Updated: June 6, 2020 7:21:16 am
CHEMOTHERAPY sessions on hold, a surgery for breast cancer delayed and a late night scramble at the emergency ward to treat a 12-year-old — doctors at the premier Sir Ganga Ram Hospital say it has been a struggle ever since the Delhi government asked them to stop Covid testing.
On June 3, the hospital received an order from the Delhi government for allegedly flouting ICMR guidelines for testing coronavirus patients. “RT PCR sampling for Covid-19 suspect/ confirmed cases should be stopped with immediate effect,” the notice read. The same day, the Delhi government announced that the 675-bed hospital will have to reserve 80 per cent of its beds for treatment of Covid-19 patients.
According to doctors, the two decisions — asking the hospital to start admitting more Covid patients and then to stop testing for the infection — are at odds with each other.
“I am flooded with calls from patients who are supposed to be administered chemotherapy. They are supposed to come once every week or two weeks. We have maintained they should get Covid tests done once every two weeks because chemotherapy on a patient who is Covid positive can be disastrous. They are immunocompromised and administering chemotherapy leads to further immune-suppression,” said Dr Shyam Aggarwal, medical oncologist and bone marrow transplant specialist at Sir Ganga Ram Hospital.
“They are now calling to ask where they should get tested. Not many labs in Delhi are doing the test these days. We have checked with six-seven labs; now what do I do with my treatment? We have told them that if the test is not done, it (chemotherapy) can be harmful for them.”
On Wednesday, 174 samples for Covid testing were collected by the hospital’s lab. Before testing was halted, the hospital used to test 150-170 samples a day. According to doctors, approximately 30-40 surgeries were performed in a day, but since Thursday, surgeries have stopped as well.
Late Thursday night, the hospital’s emergency room saw a 12-year-old boy with altered consciousness, breathlessness, high-grade fever and uncontrolled diabetes from Bhind near Gwalior. With testing banned, and no time to wait for a Covid confirmation, doctors initiated treatment by creating a separate space for the boy, with an assumption he had the virus.
“Thankfully the patient is stable. But everybody in the area at that time got exposed while managing the boy. We had to create a system for him. If we treat him as Covid positive till results are out (which may take longer from outside labs), the patient will end up paying lakhs for adequate protection (PPE, separate doctor, a separate ward with dedicated nurses). And if I keep him with other Covid patients, this innocent child may catch an infection from them,” said Dr Dhiren Gupta, a paediatric intensivist in the hospital, of the difficult choice before him.
The fallout has also been felt on scheduled surgeries. “I had to discharge a breast cancer patient yesterday since the hospital couldn’t test. Her cancer might spread but I had no other option. It took me a while to make her family understand about the recent orders. She was admitted late Wednesday night and was scheduled to be operated Thursday afternoon,” said Dr B B Agarwal, vice-chairman, laparoscopy and general surgery, Sir Ganga Ram Hospital. He has postponed three patients in the last two days.
Two hospitals affiliated with Sir Ganga Ram – Kolmet with 40 beds and City hospital with 140 beds – were earlier turned into Covid-only facilities. Sir Ganga Ram, meanwhile, can reserve 20 per cent beds for non-Covid patients now.
The June 3 order issued to the hospital stated: “The district has come to know that the hospital is still not using RT PCR app even till today. The hospital is directed to explain why they have not yet started sample collection via RT PCR app within two days of receipt of the order.”
When asked to comment on the issues flagged by doctors, a Delhi government spokesperson said: “There are 35 labs in Delhi authorised by ICMR. These eight labs were found not following the prescribed protocol by ICMR. Therefore, action was initiated. As a temporary measure these labs have been asked not to pick up individual samples. However, samples sent by various hospitals and other agencies will continue being processed in these labs.”
When contacted, D S Rana, Chairman (board of management) at the hospital, said: “We have replied to the government’s order. This is a minor issue and we hope that the services will resume soon for the benefit of patients and the hospital.”
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