Equal treatment for all, even in Covid-19 times

Preparing for a pandemic requires perspective and balance, especially in a country where healthcare infrastructure is woefully inadequate, with just 0.7 hospital beds and 0.8 doctors per 1,000 persons. With outpatient departments of all public hospitals having been shut either due to the lockdown, or because of their being turned into Covid-19 designated centres, patients with other critical ailments have been abruptly discharged or asked to reschedule their treatment, with fatal consequences in some cases. At the same time, India’s famed private sector, that accounts for an important share of existing health facilities — and significantly, 70 per cent of the overall healthcare expenditure — has been functioning at less than half strength. At Delhi’s Lok Nayak Jaiprakash Narayan (LNJP) hospital, a 40-year-old woman on dialysis was abruptly discharged without any alternative arrangement last week, because the hospital was turned into a Covid-19 facility. She died the next day after having been refused treatment by two other hospitals. Around 50 cancer patients from King Edward Memorial (KEM) hospital in Mumbai were reportedly shifted by the Brihanmumbai Municipal Corporation (BMC) under the Hindmata flyover to avoid overcrowding at the hospital. Patients at the Delhi State Cancer Institute were abruptly discharged last week as the Institute was temporarily shut because some staff members tested positive for Covid-19.

It would be instructive in this context to understand that for the 308 deaths and 7,987 active Covid-19 cases as on Monday, there are a staggering 4,000 daily deaths in India because of Ischemic Heart Diseases. Chronic obstructive pulmonary diseases (COPDs) kill over 2,600 people, cancer kills about 2,200 indians and nearly 2,000 die of diarrhoea and 1,200 from tuberculosis every day in India. It is established now that swine flu (H1N1), another strain of influenza virus that caused panic a decade ago, has become endemic to India and has claimed about 1,000 lives annually over the last four years, infecting over 15,000 people on an average per year. In fact in 2017, a staggering 38,811 people were infected by H1N1 and 2,270 people died.

These figures depict the consequences of abandoning patients other than those suffering from Covid-19. There are certain good practices being developed in the All India Institute of Medical Sciences (AIIMS) that can be replicated. While the OPD in AIIMS is shut and students in the Institute have volunteered to inform patients with appointments about changes in schedule, the emergency and casualty services are still running and in-house patients are being routinely treated. Different departments have started their telemedicine facilities and the doctors on call respond to patients’ queries online. At the same time, the trauma centre, its adjoining building, along with the Institute’s cancer facility at Jhajjar have been turned into Covid-19 facilities. While India cannot afford to be complacent about the pandemic, a rational approach is urgently required. Essential health services need to be maintained even as preparations are made to deal with Covid-19.

COMMENT NOW