Concerns over virus prompt doctors to apply for leaveGovernment directive to hospitals with more than 100 beds to not refer cases has made health workers wary, administrators say.
On Saturday, over 20 staffers, including nurses and doctors, serving at Sumeru Hospital, Lalitpur, applied for leave. This startled the hospital management.
"The number of staffers applying for leave has been rising by the day,” Hemraj Dahal, the hospital’s chairman, told the Post. “It’s not difficult to guess the reason. Health workers fear that the coronavirus could spread.”
Dahal said he is extremely concerned as staffers could tender their resignation if they are denied leave. “We have no option but to approve their [health workers’] leave requests,” he said.
Sumeru Hospital is not the only health facility facing the problem, although only one confirmed case of Covid-19 has been recorded in Nepal. Worldwide, more than 284, 710 Covid-19 infections have been reported in 186 countries and territories, with more than 11,842 deaths, as of March 21.
Green City Hospital, Basundhara has also faced the issue. “Some nurses and lab technicians serving at our hospital have applied for leave," Manish Dawadi, manager at Basundhara-based Green City Hospital, told the Post. "Doctors at our hospital have not yet requested leave from work, but we can’t say what would happen incase of an outbreak."
Their concern also stems from a recent notice by the Ministry of Health and Population. The ministry has directed hospitals with over 100 beds not to refer patients to other centres, and handle cases on their own.
The government has taken a slew of measures to control the spread of the virus and suspended all non-essential services. Private hospitals, who are bound by legal provisions that don’t allow them to suspend services, however, are now wary of the situation given the rising number of leave applications they are receiving.
Even as the country stares at the possible spread of the virus, health facilities largely lack protective gear— personal protective equipment, face masks and caps—and training. Private hospital officials say health workers are worried about handling patients fearing they might be carrying the virus.
"How can we ask our health workers to go see patients possibly infected with coronavirus? We don’t have personal protective equipment and even masks," said Dawadi. "The government should provide us necessary gear if we have to attend to patients."
Doctors concede that it's their duty to extend possible support to the government at the time of crisis, but they say they need to be equipped to do that.
Dahal, also the general secretary of the Association of Private Health Institution of Nepal, said asking health workers to attend to the patients without proper safety gear would amount to jeopardising their lives and risking infection to the entire hospital staff and the community.
The Washington Post reported last week that an Italian doctor died of the coronavirus after treating patients without gloves, highlighting the importance of protective gear while dealing with such a contagious disease.
According to Dahal, private hospitals have increased incentives for health workers, reduced their duty hours and provided insurance. “But they don’t seem convinced,” he said.
In his address to the nation also, Prime Minister KP Sharma Oli said incentives will be provided to health workers involved in the treatment of patients infected with coronavirus. According to Mahendra Prasad Shrestha, director general at the Department of Health Services government insurance cover will be provided to health workers serving in private hospitals if they are involved in the treatment of coronavirus cases.
“The details of the prime minister’s announcement are yet to be finalised, but government insurance will also cover the health workers serving in private hospitals if they are involved in treatment of Covid-19 cases,” he said.
Meanwhile, the association has held two rounds of meetings with member hospitals to discuss their strategy for a possible outbreak.
Dahal admitted that discussions took place, but said that the association directed all member hospitals not to deny services, as it was their duty to do so on humanitarian grounds.
The association has also written to the Ministry of Health and Population, asking it to provide safety gear and designate particular hospitals for treatment of patients.
"We have also proposed that such hospitals be identified," Kumar Thapa, chairman of the association, told the Post. "We have also proposed that public hospitals, schools, colleges, and unused apartments, among others be used to treat patients."
Frequently asked questions about the coronavirus outbreak
UPDATED as of March 28, 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. As of Wednesday, Covid-19 had spread to 199 countries and infected more than 615,576 people with 28,538 deaths. In South Asia, Pakistan has reported the highest number of infections at 1,408 with 11 deaths. While India has reported 819 confirmed cases with 19 deaths. Nepal has so far reported five cases, in which one patient recovered.
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.