Dr Muffazal Lakdawala fight against Covid

In March 2020 as the Covid crisis deepened, Dr. Muffazal Lakdawala, one of India’s leading bariatric surgeons with a thriving private practice volunteered his services with the Municipal Corporation of Mumbai (BMC) to help contain the spread of the pandemic in his beloved city of Mumbai. What began as an advisory service has now snowballed into one of the largest Covid-positive facilities in Mumbai, with Dr. Lakdawala leading a team of 40 health-care professionals to deliver quality care to over two thousand patients.

The NSCI Dedicated Covid Hospital is a 500-bed facility that was set-up and made operational in a span of just 5 days with the objective of providing quality care to Covid positive patients of Mumbai at scale. Dr. Lakdawala’s vision was to not only deliver the highest level of patient care, but to also ensure the lowest risk of transmission to the working healthcare staff. With this in mind, the facility was built on a ‘contactless’ clinic model (probably one of the first in India). Here all activities such as patient examinations, doctor-patient communication as well as swab collection, happen in a ‘contactless’ manner through a glass cubicle, making it safe for doctors and reducing the chances of nosocomial spread. This facility also has four large screens through which yoga classes, counselling sessions by psychiatrists and motivational talks by entertainers & sportspersons are organized to ensure that the patients’ mental well-being is also looked after.

Working closely with the BMC, Dr. Lakdawala successfully implemented a self-sufficient system of data management, research and patient care at the NSCI Covid Hospital which resulted in better patient outcomes. Some of the highlights of the past 5 months include:

• This facility has one of the highest recovery rates in the country at 82.11%. This can be attributed to measures like remote intensive monitoring, use of blood thinners such as Heparin and frequent, repeated X-rays to monitor deteriorating patients and putting them on oxygen early-on.
• Over 2000 COVID-19 positive patients have been discharged from the facility since inception.
• The transfer rate to higher centers for advanced care is at 6%, which is one of the lowest in the country.
• NSCI was the first Covid centre to use X-ray with artificial intelligence to help accurately detect presence of the Coronavirus even without a swab test result. This helped them monitor the progress of the disease, predict who was more likely to worsen and act pre-emptively by putting such patients on oxygen.
• In a time when no hospital in the city was willing to take cancer patients infected with COIVD-19, more than 80 cancer patients including children from ages 2 to 13 years, have also been successfully managed here (with the help of Tata Memorial Hospital).
• The centre has also successfully treated pregnant women and patients with chronic kidney disease who were on dialysis.
• Along with the results mentioned above, a dedicated research unit has been established with currently 14 studies, ranging from epidemiologic surveillance studies to clinical randomized trials, underway at the facility. These studies will help in gaining a better understanding of the disease and will help pave the way for new effective treatments against the Coronavirus.

A recent addition to the centre includes ‘portable, container ICUs’ conceptualized by Dr. Lakdawala to help resolve the issue of shortage of ICU beds and doctors. Built inside shipping containers, these modular ICUs can be transported in the back of a truck to any part of India, where a baseline nurse can operate them with an expert monitoring the patients remotely. This unique idea will open up a new frontier in the fight against Covid-19 and will help make quality care and treatment accessible to the most vulnerable sections of society.

Dr. Lakdawala believes it’s ideas like these which combine humanity, technology and out-of-the-box thinking that will play a long-term role in the city’s pandemic containment efforts. The NSCI facility was built on these principles and its success comes from using technology with ingenuity, which helped save many lives despite limited resources. The practices adopted at NSCI are now serving as an excellent blueprint for other centres being built across the country, with it being a great example of public-private partnership, team work and collaboration.