19 June,2020 07:00 AM IST | Mumbai | Prajakta Kasale
Civic staff on their way to conduct COVID-19 check-ups, at Hill Road, Bandra West, on Thursday. Pic/ Pradeep dhivar
The city's private hospitals are now in a fix over a circular issued by BMC Commissioner Iqbal Singh Chahal. It mentions that hospitals and nursing homes will not be able to directly admit suspected or positive COVID-19 patients before informing the local ward war room, but offers no clarity on issuing permissions. Calling the circular vague, doctors have asked as to who would be responsible for the patients' lives in such a scenario.
The circular (dated June 15) comes days after the civic chief directed private labs to send COVID-19 test reports only to the BMC and not share it with patients. Even after a month of the civic body starting a real-time dashboard and ward-level war rooms for better management, the issue of non-availability of beds for COVID-19 patients remains unresolved.
The current circular mentions that if beds are not available in private hospitals or allotment takes time through the local ward war room, then the doctors should first stabilise the patients. It also says that asymptomatic patients should have a COVID-19 positive report when they approach a private hospital or nursing home for admission. The BMC has strictly asked hospitals not to admit walk-in COVID-19 patients. Also, in cases of urgent transfer of patients from one private hospital to another, the authorities should inform the ward war room.
The move comes in the light of allegations against private hospitals for admitting asymptomatic patients who panic on being informed by private labs that they are COVID-19 positive. A civic official said that the circular was issued because asymptomatic positive patients were occupying all the COVID beds in private hospitals, which was against the ICMR guidelines.
"In many cases, labs inform patients about their test results even before sending the reports to BMC. These patients pay money and occupy beds, which are reserved for symptomatic patients. Even hospitals earn by just providing quarantine facilities without any treatment," said a senior BMC official.
Pointing out a number of issues with the circular, Dr Deepak Baid, president of Association of Medical Consultants, said, "When you are issuing a circular which is directly connected to a life-and-death situation, it has to be clear. There are a couple of issues with the circular, which we have pointed out, but no one seems to be in a mood for a clarification."
Dr Nilima Vaidya Bhamre said, "What will happen if hospitals refuse to take in symptomatic suspected patients as the person will not have a positive report? As per the World Health Organisation, there is 38 per cent possibility that a patient will be COVID-19 positive despite having a negative report. In such cases, clinical diagnosis through CT-scan gives a better idea. Who will take responsibility for the lives of such patients if their condition deteriorates?"
"While the circular mentions that asymptomatic patients without co-morbidities should not be allotted beds, it does not mention anything about senior citizens without co-morbidities. These patients need care," added Dr Baid. He further said, "If the local authority wants to check wrong practices then it should be done in a particular manner. Such kind of circulars are demoralising for doctors who genuinely make efforts to treat patients."
Prabhakar Shinde, group leader of BJP in BMC, said, "While the circular has been issued in good intention to free up beds occupied by asymptomatic patients, it should not harm the needy ones. We have already asked for a clarification of the circular from the BMC." Meanwhile, the civic body has also warned private hospitals to not inform patients about their test results. "The BMC has asked private labs to clear all reports within 24 hours, so that there is no delay in informing the patients or providing them the required treatment," said a BMC official.
A doctor from a nursing home said, "It's a good move to not inform patients quarantining at home about their test results directly, but what about those who are already admitted in hospitals for surgeries and other treatment. Even they have to undergo COVID-19 tests. They are already there in the hospitals, so how can the hospitals take undue advantage?"
Speaking to mid-day, municipal commissioner Iqbal Singh Chahal said, "Most of the COVID beds in major private hospitals are occupied by asymptomatic patients. The BMC strictly wants to safeguard the interest of positive patients who need urgent care."
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