Leading Rajasthan’s COVID-19 Response – Clinical Strategy, Capacity & Coordination

When COVID-19 reached Rajasthan in early 2020, Dr. Sudhir Bhandari was serving as Principal & Controller of SMS Medical College & Hospital. During the pandemic response he also served as a Member of the State Advisory Board for COVID-19, headed the Government of Rajasthan’s Core Treatment Group for COVID-19, and led the COVID-19 containment programme of SMS Medical College and its attached hospitals. A Government of Rajasthan order dated 20 March 2020 formally constituted a core group of doctors at SMS Medical College for treatment of coronavirus patients, with Dr. Bhandari named in that group. The role placed SMS at the centre of clinical strategy, treatment coordination and rapidly evolving medical decision-making during the first wave.

The COVID management structure described in the institutional record extended beyond bedside treatment. It included micro-containment, deployment of rapid-response teams, creation of COVID-care facilities, implementation and monitoring of treatment protocols, development of plasma-therapy capability, and orientation programmes for doctors and paramedical teams across Rajasthan. District-level monitoring mechanisms were used to help standardise clinical management. The purpose was to create a coordinated response in which evolving medical guidance could move quickly from the state’s tertiary-care leadership teams to hospitals and health personnel across the state.

During the first wave, SMS Hospital rapidly reorganised services for COVID care. Contemporary reporting described 300 ICU beds and more than 1,000 inpatient beds dedicated to COVID patients, a separate COVID OPD and observation area at Charak Bhawan, 28 wards for different categories of patients, and round-the-clock deployment of faculty, residents, nurses, paramedics and technicians. At the peak of the initial response, more than 500 patients a day were being managed across categories from asymptomatic to severe disease. By June 2020, SMS Medical College had also performed more than 1.35 lakh RT-PCR tests while continuing to expand daily testing capability.

The SMS team developed a detailed clinical work-up for COVID patients that went beyond routine testing and included HRCT chest, CT pulmonary angiography, point-of-care lung ultrasonography, echocardiography, coagulation assessment and markers associated with severe inflammatory response. Institutional documentation also records lung-biopsy research in deceased COVID patients to better understand disease pathology. As evidence changed during 2020, the team evaluated and used therapies that were part of the contemporary COVID treatment landscape, including hydroxychloroquine, antiviral combinations, remdesivir, tocilizumab and convalescent plasma, while participating in research and clinical-trial activity. These treatment descriptions are historical to the pandemic period and do not represent present-day medical guidance.

In May 2020, SMS Medical College received ICMR permission to use convalescent plasma therapy for 20 critically ill COVID-19 patients. Rajasthan’s Health Minister formally launched the programme through video conference, and Dr. Bhandari presented the clinical process and donor-selection criteria. Contemporary coverage also records the state leadership congratulating Dr. Bhandari and the SMS team for their early work in COVID treatment.

The pandemic response was accompanied by active clinical research. Dr. Bhandari and colleagues published early work on the characteristics and treatment outcomes of 522 hospitalised COVID-19 patients in Jaipur, patient-flow dynamics during the pandemic, clinical profiles, mortality-risk prediction and the epidemiological trend of COVID-19 in Rajasthan. This research function complemented day-to-day clinical management and helped convert observations from a rapidly changing hospital environment into documented evidence.

The client’s institutional record describes extensive virtual communication with doctors, nurses and paramedical personnel during the pandemic. Dr. Bhandari also participated in repeated professional and public discussions on COVID-19, diabetes, treatment strategy, convalescent plasma and safe behaviour during the unlock period, extending the response from hospital management to medical education and public awareness.