Hospital fires during covid: A coincidence?
As India battles the coronavirus pandemic at its peak, hospitals have become the battleground for this war. However, in recent weeks, due to the immense stress on the hospital infrastructure, a grim scenario is unfolding in every part of the country. Fires are breaking out in the ICU wards, where the most critical patients are battling for their lives.
In Gujarat, three major fires have broken out in Ahmedabad, Surat, and Bharuch. They accounted for 30 people, including nurses. Similar instances of fires in Mumbai (more than 40 dead) and Delhi (50 people affected) have added to the list of casualties that otherwise would have been prevented. Internationally too, a similar incident led to 82 deaths in a hospital in Baghdad, when its ICU ward caught fire.
What is the primary reason behind these fires? People often attribute it to carelessness and short circuits, but it’s a much more complicated answer. Here’s a hypothesis proposed by multiple forums online:
The average oxygen saturation in the air is 21%. In an ICU of a Covid ward, most patients require medical oxygen which has a concentration of more than 90%. With poorly ventilated ICUs, the oxygen concentration might marginally increase, making the place highly inflammable.
Moreover, with the rising covid cases, many hospitals have had to develop ICU facilities overnight. ICUs are equipped with high-end electronic medical gadgets which consume a lot of electricity. Since the high ICU demand isn’t planned, hospitals often add equipment beyond capacity, which does not allow them to install proper ventilation systems or get proper earthing of connections done or fireproof switches.
So, what can be done?
Well, let’s first look at long-term solutions. In December last year, the Supreme Court directed all States to carry out fire safety audits of dedicated COVID-19 hospitals. In March this year, because of repeated fires in hospitals, the Central government announced in the parliament that a Fire Safety Committee would regularly audit ventilation, heating, air-conditioning, and electrical equipment in Union Hospitals. The Health Ministry also circulated strict guidelines in September 2020, which stipulated third-party accreditation for fire safety. The National Disaster Management Authority laid down guidelines, based on the National Building Code, to increase the fire safety of hospitals.
The National Building Code, drafted by the Union government, includes by-laws and specifications on the fire safety of hospitals. However, it is incorporated only in theory in most States’ local bylaws. The law exists, but the mandatory inspection required is often delayed or not completed due to workload. Several states like Kerala, Tamil Nadu, and Maharashtra have procedures and laws that don’t conform to the National Building Code. Increasing the overall inspection and ensuring stricter implementation of laws and the National Building Code is one of the long-term solutions.
These changes will take time. In a pandemic, when several makeshift hospitals are being created or existing ones are going beyond capacity, what is a short-term solution? Firstly, electrical equipment can be made fireproof. This limits the damage a spark can cause. Secondly, hospitals can install relatively cheap and small detectors that detect the oxygen saturation in the air. As soon as it crosses a threshold, an alarm can go off, which could be treated as a signal for ventilation, natural or forced, to reduce the overall danger.
It might feel unimportant to worry about the fire-safety protocols that a hospital follows in a time when finding a hospital bed itself is a challenge. However, if the safest of spaces are vulnerable for both patients and doctors, measures need to be taken. As is with multiple sections of the society, the pandemic has only brought to light the various inadequacies and strains that are placed on our healthcare systems. Enough fires are being lit in cremation grounds; let hospitals not join them.