Two days after BMC amended its testing protocol again to allow private doctors to prescribe a Covid-19 test, lack of communication on the updated protocol to private laboratories led to multiple instances where patients were refused the test.
Father of a two-month-old baby, who requires an urgent hernia procedure, said he has been trying to get his daughter tested for Covid-19 since three days. Even though the baby has no symptoms of the virus, the test is a prerequisite for surgery to relocate her ovary.
“Initially, we were told only government doctors can recommend Covid-19 tests. I had been visiting BMC office in Ghatkopar to get permission letter,” the father said. On Saturday after BMC notified that private doctors can prescribe a test, he visited the treating surgeon who wrote a prescription for Covid-19 test. But private laboratory, Suburban Diagnostics, refused to do a test, claiming they are yet to be notified by the BMC.
The father again visited BMC medical officer with doctor’s prescription and new notification. “It took time to convince them. Finally they agreed to call the laboratory for tests,” the father said. When he reached the laboratory, it was shut owing to a holiday on Sunday. “The surgery was scheduled for today. It has been postponed now. This is a struggle, my daughter needs surgery urgently,” the father said.
Dr Ketan Parikh, who prescribed a Covid-19 test for a six-year-old boy on Sunday, said even the child was refused test by a private laboratory. “He requires a stent removal surgery. We need a Covid-19 test to confirm there is no risk of infection,” Parikh said. He had to click a picture of BMC’s latest notification and ask local ward officer to help in getting a test done on Sunday. “This problem has been existing since last few days now. The testing criteria is changing every day,” Parikh said. The six-year-old’s surgery had to be delayed by 48 hours after private laboratory refused to test.
In the past, circular for testing have been issued on April 15 and April 20. On May 8, the BMC issued an updated notification that reiterated to test all high-risk contacts with comorbidities, pregnancy, age above 60 years apart from people presenting symptoms of Covid-19. The updated notification also allowed testing for high-risk contacts of confirmed Covid-19 cases after fifth day of exposure. The new notification, dated May 8, has been signed by the additional municipal commissioner (western suburbs).
It stated government or private doctor could prescribe a Covid-19 test, changing its earlier stand of allowing only government doctors to prescribe tests. BMC made prescription compulsory for Covid-19 testing. It has asked private laboratories to not test patients on their own.
Dr Nilima Bhamare, secretary in the Association of Medical Consultants, said doctors are forced to make calls to laboratories and ward officers requesting them to process tests for patients. “That is delaying treatment. The BMC’s new notification is not being followed by all laboratories. The civic body should have widely circulated it,” she said.
Private labs said with constantly changing testing protocols it has become difficulty to remain updated with latest criteria. An official from Suburban Diagnostics said, “The latest notification we have states a test can be done on prescription of only ward medical officer or government doctor. We are also waiting for some clarity. Our team has reached out to BMC to check if there is change in testing protocol and whether private doctors can prescribe a test.”
An official from BMC said all latest circulars are notified to concerned authorities immediately.
“We are now following ICMR protocol for testing. It does not say that testing a patient before surgery is mandatory. We also have to use our resources very carefully,” said Dr Daksha Shah, deputy executive health officer, BMC. She added that confusion has been cleared and all private laboratories have been notified clearly about the revised circular. “Indication criteria of ICMR before a Covid-19 test must be followed,” Shah added.
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