Emergency, asymptomatic mortality on a high: Hospitals continue shunning admissions
Multiple reports of deaths on a rise, due to hospitals— be it private or public, denying admissions, across India have surfaced recently. The recent case of the DU professor, Wali Akhtar’s death after being denied admission by 6 hospitals, has made heads turn. Wali who fell sick on June 2, had been hunting for hospitals since June 6, that came to an end on the evening of June 9, when two hours after his Covid-19 test was taken, the professor passed away. It was only two days later that his result came back positive.
Of lives that could have survived
Families of the deceased are seen left with a lifetime of regret, wherein lives that could’ve been saved or attended on time, to avoid the apathy over death. Kinara Lakshmi (27), from Chinna Salem, a town in Tamil Nadu, recalls the tragic death of Dhanalakshmi, her 82-year-old grandmother back in April. “We took her in an ambulance, providing her with oxygen, throughout the journey of over a 3 hour drive from Chinna Salem to Chennai, starting at 10pm.
As she had comorbidities of high sugar levels and blood pressure, the doctor had asked us to not feed her anything, hoping that she would be attended immediately once we reach Chennai,” she said with reference from a private hospital in Chinna Salem, who did not admit Dhanalakshmi either, but made necessary arrangements for the family due to personal rapport.
According to Kinara, her grandmother was brought to Chennai’s St. Isabel hospital at wee hours, where she was regularly attended to over the past few months. The family was shocked, when the hospital bluntly refused to admit Dhanalakshmi, even after showing the necessary medical documents. The family even made several requests to the hospital authorities, to at least attend to her first aid needs, while they found an alternative. To their vain, the hospital denied.
The panic situation made the family rush to Chennai’s SRM Hospital, Peranglathur, after they came across an advertisement that promised to attend to patients under any circumstances. “Before even we could explain, the security guard denied entry. Not even doctors, but only the admin incharge came out and said they can’t help us,” Kinara adds.
Followed by the 3 attempts of running from pole to post, it was the Hindu Mission Hospital, Tambaram, a private one, that admitted her and after 10 long days of providing her treatment, Dhanalakshmi, who was also a heart patient and with consistent increase in sugar levels, succumbed to death on April 1. “We were thankful that at least this hospital had the mercy to admit her. Even though we lost her, we can never forget the scenes that led to her death, which could’ve been avoided if she had been attended a little earlier,” Kinara regretted.
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Several such reports in recent times, have left the citizens on lurch and question the hospitals that outrightly deny admissions. According to a Times of India report, yet another case of shocking medical apathy in Dehradun came to light, where 24-year-old Sudha Saini, a pregnant woman lost her life, just 2 days after giving birth to twins, as she was refused admission by several hospitals suspecting her to be infected with COVID-19. Sudha, in her seventh month of pregnancy, who had developed some complications after the delivery was finally admitted to a fifth hospital after a local MLA’s intervention, but passed away on June 11.
In Kerala, a case was registered on June 4, against a Government Medical College and two private hospitals, for allegedly denying admission to a 62-year-old man who died after being turned away by the 3 hospitals, police said.
Rajkumar Puri, an autorickshaw driver, who roamed the entire day in Bengaluru on April 9 and in the early hours of April 10 with his 28-year-old pregnant wife Gayatri, lost her the very day, after 7 public and private hospitals in the city denied her admission for varied reasons. Following her death, Puri, who came to Bengaluru in search of a better life, left for his village in Bilaspur mid-April, with his two young children.
With lack of humanity or on grounds of certain ‘protocols’ sighted by the hospitals, accountability of deaths due to such emergency cases remains to be a big question. Rising asymptomatic cases and hospitals shunning them away with priority cases, is another threat of the hour.
Non-admission of asymptomatic, another deadly threat in the making
The World Health Organization (WHO) on June 9, attempted to clarify comments made within a time frame of just 24 hours, that transmission of the novel coronavirus in asymptomatic carriers happened in “very rare” cases.
The WHO currently estimates that 16% of people with COVID-19 are asymptomatic and can transmit the coronavirus, while other data show that 40% of coronavirus transmission is due to carriers not displaying any apparent symptoms of the illness.
According to a study by researchers at the University of California, asymptomatic transmission “is the Achilles’ heel of COVID-19 pandemic control through the public-health strategies we have currently deployed,” San Francisco published May 28 in the New England Journal of Medicine.
According to the Indian Council of Medical Research (ICMR), a Covid patient can be certified as recovered only after testing negative twice. However, with the overflow of positive cases, many states in India have opted for keeping asymptomatic cases in home quarantine.
Asymptomatic: people who are infected but never go on to develop symptoms— World Health Organization (WHO) (@WHO) June 9, 2020
Pre-symptomatic: people who are infected but have not yet developed symptoms
Symptomatic: people who are infected and showing symptoms#COVID19 #coronavirus
Learn more ⬇️ https://t.co/5p2gW5g07q
Jammu & Kashmir is one such example, where hospitals are ‘overburdened’ and the doctors in Jammu and Kashmir want the administration to change its policy as soon as possible, by keeping asymptomatic patients in home quarantine. Recently in Tamil Nadu’s Chennai, which has been bubbling with over 30,000 total positive cases till date, the Greater Chennai Corporation (GCC) Commissioner G Prakash instructed a 14-day mandatory home quarantine for all those who underwent Covid-19 tests in the city, along with their entire family— later clarified as a ‘precautionary announcement with a good intention’ by J Radhakrishnan, the new Health Secretary of the State.
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Govt issues warning, no change on ground
Back in April, the Delhi government had ordered private hospitals and nursing homes in the city to not deny treatment to non COVID-19 patients. The order issued a stern warning that flouting of the directives will invite severe actions, including cancellation of license. This order came from the health department, after reports of some private hospitals denying critical services like dialysis, blood transfusion and chemotherapy on account of contracting COVID-19.
Around the same time, the Centre had directed medical facilities, especially the private hospitals in all states to ensure that they do not insist on a Covid-19 test before routine procedures. ICMR rulebook says that only asymptomatic health workers who have been exposed, asymptomatic direct contacts of laboratory confirmed cases and asymptomatic expectant mothers who are nearing delivery dates can be tested. No other asymptomatic patient can be tested.
The Modi government has recently warned all Central Government Health Scheme (CGHS) hospitals, against denying treatment to beneficiaries during the Covid-19 pandemic, violation of which will lead to suitable action being taken. Post which, CGHS in its June 9 order, issued guidelines to all its healthcare organisations for the same and also said that patients will be charged according to the CGHS norms. In another order issued on June 10, CGHS also said that all wellness centres run by the CGHS must start “fever clinics”–clinics that one can access when they have a fever, which is one of the key symptoms of Covid-19.
With several such orders and guidelines in place, the reality on ground still remains to be unchanged. With India standing at number 4 on the global Corona meter, the country’s key challenge is to control its mortality rate, at the same time keep an eye on the incoming battles of asymptomatic transmission of Coronavirus, which appears to be worse than the SARS or influenza spread.