Covid’s ‘other’ victims. It’s ‘trading one health crisis for another’

If the situation is tough for Covid-19 patients, it’s just as bad for those with other illnesses/diseases.

At one end, hospitals are channelling almost all their resources into Covid treatment. At the other end is the fear among the people that they might get exposed to Covid if they go to a healthcare facility for some other treatment.

Impacted by Covid one way or the other, people fighting cancer, tuberculosis, thalassemia, kidney diseases, diabetes, hypertension, etc., are finding it arduous to get themselves tested and treated.

In the last six months, 12 letters have been sent to seven top government representatives requesting that testing and treatment for Hepatitis C and HIV patients be resumed, said Loon Gangte of the Delhi Network of Positive People.

“For new patients, testing is important to start treatment. Half the year is over and we have received no response from the authorities. Don’t treat us like second class citizens. We are not saying don’t treat Covid, but treat other illnesses too,” he added.

Many hospitals have closed their outpatient departments (OPD) fearing that a patient could walk in with the virus, resulting in a shutdown and quarantine of doctors, nurses and other staff.

Limited options

Some facilities are tentatively opening their doors to non-Covid services, but BusinessLine correspondents found that patients and their families still have limited options — be it a child or a senior citizen needing physiotherapy or surgery.

A doctor in Mangaluru, for instance, recounted instances of deteriorating patient-health and deaths due to delay in accessing treatment for non-Covid issues. Another from Gujarat said fear and income loss kept people away from hospitals.

In Chennai, large hospitals did keep their dialysis units open, but many patients deferred treatment for fear of Covid infection. There were also some who found it difficult to find a hospital for dialysis.

Immunisation disruptions

“We cannot trade one health crisis for another,” Unicef Executive Director Henrietta Fore said recently as the agency, along with the WHO, warned of disruptions in immunisation programmes. “Covid-19 has made previously routine vaccination a daunting challenge,” she said, urging a resumption in vaccine programmes before children’s lives were threatened by other diseases.

Leena Menghaney with the Médecins Sans Frontières explained that diseases dependent on the public health system for delivery of treatment — such as TB, malaria and viral hepatitis — saw the most sufferers. HIV and hepatitis require frequent examination of viral load for deciding on the treatment, but equipment and manpower used for this were mostly diverted for Covid testing, said Menghaney.

“One can understand the need for doing so in the initial days of the Covid crisis, but government(s) never felt the need for augmenting the public healthcare system subsequently so that patients suffering other diseases did not suffer.

Similarly, with the bednet scheme temporarily stopped due to Covid, the incidence of malaria (and also snakebites) is expected to go up in most malaria-infected regions in the country,” she added.

Drastic decline

The numbers confirm the fears. Max Healthcare reported a drastic fall year-on-year in the number of patients admitted at its Delhi-NCR hospitals for non-Covid conditions between March and May 2020.

The fall has been particularly steep in specialties such as orthopaedics, cardiology, oncology, neurosciences, paediatrics and nephrology departments.

Orthopaedics saw the steepest fall of 64 per cent in these months, followed by cardiac department (including cardiac medicine and surgery), at 63 per cent.

The number of patients admitted for kidney-related procedures (including urology and nephrology) fell 55 per cent. Neurosciences (including neurology, neuro-surgeries and spine surgeries) saw a decline of 50 per cent, oncology (including medical oncology and onco-surgery) 49 per cent, and paediatrics 43 per cent.

Pointing to the large-scale disruption, Harit Chaturvedi, Chairman, Max Institute of Cancer Care, said: “Several major diseases have lost their pre-eminent position in the fear of this pandemic. Not only data from our hospitals but supporting data from the NHS of the UK suggest that referrals in cancer alone have dipped by 70 per cent during this pandemic.”

With inputs from AJ Vinayak, Narayanan V, Anil Urs, Rutam Vora, Abhishek Law, TV Jayan and Maitri Porecha

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