While convention centers, stadiums, multi-purpose arenas, and other plus-sized venues the world over are being converted into makeshift medical facilities in response to the coronavirus (COVID-19) pandemic, India is taking a different approach by turning decommissioned passenger train cars into isolation wards.
In an effort to halt the spread of the virus, Indian Railways suspended all service until April 14. Taking full advantage of the unprecedented pause, the government-operated rail service—the oldest in Asia and the fourth largest in the world—is now transforming up to 20,000 old coaches into emergency care units that can be deployed to remote and hard-hit areas of the country experiencing a shortage of hospital beds. As the Ministry of Railways elaborated in a statement, the coaches are “being prepared only as a contingency and to supplement the efforts of the Ministry of Health.”
Preparing to Combat Coronavirus: In a novel initiative, Railways has converted train coaches into isolation wards for COVID-19 patients 🛌
— Piyush Goyal (@PiyushGoyal) March 28, 2020
As reported by The Tribune, each retrofitted train car—a proper quarantine coach—can accommodate up to 16 patient beds along with a nurse’s station, doctor’s cabin, and ample room for supplies. It’s worth noting that the modified cars lack air conditioning, as newer, air-conditioned carriages are being held for regular passenger use when service resumes. Five thousand coaches with the capacity to accommodate 80,000 patients are currently being readied in all 16 of India Railways’ service zones. Per the Indian Express, half of those have already been fully completed, with an average of 375 converted per day since the scheme was first announced.
“In times of lockdown, when manpower resources are limited and have to be rationalised and rotated, different zones of Railways have almost done an impossible task of so many conversions in such a small span of time,” said the Ministry of Railways.
— VIJAY KUMAR SINGH (@pappubhaiya_) April 6, 2020
The Indian Express detailed the resourceful, rapid-fire modifications:
“Two of the four toilets have been converted into bathrooms. The middle berth on one side in each cabin has been removed while the lower berth there will act as the patient bed.
“Each cabin has been separated with proper plywood covering and every patient area has medical-grade plastic curtains to give the coach the look of a proper isolation ward. There are cabins for a doctor as well as other medical staffs. More electrical sockets for medical instruments, more bottle holders to act as holders of intravenous drip stands etc., have been provided. It also has provisions for connecting to an external electric supply.”
While there’s been no indication that Indian Railways won’t resume service on April 14, the converted carriages will be ready to go regardless in the event that infection numbers start to spike. India currently has 4,778 confirmed cases of coronavirus and 136 deaths. While this isn’t a tiny number by any means, for a nation of over 1.3 people billion people it’s astonishing. By comparison, India falls directly behind Oakland County, Michigan (population: 1.25 million ), and Nassau County, New York (population: 1.37 million ), in its number of reported deaths, and trails Denmark and Chile in confirmed cases. Still, India, a country with a dearth of hospital beds and fragile public health infrastructure that varies wildly from state to state, is very much not out of the woods yet.
Converting thousands of trains into emergency isolation coaches may seem like an overly complicated, non-obvious solution to extreme potential hospital overflow. One can imagine what it would look like if Amtrak got into the healthcare business. But in India, a country where its national railway system is also its largest employer and where rural areas are largely unequipped for a public health crisis at his magnitude, the idea is something of a no-brainer as far as emergency back-ups go.
As CNN notes, Indian Railways currently operates 125 non-train-based hospitals across the country. The agency has also been running the Lifeline Express, a mobile hospital equipped with an operation room, private treatment areas, recovery wards, and accommodations for medical staff since 1991 when it was launched in collaboration with the Impact India Foundation and the Indian Health Ministry.