About 20 people are hospitalised every day in the city for showing symptoms of H1N1 infection. While the number is not alarming, officials say most of them are cases of unnecessary hospitalisation owing to growing anxiety among patients and profit-making mentality of doctors.
Last week, a 20-year-old woman from Santacruz approached a doctor after contracting high fever and suffering a sore throat. The doctor before starting her medication advised her to undergo a test. He told the patient that medication for treating the H1N1 infection cannot be prescribed without a positive report. The woman’s mother who also contracted the infection said that the doctor then directed them to a posh Andheri hospital. He claimed that no other private hospital would admit H1N1 patients. The mother said, “In panic, we blindly believed the doctor. We spent close to ₹70,000 over three days for my daughter’s hospitalisation. While my daughter has now been discharged, she continues to be under treatment.”
The case highlights how several city doctors set aside protocols set for H1N1 diagnosis and treatment to fleece patients. Dr. Padmaja Keskar, Brihanmumbai Municipal Corporation’s executive health officer, says all public and private doctors are regularly briefed about the guidelines on H1NI treatment. Dr. Keskar said, “The patients can be identified as Category A, B and C. The government has provided detailed guidelines to categorise patients.” She added, “About 15 to 20 people are admitted for H1N1 treatment in public and private hospitals in the city. Dr Keskar said compared with previous outbreaks of the disease, the present numbers of patients is not alarming.
The symptoms of H1N1 are similar to the symptoms of seasonal viral fevers and this poses a problem. “A doctor with a few years of practice will know how to identify and differentiate between the symptoms,” said a doctor from South Mumbai. He added that according to guidelines, patients can be put on an antiviral medication immediately if they show severe symptoms of H1N1 or do not respond to the first line of treatment. He said, “But the ground reality is that some doctors take advantage of the patient’s anxiety.”
So far this year, H1N1 has claimed the lives of 254 people and infected 1,450 patients in Maharashtra. Mumbai has reported seven deaths and 200 cases. “Generally, 1% of all influenza cases require hospitalisation, but unnecessary testing may be taking place,” said Dr. Pradeep Awate, the State’s epidemiology officer. He said in many cases patients insist on getting tested or hospitalised.
H1N1 protocol:
Criteria A patients
Mild fever, sore throat with or without body ache, diarrhoea, vomiting
Should be monitored for 24-48 hours
Bed rest and hydration
Home isolation
Symptomatic treatment
Oseltamivir only to be prescribed if there are cases of H1N1 coming from the locality of residence
No testing required
Criteria B patients
High grade fever, severe sore throat, body ache, diarrhoea
Oseltamivir to be prescribed immediately
Home isolation
Bed rest and hydration
High risk patients like minors, pregnant women, senior citizens and those with co-morbid conditions come under this category
No testing required
Criteria C patients
High grade fever, cough, sore throat, body ache, breathlessness
These are patients who have symptoms for long time but have not got right treatment or see a doctor late
High risk patients from CAT B
Oseltamivir to be prescribed immediately
Hospitalisation needed
Testing can be done but doctors should not wait for results
