How Non-Covid Patients are suffering during the lockdown!

The lockdown has brought a harrowing time on non covid patients and also other patients who needed emergency treatment for other ailments but simultaneously developed COVID infection

India recently completed a 21 day lockdown. It was a massive and praiseworthy effort. We were able to

stall the spread of the disease to dangerous levels and the intervening period gave adequate health

infrastructure to come up both in government and private sectors.

There’s no question on the need and efficacy of lockdown. But with almost a similar extension of

lockdown things are becoming difficult with each passing day. I will restrict my discussion to only the

medical aspect though lockdown has also had a massive impact on social and economic health of the

people as well.

The lockdown has brought a harrowing time on non covid patients and also other patients who needed

emergency treatment for other ailments but simultaneously developed COVID infection.

1. With most private clinics closed by doctors on their own citing various reasons ranging from

non-availability of staff to fear of catching infection from patients, the entire system has gone

for a toss. All major hospitals had already curtailed non-essential OPDs voluntarily or on

government orders. We need to look into this word NON ESSENTIAL. A person who has severe

pain in abdomen, or acute constipation or even a simple issue like gastroenteritis for him his

illness is supreme. He needs immediate pain relief. But what can he do?

More than half of the doctors are not available in neighbourhood. He cannot travel to far off

places as security personnel stop him at every barricade and at times they are not convinced

about their medical condition .even if he is lucky to find a doctor and the doctor advices blood

tests and x ray, ultrasound, CT scan or MRI etc., the next phase of ordeal begins. Most diagnostic

centers are shut. So a definitive diagnosis is not possible.

2. The situation has become really pathetic for chronic patients. The most common being renal

failure and cancer patients. As they need weekly or even biweekly treatments. They are being

refused by various centers on pretext of getting a covid test first. Now getting a covid test done

is another herculean task. Besides the paperwork there are very few centers doing it and reports

are available at least 24-48 hours later. That means a delay and this delay can be fatal as far as

dialysis patients are concerned.

3. Similar is the story with people who require regular blood transfusions. The blood banks are

running dry. Camps cannot be organized and people can’t/ don’t want to enter hospitals.

4. To make the matters worse some states have issued orders not to treat non-emergency patients

from other districts/states so that in case they are covid positive/carriers their statistics get

disturbed and fresh infusion of covid occurs in their districts.

5. Almost all over the country certain hospitals have been marked as designated covid facilities.

This is absolutely the right thing to do as covid patients shouldn’t be mixed with non covid

patients as they infect them heavily and there’s a manifold increase in deaths as other patients

are not in the best of their health. But a real fall out of this has been that the patients who were

earlier availing treatment from that hospital for various other illnesses have been left in a lurch.

Having discussed all this grim scenario- What’s the way forward?

1. In my opinion CORONA is not going away anytime soon. This has been well documented by

scenario in China, Korea and Singapore where fresh waves of cases are occurring. Worldwide

experience has taught us so far that covid patients should be treated in covid specific centers

only. That means rest of the hospitals should start their work back to normal though in a

graduated fashion. They should restart the OPDs and also operation theatres. At least the semi

essential procedures which have an inherent capability of becoming complicated if left uncared

should be operated. Hernias are one classical example.

2. These hospitals should however see to it that opds are not over crowded. Visitors are not

allowed to visit patients. Long queues are avoided at various counters and all the departments

are vigilant about the corona patients. Any staff /patient / accompanying person if found

suspicious should be immediately segregated.

3. Coming to single doctor clinics they should be opened now even if with less staff and facilities.

Patients should be given well-spaced out appointments and universal precautions should be

followed. The doctors and staff can use PPE kits while seeing patients especially respiratory

specialists and Internal Medicine doctors. All attempts should be made to minimize the patients

stay at the clinic. Less social talk and faster payment methods should be used. All the workers in

the establishment should be screened on daily basis.

4. It’s high time that regular vaccinations of children and regular follow up of pregnant patients

should begin but avoidable visits shouldn’t be encouraged at this moment.

5. The owners and doctors at diagnostic centers should restart their centers even if with curtailed

hours and doing tests etc. by appointment.at least some pressure will come down. Needless to

say that all the staff has to take proper training in prevention of covid spread. The earlier we

restart the quicker will be the learning curve for all these things.