Covid-19: India redeploys converted medical train carriages as hospitals fill

India is deploying makeshift rail carriage hospitals as thousands of coronavirus patients scramble for beds and medicine following a brutal second wave.

On Monday, India declared a record 273,000 new cases of Covid-19, taking the country’s total to 15 million since the start of the pandemic in January 2020.

Several states and cities are witnessing distressing shortages of hospital beds and medicine, forcing authorities to set up temporary hospitals in hotels, auditoriums, schools and railway yards.

Distressed families flooded social media with pleas for hospital beds, oxygen supplies and drugs for sick relatives.

Authorities refurbished 5,000 state-owned Indian Railways train carriages into field hospitals in March 2020 to treat Covid-19 patients suffering from mild to moderate symptoms.

At the time, many of the ‘hospitals-on-wheels’ were surplus to requirements as strict lockdown measures saw a dip in cases, but the carriages will now see patients admitted.

Indian Railways normally operates 20,000 passenger trains daily, carrying 23 million people across the country on its 115,000- kilometre rail network, the world’s second-largest after China, but quickly pivoted to offer Covid-19 carriage wards and oxygen services.

The trains are being kept at depots and will be driven to stations in cities and towns where required.

The trains have patient beds, cabins for medical staff, bathrooms and power points for medical equipment. Patients will also be provided with water coolers as temperatures approach the annual peak in May.

Indian Railways has so far deployed 169 of its 3,800 converted coaches as case numbers rise.

In Maharashtra, India’s worst-hit state, railway companies deployed 94 Covid-19 care coaches in the northeastern city of Nandurbar. So far, 20 patients have been admitted.

In India's capital city New Delhi, 75 Covid-19 isolation coaches with more than 800 beds are ready to be deployed, railway minister Piyush Goyal tweeted.

The city, with a population of 20 million, is recording over 25,500 cases every day and has less than 100 intensive care beds available, the city’s top minister Arvind Kejriwal said on Monday, as he announced a week-long lockdown in the city.

"We have been receiving requests for the deployment of these coaches. We have 3,800 such coaches ready and can deploy at anywhere in the country," Indian Railways executive director Rajesh Dutt Bajpai told The National.

“The railways is taking care of cleanliness, meals and oxygen cylinders whereas the hospitals associated with state governments where the trains are stationed have the responsibility for doctors, paramedics and medicines,” Mr Bajpai added.

Mr Bajpai said the coaches are meant for patients with mild symptoms who do not require ICU beds or ventilators, adding that only hospitals can admit patients.

The railways are also running a special ‘Oxygen Express’ to transport liquid medical oxygen and oxygen cylinders to different parts of the country, said Mr Goyal.

The continued spread of the disease has pushed India into second place on an ominous leaderboard of nations with the most cases, behind the US.

It is hoped the train carriages will alleviate a health system pushed to breaking point. Hospitals, large and small, are running out of space and equipment, with patients having to share beds and oxygen cylinders as they gasp for breath and await treatment.

Videos on news channels have shown desperate families waiting outside hospitals, while Covid-19 patients are being kept in ambulances and private vehicles as doctors struggle to find beds and oxygen facilities.

The world’s fourth-largest economy spends only 3.5 per cent of its GDP on public healthcare, with a large section of the population deprived of basic medical care as they cannot afford private hospitals.

The country has just 23,582 state-run hospitals with 710,761 beds for its 1.3 billion people: a ratio of one bed per 1,844 people, according to World Bank data.

It also has a shortage of doctors, with one doctor for every 1,457 people – lower than the World Health Organisation norm of one per 1,000.