Treat Coronavirus Patients But Save Others Too, Say Doctors, Oppose Turning Every Hospital Into COVID Block

Senior doctors in government and private hospitals currently leading the battle against the deadly Coronavirus, which has brought the world to a standstill, have expressed concerns over opening separate COVID-19 blocks to admit and treat the infected patients.

They say Italy made the same mistake and paid a heavy price.

Outlook spoke to about a dozen senior doctors who say the current hospital management for COVID-19 and other patients is completely flawed.

Presently, the Centre and State governments have converted the majority of their hospitals into two categories. While some hospitals have been completely converted into COVID-19 centres, others have opened a dedicated COVID-19 block. However, none of them is filled to the capacity.

Ram Manohar Lohia Hospital (RMLH) in Delhi has converted its trauma centre into a COVID-19 block. It has over 60 beds, of which only 10 has Coronavirus patients.

Similarly, a COVID–19 block in Lady Hardinge Medical College (LHMC) has only two patients. AIIMS trauma centre is no different.

Other states have adopted a similar approach.

In Bhopal, three top hospitals -- AIIMS, Gandhi Medical College and Bhopal Memorial Hospital And Research Centre -- were vacated to be converted into COVID-19 hospitals. While these hospitals are empty and not serving routine patients, COVID-19 patients are admitted to a private hospital.

In Rohtak (Haryana), the state government has declared a COVID-19 block in prestigious Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences. Sources say the ward is almost empty. However, COVID-19 patients are admitted to other hospitals.

Experts say it is a complete waste of invaluable resources. They say when only 20 per cent COVID-19 patients need intensive care, why cannot schools, community centres, marriage halls be converted into quarantine homes and accommodate rest 80 per cent.

Reserve one hospital for COVID -19 patients

“Why cannot we identify one big, medium or small hospital in a city depending on its population and convert it into COVID -19 hospitals?,” says a senior doctor from LHMC.

“All other hospitals should be allowed to do routine work and a COVID-19 hospital should be used to treat only serious patients, i.e, 20 per cent of the total patients,” he said.

Dr Manoj Mahajan, a former medical researcher from Army Hospital Research And Referral, Delhi, seconds the view. He says initially, Italy made the same mistake.

Mahajan, currently a senior oncologist in American International Institute of Medical Sciences, Udaipur, says, “Assigning few beds or blocks in every hospital is a bad strategy.”

Dr Usha M Kumar, a senior doctor from Max Hospital, Saket admits that India should learn from the mistakes Italy committed. She doesn’t like the practice of using hospitals only to quarantine patients.

Some experts say it is easy to assign other hospitals to those patients who get displaced from one hospital, dedicated to COVID-19.

“When all the patents of COVID-19 will be treated at one place, a lot of complications about hospital management can also be taken care of,” another senior doctor from Maulana Azad Medical College (MAMC) said. The Centre has also opened a COVID-19 block.

Respective hospital administrations argue all these blocks are completely separated from the hospitals with a separate exit and entry point to contain the infection.

A senior doctor from LHMC, which runs a COVID-19 block, says, “Not only the other doctors but also patients who come for treatment become susceptible to infection. Though COVID-19 Block is separated, we work under extreme fear and risk as it is a highly contagious disease.”

End the misery of non-COVID patients

The erroneous hospital management, along with closer of OPDs in all hospitals, has led to unbearable pain to lakhs of patients of heart, lungs, cancer, TB, neuro, renal failure among others as these hospitals have become inaccessible for them.

“Further closing of OPDs in almost all the hospitals have left patients at God’s mercy,” a senior doctor in AIIMS says.

Anubha, a thalassaemia patient, says that she is scared of going to LHMC for blood transfusion as it has opened a COVID-19 ward. “I might get exposed to infection. It is life-threatening for me,” she said.

Adarsh Pratap Singh, President, Residents’ Doctors Association, AIIMS blames the government for its failure to protect doctors and treatment to non-COVID-19 patients.

“The whole health care system cannot be dedicated to treat COVID-19 patients and let others die. This is an erroneous strategy to fight against a pandemic,” he said.

Covert all OPDs in Telemedicine mode

Another challenge non-COVID-19 hospitals face is the treatment other patients require

“All OPDs are closed because we don’t know who is infected among the patients coming for consultation. Similarly, patients who come for admission for treatment might be a carrier of the infection also,” Singh said.

Doctors suggest telemedicine for all type of consultancy. They say that closing OPDs for long harm new and follow-up patients.

“Based on a telemedicine consultation, if patients require a physical examination, he or she should be called.

“COVID -19 test should be conducted on all the patients coming for either consultation or admission and those who test positive will be sent to the isolation homes or COVID-19 hospital depending on his condition,” a senior doctor from AIIMS said.