Doctors Without Borders (MSF) has opened a temporary Covid-19 hospital in India amid fears the country's Bihar state will experience a surge in cases as its large migrant population returns from the cities. Bihar's capital district, Patna, has limited health infrastructure and fewer than 1,000 hospital beds to serve a population of 5.6 million, so MSF set up an emergency field treatment centre in an indoor sports stadium to help ease the pressure. Bihar is still ahead of larger cities like Mumbai and New Delhi in terms of case numbers, but Dr Prince Mathew, the regional head of MSF's Asia mission,<strong> </strong>said<strong> </strong>the state's centres for treating Covid-19 patients could be overwhelmed. "It is important to set up new decongestion sites so that the existing health infrastructure can continue functioning and the new site can reduce the burden on current hospitals," Dr Mathew told <em>The National</em>. "[This is] the perfect time for MSF to set up and prepare a treatment unit so that when the caseload increases heavily in the coming months, we will be pre-positioned and ready to respond." In the initial stages, Dr Mathew said the facility would manage mild and moderate cases to help with isolation and reduce the viral spread within the community. However, as the situation worsens it will focus providing oxygen. With 180 MSF staff, the centre will accommodate up to 100 mild and moderate cases. It will also offer inpatient care, health education, mental health support, access to all essential medicines and, later, oxygen. “Responding to emergencies is at the core of what MSF does,” Dr Mathew said. “We are putting our knowledge and experience in epidemic management to help mitigate the impact of Covid-19 in Bihar state.” India – with 457,621 conformed cases and about 14,500 deaths – is the world's fourth hardest-hit country after the US, Russia and Brazil. The country witnessed its largest single-day surge on Wednesday with 15,968 new cases, sparking concerns about its ability to manage the crisis. New Delhi is emerging as a cause of concern and its authorities are being criticised for poor contact tracing and a lack of hospital beds. With infections set to surge, the government estimates it will have nearly 550,000 cases by the end of July. The actual numbers, like elsewhere in the world, are thought to be much higher due to a number of reasons, such as limited testing. It is believed that the migration of many newly unemployed workers who were forced to leave India's cities and return to their home states, such as Bihar, could spread the virus significantly. "With its large population and many living in densely populated clusters – combined with the unlocking of the lockdown and the resumption of economic activities – case numbers will certainly increase heavily in India before the curve is flattened," Dr Mathew said. "States like Bihar need to drastically scale up their testing numbers to be able to effectively manage this outbreak."
