‘A person who is sick can’t be refused treatment’
NEWDELHI: Delhi should not restrict its health services to the state’s residents alone, but look at optimising Covid-19 hospital admissions and encourage people’s participation to stop further spread of the disease, said Dr Randeep Guleria, professor of pulmonology and director of All India Institute of Medical Sciences, in an interview with
Dr Guleria also heads the clinical research group within the national task force set up by the Indian Council of Medical Research. Edited excerpts: to Delhi from other states to be very high as transferring a person who has tested positive to Delhi will not be easy.
With the lockdown gradually being lifted and people mixing with each other, there will be an increase in the number of cases. What will really help is the people’s participation. People have to understand that despite the lockdown being lifted their responsibility in terms of infection control doesn’t come down, actually it increases much more – social distancing, hand washing, wearing a mask in public, avoiding crowded places, high-risk groups not going out unless essential becomes all the more important.
But the increasing number of cases means hospital admissions will also go up. Luckily, the number of people requiring ventilator support is low and most people get a mild illness. But we will have to look at strategies to optimise hospital admission.
Protecting health care workers is paramount and we have been working on it aggressively for the last two months. If you look at our data, only about three or four healthcare workers have got the infection from within the hospital. The remaining staff were working in non-covid areas and got the infection from the community; most of their family members have also tested positive.
Our concern is they should not pass it on to others and create a cluster within the hospital.
For that, we have a hospital infection control team that has been training everyone -right from the sanitation workers to the faculty -- on infection control measures. We have now designated nodal officers for each area, who make sure the infection control measures are followed. All the staff members who come from outside the campus are screened for fever, cough, cold, and body ache. If they have any of these symptoms, they are asked to go home or get tested. And, of course, we will have a new normal where all doctors and staff irrespective of their wards or duty areas will have to protect themselves with N95 masks, gown, or shields.
There has to be a low threshold for testing so that even if there is a small suspicion, a test should be done.
First, we have to see how the pandemic behaves. Do you manage the non-covid patients who are relatively stable versus a huge surge of Covid-19 patients that are emergent? Of course, patients who come into the hospital in an emergency or even semiemergency such as trauma, or in need of dialysis, blood transfusion, or chemotherapy will continue to be managed. However, patients who need, say a knee replacement surgery or gall stone removal or hernia surgery, can wait. If there is a huge surge in cases, you will have to prioritise the beds. Once there is a downward trend, then with all infection control measures, one can start looking at opening up other services. Plus, right now doing routine procedures would mean us exposing them to the infection.