A panel of government doctors is visiting hospitals and requesting authorities and doctors to shift Covid patients out of intensive care units when they show signs of improvement.

The move will help hospitals in admitting more critical patients to ICUs, the panel has said.

Hospitals in several countries have faced shortage of ICU beds during the pandemic. In countries like the US and Italy, many hospitals have said they could not provide critical patients with proper care for want of ICU beds.

“In India and Bengal, the situation is still not that bad. But with thousands of fresh cases being reported in our state daily, keeping ICU beds available, as many as possible, is one of our top priority,” a health department official said. “We cannot force doctors to shift critical patients out of ICUs but we are advising them how they can be less rigid in evaluating the criticality of a Covid patient.”

Had Covid not struck, such patients would have been in ICUs till they became completely stable, the official, who is a public health expert as well, said. “But Covid treatment should be a mix of scientific decision-making, pragmatism and humane approach.”

If a patient’s oxygen requirement drops to less than two litres a minute for the past few days and his/her oxygen-saturation level in the blood doesn’t fluctuate, that person maybe shifted out of the ICU, Gopal Krishna Dhali, the head of gastroenterology at SSKM Hospital, said. “He needs intensive bedside monitoring either in a cabin or a ward.”

Dhali is leading the panel of government doctors to check if treatment protocols are being followed in Covid hospitals. “It is important to create facilities for more serious patients who require immediate intervention.”

The panel has been suggesting to doctors that elderly people who don’t show any major fluctuations in their oxygen saturation level in the blood can be shifted out of ICUs if their blood pressure stabilises.

“Patients with no reports of any organ distress and who don’t require high-flow nasal cannula for their oxygen support and can do with an oxygen mask maybe considered for shifting out of ICUs,” a health department official said. “Once out of ICUs, nurses have to continuously monitor them.”

An increasing number of asymptomatic or mildly-infected Covid patients are suddenly developing breathlessness because of a fall in the saturation level of oxygen in blood. Such patients can recover fast if they are shifted to ICUs, the official said.

“The idea is to start non-invasive ventilation at the earliest for critically ill Covid patients. This can prevent rapid deterioration where the patient might need invasive ventilation,” the official said. “So, ensuring a bed in an ICU remains vital. Doctors can’t shrug their responsibility and keep a patient in ICU to play safe.”

Several senior doctors said ICU management had emerged as the most vital element in treating serious Covid patients with pneumonia. If these patients are shifted to ICUs in the early stage, they can recover fast, the doctors said.

“We have seen close to 50 per cent of Covid patients in ICUs recovering fast and moving out,” Sumit Sengupta, a senior pulmonologist in Calcutta, said. “Usually, ICUs have trained nurses to constantly monitor patients and alert doctors about their condition. That makes all the difference. So, if a patient has to be shifted out, the monitoring has to be ensured.”

One problem of shifting such patients to general wards was the lack of infrastructure, the CEO of a private hospital said. “The wards and private cabins don’t have high-flow oxygen supply system that is there in an ICU. High-flow oxygen supply means more than 20 litres of oxygen can be supplied in a minute. Also, many crucial monitoring gadgets are not there that record a patient’s vital parameters. But if experts advise, we have to see how this can be managed.”