Doctors at Delhi’s Lok Nayak hospital, where six patients infected with the coronavirus disease (Covid-19) are admitted, have asked the hospital to form a separate block that would include all wards and diagnostics related to the Covid-19 treatment, so that other patients visiting the hospital are safeguarded from any possible exposure to the virus.
They have also demanded discontinuation of general out-patient clinics and diagnostic services.
“We suggest that such isolation or quarantine can be done in one block like the entire MAIDS (Maulana Azad Institute of Dental Sciences), new medicine block or the entire orthopaedics block, and these should be declared as corona-treating units with different floors managing various categories of patients,” the teacher’s association of the Maulana Azad Medical College that is linked to the Lok Nayak hospital said in a letter dated March 23.
The Lok Nayak hospital near Delhi Gate has a 34-bed isolation ward for suspected patients and 11 isolated rooms for Covid-19 positive patients. It is one of the 27 hospitals with isolation facilities in the national capital.
Till now, people who are suspected Covid-19 patients are first triaged (order and site of treatment is decided) on the ground floor of the hospital’s emergency building and then moved to the Covid-19 isolation ward on the sixth floor of the same building.
Often, patients being diagnosed or treated for Covid-19 have to be taken through the out-patient clinics and the pharmacy department to the X-ray unit in another building, which is common for general patients as well.
Such movements of Covid-19 patients, doctors say, could expose others to the high-contagious infection.
If the test is positive, the confirmed patient is shifted to an isolation room in another block across a third building in the campus. For this too, the Covid-19 patient has to cross out-patient clinics as well as the in-patient wards, according to doctors. Similarly, for using a ventilator, a Covid-19 patient will have to be brought back to the emergency building.
“Moving Covid-19 patients from building to building will put the general patients at risk,” a senior doctor from the hospital said on condition of anonymity.
Another ward being prepared by the hospital to treat more Covid-19 patients is in the orthopaedic block, which will be located in a fourth building.
While the 2000-bed hospital has cut OPD registration timings by two hours, the clinics continue to function. The hospital has also stopped all elective non-emergency surgeries to reduce the crowd.
“Yes, the facilities are fragmented, there is no doubt about that. But the government of India has declared us a Covid-19 hospital and we are doing the best with what we have. We are taking every precaution to ensure that the infection is controlled. We have cut down the OPD, but I am not willing to shut it completely because where will the poor patients go otherwise? We are also reminding people to maintain distance and wash their hands before touching their eyes, nose, or mouth regularly through announcements,” said Dr Kishore Singh, medical director of the Lok Nayak hospital.
Apart from the fragmented facilities, the doctors are also concerned about personal protective equipment (PPE) being provided to health care workers. “There is a shortage of PPE in the hospital. The doctors working in these isolation wards were not being given PPE and the supply that has now come have stitches coming loose and pores in the fabric. We are knowingly subjecting our people to the infection,” the doctor cited above said.
Experts agree that a single facility dedicated to treating infected patients is better than the piecemeal approach.
“Of course, moving the patient around across the hospital increases the chances of them giving the infection to others in the hospital. To effectively manage the Covid-19 patients, either the hospitals should discharge their other patients or use vacant facilities – like AIIMS will be using its Jhajjar cancer centre that is not yet fully operational – to treat Covid-19 patients,” said Dr MC Mishra, former director of All India Institute of Medical Sciences (AIIMS), New Delhi.