On 8 April, representatives of more than 10,000 private hospitals across India got on a call. All office-bearers of the Associations of Healthcare Providers Indian (AHPI), none of them were in a position to pay staff their entire salary for April. With the 21-day lockdown extended for another 20 days till 3 May, and possibly more extensions in the offing, the situation only looks set to worsen.
Hospital earnings have been battered since the Covid-19 pandemic began picking up pace in India. On 22 March, an advisory from the government urged private hospitals to forego all non-emergency procedures. Instead, they were asked to prepare for a deluge of Covid-19 cases, even as government hospitals with 500-plus beds in every state were readied as primary centers for admitting Covid-19 patients.
Private hospitals obliged, but that influx did not materialise. At the time of writing this story, over 11,000 people have tested positive for Covid. The overall Covid-associated hospitalisation hospitalisation The Centre for Disease Control and Prevention The highest hospitalisation rates are in persons 65 years and older (38.7 per 100,000) and 50-64 years (20.7 per 100,000). Read more rate is 12.3 per 100,000 of those suspected to be infected.
As a result, private hospitals are eerily empty. Inpatient occupancy ratios have dropped by as much 80%. With a nationwide lockdown currently in place, outpatient consultations are practically non-existent.
“It’s a funny situation. We’ve shut down routine work. But without any accidents, no consultations, and no surgeries, how are hospitals to pay salaries to doctors and nurses?” asks a senior executive with one of the largest hospital chains in India.
In a report released on 25 March, credit rating firm ICRA estimated that without medical tourism, big hospitals could lose as much as a quarter of their revenue over the coming months.
While the sector as a whole has been adversely impacted, the severity of the situation isn’t necessarily the same across the spectrum. Nursing homes—hospitals with under 30 beds—are hardest hit. They account for over half of India’s 68,000-odd hospitals, both government and private, according to an AHPI office bearer. Often owned and managed by doctors and unable to compete with large hospital chains, these have been struggling for years now years now The Ken Buying in, building out: Indian hospital giants get bigger Read more . The present crisis could be the final nail in their coffin.

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With little visibility on earnings, hospitals have resorted to drastic measures.