New Delhi: Doctors in government hospitals in the national capital are calling for curbs on outpatient department (OPD) services in a bid to check the surging number of infections among healthcare staff.
Delhi has seen an exponential rise in daily Covid-19 cases over the last week. On Sunday, the city reported 22,751 cases, with a positivity rate of 23.53 per cent. The caseload was 12 per cent higher than Saturday’s number (20,181).
Cases among healthcare staff such as doctors, nurses and other members have shot up proportionally, several doctors told ThePrint. At least 750 doctors and hundreds of nurses and paramedic staff are infected currently at six major hospitals in the city, reported the Indian Express.
“It has not been even a week since cases started to really ramp up in Delhi and half of my department is already positive,” said Dr Aastha Kumari, senior resident in anaesthesia and critical care department, Safdarjung Hospital.
According to the doctors, the explosion of infections is due to patients arriving in the OPD as well as the emergency section while having mild or no symptoms. This has exponentially raised the virus exposure in the hospitals. As a result, they now want the government to at least shut down non-life-threatening surgeries for the time being.
“We have requested for elective OPDs and non-essential services like patients with a hernia, appendix and other routine diseases to be curtailed for a period of time as doctors have to attend various such patients which usually have mild symptoms or are asymptomatic leading to multiple exposures and then they meet their colleagues in other departments causing exponential rise in cases,” Kumari said.
“We are observing this with the 3rd wave that many patients coming in regular OPDs and OTs (operation theatres) are coming RAT or RT-PCR positive. The OPD timings have been cut down at least for now and we expect the same of OTs,” she said.
“Especially in government hospitals, people come in huge numbers from far off states like Bihar or Odisha, thereby they are also getting various exposure in their due course of travel and at the same time also infecting a large number of people if they are positive with mild symptoms or asymptomatic,” she added.
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Worsening situation
Around 60 doctors and seven nurses had tested positive in Safdarjung as of 7 January, ThePrint reported earlier. Latest reports say this number has jumped to nearly 200 resident doctors.
The situation is equally bad in another major government hospital, the All India Institute of Medical Sciences (AIIMS), wherein close to 350 doctors are reported to be infected.
“Initially, the doctors from elective OPDs such as ENT got infected from the virus through patients arriving in large numbers with mild symptoms… However, this rapidly spread to other departments as well from thereon,” said Dr Rohit Raman Pandey from Safdarjung Hospital, who has tested positive for the virus.
Both the junior as well as senior doctors of the hospital have strongly urged the authorities to shut down non-emergency OPDs and OTs for a few days so that the rest of the staff can be allocated for critical Covid care duties, a junior resident doctor from the hospital said on condition of anonymity.
“Despite curtailing the OPD timings there are still a lot of cases coming in OPDs with their attendants, with the majority of people having mild or no symptoms despite carrying the virus and then infecting everyone from their home to hospital. This leads to not just higher cases among doctors but is also pushing the overall figure,” the junior doctor added.
According to Dr Manish Jangra, founder of the Federation of All India Medical Association (FAIMA) and spokesperson of Resident Doctors’ Association (RDA), Ram Manohar Lohia Hospital, there is an issue because there is no mandatory Covid testing of patients coming into government hospital OPDs.
“If a patient comes for a knee problem and is a mild or symptomatic one as in the majority of cases in the current wave, how will we know that he is carrying the virus? Due to the huge patient load in government hospitals, doctors are repeatedly getting exposed to the virus and are getting infected with it,” said Jangra.
“If this continues, it will create a severe staff shortage in hospitals. Therefore non-emergency services must be shut down for a few days,” he added.
The situation is equally grim in state government-run hospitals in Delhi.
“We have asked the government to at least shut the OPDs and non-life-threatening operations like cataract surgery or knee surgery to avoid staff crunch in hospitals and massive numbers of healthcare workers getting down from Covid,” said FAIMA president Dr Rohan Krishnan.
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Private hospitals hit too
Even the private hospitals are witnessing a similar trend of sizable numbers of non-Covid patients coming in for a treatment or regular check-up and testing positive for the infection.
“We are also detecting Covid in patients who are coming for surgery or for angiography and prior to surgery as we are testing them as per routine we find them to be positive. We don’t have any percentage yet but definitely, it’s quite high,” said Dr Ashutosh Shukla, senior director, internal medicine and medical advisor, Max Hospital, Gurugram.
“This strain is highly infectious… Most of these patients are asymptomatic carriers. Such cases are being identified after routine testing and it’s increasing daily as we are in community spread now,” he added.
“Apart from Covid patients, as per standard procedure we do RT-PCR testing of every other patient before surgeries and from that, there are also sizable patients coming positive. Out of total Covid cases getting detected, these patients are at least 30 per cent and increasing,” said Dr B. Vijay Kumar, a consultant physician at Yashoda Super Speciality Hospital.
“Three things will save us: Covid-appropriate behaviour, testing and vaccination. If we look at South Africa data, maximum patients were below 20 years who were not vaccinated… rapid vaccination with booster doses should be ramped up to cover as many people as possible,” he added.
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