When the government launched the immunisation drive against Covid-19 in January, frontline workers—health workers, sanitation workers, supporting staff of the hospitals—were given the first priority.

No discrimination was made between the frontline workers serving at private and state-run hospitals.

But as the second wave of the pandemic grips the country and beds in state-run hospitals have been fully occupied with seriously ailing patients, most private hospitals are not taking in Covid-19 patients. They are instead referring patients to government hospitals without ensuring that beds are available for them.

“We have dozens of patients, who were referred by private hospitals,” Dr Sagar Rajbhandari, director at the Sukraraj Tropical and Infectious Disease Hospital, told the Post. “Some patients sent by private hospitals are waiting at the emergency ward and on the premises of the hospital for beds.”

“But it is not possible to provide care to the infected patients only from government hospitals.”

The Ministry of Health and Population has directed all private hospitals not to refer patients without ensuring there are beds in the hospitals designated for the treatment of Covid-19 patients. The ministry has also directed all hospitals to set aside 20 percent of the beds for such patients.

However, only a few private hospitals have been providing care to Covid-19 patients.

“They take in only non-Covid-19 patients and if such patients test positive for Covid-19 during screening, the hospitals immediately send the patients to government hospitals,” said Rajbhandari. “Screening of patients should be done as a standard procedure but they should stop screening patients for financial conditions and stop sending those from poor economic backgrounds to us.”

According to Rajbhandari, some private hospitals have been providing care to Covid-19 patients but have been referring those who cannot afford to pay their exorbitant fees to state-run hospitals.

As Covid-19 infections have already penetrated deep in society, chances of many more testing positive are high and if the private hospitals keep sending the patients it will not be possible for state-run hospitals to accommodate all the patients, doctors say.

Designated Covid-19 hospitals are already under enormous strain.

“I too want to request the authorities concerned to stop the private hospitals from expelling patients when they test positive,” Dr Ravi Shakya, director at Patan Hospital, told the Post.

On Monday the Ministry of Health and Population reported that of the 16,658 polymerase chain reaction tests conducted 7,388 were positive. This is the record for a single day beating the high of 7,137 on Sunday. The positivity rate on Monday stood at 44, the same as on Sunday.

The Health Ministry said 37 deaths were recorded in the last 24 hours, which is also the highest death toll in a single day, taking the toll to 3,362.

Of the total new cases, 3,666 are from Kathmandu Valley with 2,922 from Kathmandu, 522 from Lalitpur and 222 from Bhaktapur districts.

The Health Ministry said 578 patients are in intensive care units and 142 on ventilator support throughout the country.

Experts say all the health facilities, whether they are state-run or private, with oxygen supply facilities should provide care to the infected.

“This is a time of disaster and no agency should shirk their responsibilities. The logic behind providing vaccines to the frontline workers is also that they would serve to save lives,” Dr Biraj Karmacharya, an epidemiologist, who is also the chief of the Department of Community Programme at Dhulikhel Hospital, told the Post.

With the surge in new cases, most of the hospitals have stopped providing out-patient department services. While the beds allocated for the treatment of Covid-19 cases by some state-run hospitals are all occupied by infected patients, hundreds of general beds, which have been vacant due to the surge in Covid-19 cases, remain unused.

“Apart from emergency, all services should be focussed for the treatment of coronavirus infections,” added Karmacharya. “Even at primary-level healthcare facilities and health posts, treatment should be provided to Covid-19 patients.”

As infections have already been rampant, all hospitals should be asked to provide treatment to the infected. Even those patients who are poor and cannot afford to pay the treatment costs at private hospitals should not be deprived of treatment, doctors say.

“The government should reimburse the private hospitals for the treatment they provide to the patients from poor economic backgrounds,” Dr Mingmar Gyelgen Sherpa, former director general at the Department of Health Services, told the Post. “This is an emergency situation, and all agencies concerned should be responsible.”

The Ministry of Health and Population has set the costs for Covid-19 treatment at hospitals—Rs 3,500 per day for normal patients, Rs 7,000 for moderately ailing patients and Rs 15,000 for those needing intensive care.

But due to lack of monitoring, private hospitals have been fleecing the patients, according to doctors serving at the government hospitals.

Thapa says that the prices fixed by the government may not be remunerative for private hospitals so they have been charging patients for the personal protective equipment too.

Meanwhile, representatives of private hospitals said that most of the private hospitals have their own limitations—limited beds and limited human resources to treat the infected patients.

“If any private hospital refuses to treat Covid-19 patients in the time of disaster, such hospitals should be shut down,” said Kumar Thapa, senior vice-president of the Association of Private health Institution Nepal. “If the hospitals have some problems, they should be addressed by the authorities concerned.”

Thapa, who is the chairman of Alka Hospital in Lalitpur, said that his hospital has allocated 31 general beds and 17 intensive care unit beds for the Covid-19 patients. “We are holding a meeting to discuss allocating more beds for Covid-19 patients.”