COVID-19 infected patients with comorbidities, especially renal issues and cancer who need specialised care, are finding it hard to get admission in hospitals as not all have the required facility to treat them.
With only a few government hospitals having dialysis facilities for COVID-19 patients, triaging of positive renal patients has become difficult, say BBMP staff involved in triaging patients.
Although most private hospitals now have a few dialysis machines set aside for COVID-19 patients, only a fraction of them are available under the government quota. People who cannot afford private treatment are forced to wait till they get admitted under government quota.
“While it is a big challenge to get admission for a patient who needs dialysis, it is even more difficult to triage a positive patient who needs both dialysis and an ICU bed as very few hospitals have both. Recently, we struggled to get admission for a 75-year-old male patient, who was brought from Hassan to Bengaluru for treatment. He required dialysis and ventilator and he had Hepatitis B. Although we managed to admit him in St. Martha’s Hospital, he did not survive,” said Tauseef Ahmed, a volunteer from Emergency Response Team (ERT), a group working in coordination with the BBMP and 108 in triaging patients. Mr. Ahmed said it is all the more difficult in case of cancer patients as Kidwai Memorial Institute of Oncology is the only government cancer hospital. “Some private hospitals that have oncology facilities refuse to take patients if there are complications,” he said, adding that there is no clarity on which hospitals have nephrology and oncology services available.
A senior doctor from Kidwai said surgeries and other procedures, including chemotherapy and radiotherapy in positive patients, are being put off till they test negative.
“Cancer surgeries are long duration ones and in any surgery there is a need to insert an endotracheal tube through the mouth into the trachea (windpipe) to help the patient breathe. This is risky and anaesthetists refuse to intubate a positive patient. With around 70 of our staff members, including the director, getting infected, we have made it a rule to wait till the patient tests negative,” said the doctor.
Admitting that this was delaying timely treatment to cancer patients, the doctor said: “We are attending to all emergencies, including surgical. The out-patient department is fully functioning and the number of patients walking in have increased after the lockdown eased.”
Sudarshan Ballal, chairman of Manipal Hospitals, said that although there was a problem initially, most large hospitals have dialysis facilities now. “Dialysis units are the lifeline of renal patients. It is important that they do not miss their regular dialysis,” he said. “COVID-19 patients with pre-existing kidney disease are a vulnerable group and it is risky for them if dialysis is delayed,” he said.
R. Ravindra, president of Private Hospitals and Nursing Homes Association, said some hospitals have reserved dialysis beds for government patients. “The government has agreed to pay us extra for dialysis of COVID-19 patients referred by the government. We have told our member hospitals to not refuse any dialysis patient,” he said.
