
Researchers at CDDEP India and Princeton University estimated the current number of hospital beds, intensive care unit (ICU) beds and ventilators across 37 states of India.
What We Found: In this report, CDDEP researchers have estimated the existing number of hospital beds, Intensive Care Unit (ICU) beds, and ventilators nationally and in 37 states of India. The analysis used data and parameters from published sources. Data for the public sector were obtained from the 2019 National Health Profile (NHP) which estimated that public health facilities had about 7 lac hospital beds. No such data could be found for the private sector. However, the percentage break-up of public and private health facilities was obtained from the National Statistical Office (NSO) 75th Round Report. Based on this information, the research team estimated the number of private health facilities and the number of hospital beds in the private sector.
“Since a large proportion of the healthcare capacity lies in the private sector, public-private partnership is a critical component of the response to COVID 19 in India. There is a need to develop public-private partnership preparedness plans at the district level to rapidly develop the surge bed capacity” said Dr Jyoti Joshi, Head-South Asia for CDDEP.
It is expected that elderly COVID-19 patients and those with other predisposing factors such as weakened immune systems and co-morbidities might be more severely affected than others. Such patients may warrant admission to ICUs and may require supportive ventilation. As health is a matter of the state and not the national government, data on the existing number of ICU beds in India is not available centrally. It is estimated that critical care beds constitute 5-8% of total hospital beds at large medical facilities in India. The research team conservatively assumed that number of ICU beds would be around 5% of hospital bed count in both public and private sector hospitals. In addition, it was also assumed that 50% of ICU beds would be equipped with ventilators.
Using this methodology, the researchers estimated that India has approximately 1.9 million hospital beds, 95 thousand ICU beds, and 48 thousand ventilators. Most of the beds and ventilators in India are concentrated in seven states – Uttar Pradesh (14.8%), Karnataka (13.8%), Maharashtra (12.2%), Tamil Nadu (8.1%), West Bengal (5.9%), Telangana (5.2%) and Kerala (5.2%).
Why It Matters: While Indian states have a varied capacity in terms of bed and ventilator counts, all have a common priority at present, and are working towards infrastructure strengthening and expansion, in order to efficiently contain the pandemic. As on 7th April 2020, the COVID-19 case count in India is nearing 4700, and is steadily on the rise.
“While we should hope for the best, we must be prepared for the worst. The current lockdown in India is a brief opportunity for health planners to accelerate action and ensure that the world’s largest democracy is well-equipped to contain the COVID-19 pandemic”, said Dr Geetanjali Kapoor, CDDEP Research Fellow.
The study titled, “COVID-19 in India: State-wise estimates of current hospital beds, intensive care unit (ICU) beds and ventilators” by Geetanjali Kapoor, Aditi Sriram, Jyoti Joshi, Arindam Nandi, and Ramanan Laxminarayan is available here.