Others suffer as hospitals free up resources to combat Covid
‘Curtailed’ services hit cancer patients, pregnant women, transplant patients hardest
NEWDELHI:A month after the surgery to remove an oral cancer malignant growth, Mohd Kareem, 40, started his radiation therapy at Delhi State Cancer Institute (DSCI) mid-February. He still had five cycles of radiation therapy remaining when the hospital shut down after doctors and nurses there started testing positive for Covid-19.
“I do not want his cancer to come back. We even went to a private hospital, but they said that the treatment should continue at the same hospital. Should we keep waiting for the hospital to re-open?” asked Saheem Bano, Kareem’s wife.
The DSCI was shut after 22 of its staff and three patients tested positive for the infection.
Hospitals across the city, government and private, have curtailed or halted “routine” services to decongest and keep beds for Covid-19 patients. This, coupled with the 21-day lockdown, has severely limited people’s access health services in Delhi.
FEW HOSPITALS OPEN
“Mortality from non-communicable diseases will shoot up in places that do not have strong public healthcare system. It is important to focus on Covid, but not at the cost of other healthcare needs,” said Dr Abhishek Shankar, assistant professor of radiation oncology at Lady Hardinge
Medical College.
“When it comes to cancer, every step is emergent. There shouldn’t be interruption in treatment. Now, private sector hospitals, which treat a majority of indoor patients, are not bound to stay open and risk their staff getting the infection. So, people depend on government facilities. In the absence of experienced doctors at district hospitals, who will treat cancer patients unable to reach AIIMS?” he said.
After taking proper precautions, the non-Covid-19 hospitals should continue all routine services, Dr Shankar suggested.
“Chronic conditions get diagnosed when patients come to our clinics. These might get missed and the patients might land up in the hospital with severe symptoms,” said Dr
Roopali Diwan, head of the department of gynaecology at Safdarjung hospital.
Services such as delivery of babies have also gone down at the busiest labour room in the city.“People from far off places, who would earlier come to the hospital for their deliveries, can’t do so now because of the lockdown,” she said.
LONGER WAIT
Transplantation surgeries across the country — have been hit, with the government suggesting that non-emergency surgeries be put on hold for now.
“No transplant surgeries have taken place in the country in eight to ten days. Some transplant surgeries are life-saving— like heart or liver transplants. Covid-19 is here to stay and we cannot deny people these procedures,” said Dr Sandeep Guleria, renal transplant surgeon, Indraprastha Apollo hospital.
Around 150 kidney transplants usually happen across the country in a week.
With surgeries getting postponed, the long waiting lists for surgeries at government hospitals will likely get longer. At hospitals like AIIMS, the wait period for surgeries in some departments can be up to a year.
ROUTINE CONSULTS
Routine out-patient services in big hospitals — like AIIMS and Lok Nayak—have been shut after they started accepting Covid-19 patients. Some others run a curtailed OPD.
“We receive less than half the number of patients in our clinics even though all services – except planned surgeries – are open. We have started giving patients with chronic conditions, like diabetes, medicine for longer periods to reduce their visits,” said Dr Rajeev Kapoor, medical superintendent of Sardar Vallabhbhai Patel hospital in East Patel Nagar, one of at least 25 Delhi government-run hospitals that are still providing routine healthcare services.
After two mohalla clinic doctors from NE Delhi contracted the virus from a patient, at least 100 of these clinics have also been shut. Besides that, half the private practitioners across the city have also closed their practice. There are around 700 nursing homes in the city, most are small with just one to 20 beds.
Although some hospitals have started telemedicine consultations after the Central government released guidelines, the uptake is not great.
“We have launched a 12-hour teleconsultation number. But we are getting just three or four calls a day,” said Dr Nimesh Desai, director of the Institute of Human Behaviour and Allied Sciences.
The hospital OPD, now shut, used to get about 1,200 patients a day.
IMMUNISATION
Although, the government has ensured that vaccines are available at all its dispensaries and non-Covid-19 hospitals, universal immunisation programme has also taken a hit in the city.
“All vaccines are available at the fixed delivery points like dispensaries and hospitals. And hospitals, that have shut routine services, have been requested to send patients to the nearest dispensaries,” said an official from the Delhi government’s health department.
“With 90% of the immunisation services being provided by government facilities, it should not be impacted too much. But there will definitely be some impact. How much, we will come to know only after a couple of months when the data comes in. We might have to carry out intensive drives to catch up,” he said.