The Non-Covid Healthcare Story
Hospitals are the hotbeds of Covid-19 virus. When lockdowns began, resources of all hospitals were directed towards controlling the virus and treatment of those who are infected. The out patient department (OPD) and non-emergency services of hospitals were shut down. This left many patients requiring dialysis, regular checkups and instant healthcare without a solution to their problems. Approaching hospitals was especially risky for those who needed healthcare services most; geriatrics and those with chronic diseases.
According to doctors, patients with curable diseases who could substantially benefit from treatment need to be given high priority, whereas patients who were being treated with palliative intent, especially those for whom interventions were expected to have marginal benefit, should be deferred. People are unable to access healthcare for three main reasons: restrictions on mobility, hospitals rejecting care and patients’ fear that they will contract the virus. With curfews and state borders being closed, patients would require a government allotted pass to travel to the hospital. According to doctors, the system to get the pass is very complicated and needs to be simplified.
Several private hospitals shut down during the lockdown. They also rejected patients, both Covid-19 suspected and non-covid patients for fear of contracting the virus1. Finally, due to the possible consequences of going outside, people had a tendency to put off seeking medical help.
Consider two of the most commonly reported serious medical problems: cardiovascular disease and cancer related problems. Hospitals across the world have reported a significant drop in reported heart problems. In India, reported cases have dropped by upto 50%. Although doctors have suggested several possibilities, fear of approaching hospitals has been a consistent reason. There has been a corresponding increase in deaths at home due to heart problems. People are postponing treatment or ignoring minor discomfort that they would ordinarily report. When it comes to cancer patients, there has been a significant impact of discovered and new cancer patients.
Very few new cancer cases have been registered. According to Ravi Mehrotra (Chief Executive Officer, India Cancer Research Consortium, New Delhi) suggested that “They are also scared of acquiring the infection in hospitals, not realising that cancer spread and the resultant poorer prognosis may be far more dangerous”2. Many hospitals have established protocols and maintained resources (at a lower capacity) for treatment for cancer, however, fear prevents people from seeking help.
With the pandemic showing no signs of abating, till when will people avoid reporting medical problems? In a time where hundreds are dying because of Covid-19, how do we ensure that we don’t unnecessarily harm non-covid patients as well?
The hospital developed a solution. Tele-consultations have started by many hospitals to make healthcare advice safer. Hospitals have been using audio and video calls to consult in the case of minor issues and follow-ups. This decongested hospitals and also made it safer for people to consult doctors. However, doctors have suggested that it is difficult to treat new patients in this way. Internet requirements are sparse for several people and in parts of the country. Further, several disorders need regular clinical check-ups. This was also tied to data safety and privacy issues. This method is by no means a replacement for hospital visits.
Ignorant people may flock to hospitals as before when government restrictions are lifted. Will hospitals be able to manage the inflow of patients? If hospitals cannot manage non-covid patients, how should this be dealt with? Even if they could manage the patients, how do healthcare institutes assure patients that it is safe for them to visit hospitals.
Reports suggest that the best course of action may be that all cases go through telemedicine for the next few months. Only if cases require in person consultation, should patients be asked to come to hospitals with a proper health advisory. It is also important for hospitals to make sure their doctors are well trained to control the infection and assure the population of the same. This will be extremely critical for proper healthcare practices to take place in the next few months.
The healthcare system in India has risen to the challenge of fighting an unprecedented situation with remarkable fortitude. Policy makers need to think about how it can be helped in managing the inevitable fallout. Many are dying due to the virus. We can’t have many more deaths that could have easily been prevented.
By - Josika Mahindru Graphic by - Yastika Shetty
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