Billionaire technology entrepreneur Elon Musk had recently taken to the microblogging site to tweet, “Yes. Just as with groceries, the panic is also causing hoarding of ventilators, preventing them from reaching the hospitals where they are needed.”
Even though the Government of India, recently, prohibited the export of surgical masks and ventilators because of its shortage in hospitals, the uber-rich are panic-buying and hoarding ventilators at home at the cost of Rs 10 lakh. Ventilators are used for patients suffering from coronavirus to keep them alive if they struggle to breathe.
But is this a sensible move? Experts including Dr Sundeep Lakhtakia, who is a senior consultant at Asian Institute of Gastroenterology, feel otherwise. “This is sheer stupidity and waste of resources. It’s like buying a fighter jet for whenever we may have a war even when one does not know how to fire a missile, let alone fly a plane,” he says.
To begin with, those buying/hoarding a ventilator tend to forget that they will still need someone to manage the machine at home. Moreover, where will they find the necessary therapist or doctor to run the ventilator if it comes to that? For those wondering if it is, in the first place, possible to run a critical care patient privately at home especially in the Indian scenario, Dr Khizar Raoof, Consultant Urologist, Olive Hospital, shares his thoughts. “Unless they have an intensivist — a specialist doctor handling ICUs — at home, it’s of no use. We just don’t have enough staff to run hospitals, let alone home ventilators,” he cautions. Adding to the above thought, Dr Sunil Kapoor, senior Interventional Cardiologist, Apollo Hospitals, says, “It needs to be connected to a high-pressure oxygen line, which is available only in the ICCU of hospitals.”
Procedure and infrastructure
In addition to the above, ventilator settings also must be monitored and changed as per the patient’s need, depending on the patient’s condition. What’s more, the patient must be appropriately sedated to tolerate the ventilator. So essentially, the issue here is about how to set it up.
“Adjustment of a ventilator is an hourly issue,” explains Dr Chaitanya Challa, Challa Nursing Home. “A doctor has to be constantly present to adjust it. Buying an oxygen concentrator at home is acceptable, but a ventilator at home is not feasible. Ventilators also need an oxygen supply and compressed air, which is again not possible at home.”
According to Dr K. Subba Reddy, Sr Consultant Critical Care, Apollo Health City, ventilating a patient requires the entire intensive care infrastructure. “Just buying ventilators and keeping them ready outside ICU settings is not advisable. Sometimes, they may require prolonged ventilator support,” he adds. “Further, they require good doctors and nurses to take care of them. They may also require other organ support such as dialysis and multiple other consultants’ involvement. Added to it all, they will require very close monitoring to wean off the ventilator. So, it is not possible to create efficient ICUs at home.”
Other valid concerns
In government-run hospitals, it is very difficult to get vacant ventilators. In private hospitals, ventilators are available but are highly priced. So also, experts think it unwise and warn against anyone getting into an unnecessary panic-buying of ventilators during this time.
“In the Indian scenario, if things go worse, the government will take over all the ventilators. Even the ones in private hospitals,” warns Dr Khizar Raoof. “They’re already getting private medical colleges ready, and if the need arises, private hospitals will also become a part of the war against corona.”
Dr Sunil Kapoor also reminds people that very few of the corona patients need ventilators in the first place.
“COVID-19 infection results in respiratory distress syndrome in only 2-4 per cent of people. For instance, as of now, there are 40 patients admitted in the COVID-19 ward of the Gandhi Hospital and not a single patient is on ventilator,” elaborates Dr Sunil Kapoor.