It’s a classic Catch-22 situation.
Last week, the BMC ordered dialysis centres to screen patients suffering from kidney failure for symptoms of COVID-19 before admission. As many bearers of the virus show no symptoms, the dialysis centres asked all those knocking on its doors to get tests done. Patients scrambled to get themselves tested, only to be told that COVID-19 testing is not for asymptomatic people, despite the BMC exempting those who need dialysis and chemotherapy. And without the test, no hospital will admit them for dialysis.
The hurdle does not end here. A dialysis patients requires repeated COVID-19 test before every dialysis round.
At KEM hospital, 53-year-old Madhuri Kansara stood crying outside the emergency ward. She requires dialysis thrice a week. Her last dialysis was five days ago. Her husband was walking from one department to another in the hospital holding her documents. “If she doesn’t get dialysis today, she will collapse,” he said.
Madhuri, a Grant Road resident, has been undergoing dialysis over the last seven years. Her regular centre is Bhatia hospital. On Saturday, the centre informed her that a COVID-19 test is required before she is put on the dialysis machine.
Since Bhatia hospital has no testing facility, the couple went to HN Reliance hospital. “There they said they could not test my wife. We went to SRL laboratory but no technician was available,” said Dharmendra Kansara, the husband.
The couple then called Kasturba hospital, where an official said they had only one dialysis machine for COVID-19 patients. They went to Nair hospital, where an official referred them to Kasturba hospital again. At Kasturba hospital, a doctor asked them to visit KEM hospital. In KEM, the emergency ward referred them to the dialysis department. It was shut. When they returned to emergency ward, a doctor said she could not be tested at the hospital.
“Staffers and doctors are sending me from one department to another. Nobody is ready to help us. My wife has no symptoms, they said they can’t test her,” Dharmendra said.
Dr R B Dastur, the director of Bhatia hospital, said, “We have to ask each dialysis patient for get tested as per BMC directions. Two days ago, a woman who came for dialysis tested positive. The entire dialysis unit has to be disinfected in such a case.”
On April 10, BMC had issued a circular with the instruction that as there had been instances of infection transmission through dialysis centres, these centres should screen the patients for COVID-like symptoms before treating them. “It has been observed that a few centres are performing dialysis on COVID-19 symptomatic patients, thereby spreading the disease. Therefore, it is directed that these dialysis centres should screen for COVID-19 like symptoms (cough, cold, fever, etc) before putting them on dialysis… any centre who is found to violate these conditions is liable for punitive action from MCGM,” it stated.
The circular added that a second alternative was to direct COVID-19 patients to dedicated hospitals in Mumbai. The BMC said COVID-19 patients should be treated separately or if such isolation facilities were not available, they should be referred to any of the five designated hospitals for the virus – KEM , Kasturba, Saifee, Nanavat and Seven Hills.
But for those with no symptoms, a screening was necessary. In effect, for dialysis centres, this has meant asking patients for get COVID-19 tests done.
Pre-testing before hospital admission has become particularly challenging for patients, as BMC has issued another circular barring tests on asymptomatic people. The circular does make an exception for dialysis and chemotherapy patients as well as pregnant woman, but KEM and Nair hospitals have refused to test them.
At Nair hospital, Dahisar resident Anurudh Sonawane waited in a critical condition in an ambulance as his mother-in-law tried to convince the casualty department official to admit him. “In Kandivali Shatabdi hospital, a doctor said Nair hospital will provide dialysis. Here the hospital said it only treats coronavirus patients. Where do we go?” she asked.
Sonawane requires dialysis every alternate day, as both his kidneys malfunction. His relative said other hospitals in their neighbourhood were shut.
With the focus of BMC hospitals on COVID-19 and several private hospitals shut, patients with other emergencies also continue to suffer.
Since Sunday night, Shahjahan Khan has taken his wife Heena to hospitals like Noor, Masina, Nagori, Kasturba and Wockhardt before reaching Nair hospital where he waited outside the casualty ward begging for admission. “She inhaled bleaching powder and is breathless. All hospitals refused to admit her. If Nair hospital also refuses, where will I admit her?” Khan said.
A senior doctor in Nair hospital said since the entire hospital has been converted into a COVID-19 centre, all other patients have been transferred to KEM and Sion hospitals. “We can’t help patients with other illnesses,” she said.
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