With patients testing positive for Covid-19, more hospitals could close down completely
If hospitals close down, more patients will be deprived of medical services and the country’s health infrastructure will come under more stress, doctors warn. Hemanta Shrestha/TKP
The detection of Covid-19 in patients admitted to hospital for other forms of treatment has led to a swift closure of those health facilities, putting the burden on other hospitals and placing the country’s health infrastructure under more stress.
Patients admitted to at least five hospitals—four public and one private—have tested positive for Covid-19, leading to the closure of the entire hospital or some of their departments.
“If we keep shutting down hospitals after the detection of Covid-19 cases, other patients could die without getting minor treatments,” Dr Sher Bahadur Pun, a virologist at the Sukraraj Tropical and Infectious Disease Hospital in Teku, told the Post.
Dhulikhel Hospital in Kavrepalanchok and Crimson Hospital in Rupandehi have both been sealed completely following the deaths of patients—a 29 year-old new mother and a 41-year-old man admitted to those hospitals, respectively.
The out-patient department of Hetauda Hospital and the neurosurgical ward of the Tribhuvan University Teaching Hospital have both been shut since patients tested positive for Covid-19.
Health workers and other staffers from the Manmohan Cardiothoracic Vascular and Transplant Centre and Grande International Hospital have also been quarantined after coming in close contact with infected patients.
According to Pun, the Health Ministry should make the conditions clear under which hospitals should be sealed and precautionary measures to follow if patients test positive for the coronavirus.
"Otherwise, all hospitals will get sealed one after another, and quarantine facilities will be filled with health workers," he said.
Most health facilities across the country have stopped providing a full range of services ever since the lockdown was enforced two months ago. Thousands of patients have been deprived of health care since then.
Dr Roshan Pokhrel, chief specialist at the Health Ministry, said that non-Covid-19 hospitals should perform at least rapid diagnostic tests before admitting patients and conduct polymerase chain reaction tests for those having symptoms of Covid-19.
"It will be costly, but the risk will increase if those tests aren’t performed," Pokhrel said.
But according to Dr Santa Kumar Das, coordinator of the Covid-19 management team at the Tribhuvan University Teaching Hospital, performing tests on patients before admitting them is not practical, as both rapid diagnostic and polymerase chain reaction tests cost a lot of money and take up time.
"Rapid diagnostic tests show the presence of antibodies only after 10 days or more of infection and have lower efficacy rates," Das told the Post. "Polymerase chain reaction tests too aren’t 100 percent accurate, and they take a lot of time."
Doctors serving in non-Covid-19 hospitals could look after patients by putting on personal protective equipment, as most coronavirus patients are asymptomatic and any one could be infected, said Das.
But many hospitals across the country lack full sets of personal protective equipment (PPE), leading them to remain shuttered and only offer emergency services.
“PPEs are costly and not easily available in the market,” said Kumar Thapa, chairperson of Alka Hospital in Jawalakhel. “Some private hospitals have bought them from China, but the government did not even provide them with a tax waiver.”
The Health Ministry has directed hospitals to resume all services, including out-patient services, but only a few hospitals currently provide the full range of services, as most lack PPE.
Dr Bikash Devkota, spokesperson for the Health Ministry, conceded that a lot of patients are being deprived of treatment, and more could suffer if hospitals continue to close at the same rate.
"We are working on new guidelines that will help health facilities take precautionary measures before admitting patients, and what to do if admitted patients test positive," said Devkota.
Doctors believe that no one should be deprived of medical treatment because of the Covid-19 pandemic and that hospitals must work to ensure that patients receive the care they are entitled to.
“Health facilities should continue with their services by applying safety measures,” said Dr Chakra Raj Pandey, director at Grande International Hospital. “If patients test positive for Covid-19, respective wards or units should be brought into operation after disinfecting them."
As of Sunday, 603 people from 42 districts had tested positive for Covid-19. Three deaths have been linked to the coronavirus.
Frequently asked questions about the coronavirus outbreak
UPDATED as of September 22, 2020
What is Covid-19? Covid-19, short for coronavirus disease, is an illness caused by the coronavirus SARS-CoV-2, short for severe acute respiratory syndrome coronavirus 2. Common symptoms of the disease include fever, dry cough, fatigue, shortness of breath and breathing difficulties. In severe cases, the infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
How contagious is Covid-19? Covid-19 can spread easily from person to person, especially in enclosed spaces. The virus can travel through the air in respiratory droplets produced when a sick person breathes, talks, coughs or sneezes. As the virus can also survive on plastic and steel surfaces for up to 72 hours and on cardboard for up to 24 hours, any contact with such surfaces can also spread the virus. Symptoms take between two to 14 days to appear, during which time the carrier is believed to be contagious.
Where did the virus come from? The virus was first identified in Wuhan, China in late December. The coronavirus is a large family of viruses that is responsible for everything from the common cold to Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). After an initial outbreak in Wuhan that spread across Hubei province, eventually infecting over 80,000 and killing more than 3,000, new infection rates in mainland China have dropped. However, the disease has since spread across the world at an alarming rate.
What is the current status of Covid-19?
The World Health Organisation has called the ongoing outbreak a “pandemic” and urged countries across the world to take precautionary measures. Covid-19 has spread to 213 countries and territoriesaround the world and infected more than 31,405,983 people with 967,505 deaths and 22,990,260 recoveries. In South Asia, India has reported the highest number of infections at 5,557,573 with 88,943 deaths. While Pakistan has reported 306,304 confirmed cases with 6,420 deaths. Nepal has so far reported 65,276 cases with 427 deaths.
How dangerous is the disease?
The mortality rate for Covid-19 is estimated to be 3.6 percent, but new studies have put the rate slightly higher at 5.7 percent. Although Covid-19 is not too dangerous to young healthy people, older individuals and those with immune-compromised systems are at greater risk of death. People with chronic medical conditions like heart disease, diabetes and lung disease, or those who’ve recently undergone serious medical procedures, are also at risk.
How do I keep myself safe? The WHO advises that the most important thing you can do is wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizers with at least 60 percent alcohol content. Avoid touching your eyes, nose and mouth with unclean hands. Clean and disinfect frequently used surfaces like your computers and phones. Avoid large crowds of people. Seek medical attention if symptoms persist for longer than a few days.
Is it time to panic?
No. The government has imposed a lockdown to limit the spread of the virus. There is no need to begin stockpiling food, cooking gas or hand sanitizers. However, it is always prudent to take sensible precautions like the ones identified above.
Arjun Poudel is a health reporter for The Kathmandu Post. Before joining the Post, he worked for Sagarmatha Television, Naya Patrika, Republica and The Himalayan Times.
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