Health workers at the Dharan-based BP Koirala Institute of Health Sciences have demanded for a point-of-care (POC) diagnostic device at the hospital's emergency ward so that they could triage suspected coronavirus patients from the outset and stop the infection among other patients and staff.

The health workers say they are vulnerable to Covid-19 infections, as the hospital does not have the device that would allow them to determine potential coronavirus infection in patients visiting the hospital for emergency services.

"Patients of different ailments and victims of several accidents are brought to the emergency unit around the clock. The health workers in the emergency ward have to act swiftly to save their lives,” said Prof Dr Gyanendra Malla, the senior emergency specialist at the institute. “But since we don't have a Point of Care machine to conduct rapid tests of incoming patients, health workers in the emergency unit and other patients are exposed to the risk of coronavirus."

As per the health protocol enforced by the government to contain the virus, PCR tests must be conducted on all patients brought to the hospital. The existing Påolymerase Chain Reaction machine at the health institute takes at least eight hours to generate Covid-19 test results. But a POC diagnostic device takes only one to one-and-a-half hours to give results, according to health officials.

"We keep suspected patients of coronavirus in area E of the emergency unit. We provide Personal Protective Equipment to the doctors, nurses and helpers deployed there,” said Malla. “For the health workers mobilised in areas A, B, C and D of the unit, we provide basic health safety materials like surgical masks and gloves."

According to him, health workers take safety precautions until the PCR test results of the patients are released. "But sometimes we can’t afford to wait for test results since we have to rush critical patients to the operation theatre," he added. “That is why we need a POC device installed at the emergency unit.”

The hospital’s emergency unit does not have a POC diagnostic device, leaving doctors and other health workers at risk of Covid-19 transmission.

In case a patient is in need of immediate surgery, the emergency unit workers collect the swab sample of the patient and rush to the Provincial Public Health Laboratory in Biratnagar, which is about 55 km away from Dharan.

"It takes around six hours to bring the PCR report from Biratnagar. We can’t wait for six hours when it comes to saving a life,” said Malla. "We had asked the higher authorities to install the device at the hospital some four months ago but we are yet to receive it."

Around 200 health workers are on duty at the emergency unit of the hospital round the clock.

BPKIHS is a well-facilitated health institution in Province 1 which used to see around 4,000 patients on a daily basis before the lockdown. Of late, around 150 patients are brought to the emergency unit daily, according to Malla.

The OPD of the institute has been closed for the past week for an indefinite period after doctors and other health workers were infected with the coronavirus. According to the laboratory unit at the institute, as many as 15 doctors and health workers at the hospital have tested positive for the coronavirus so far.

Meanwhile, the Provincial Public Health Laboratory has three POC diagnostic devices and an advanced PCR machine recently donated by the Swiss government.

“We need these machines in the lab here as we have to conduct PCR tests of around 1,500 swab samples daily," said Jayawendra Yadav, director at the provincial laboratory.

When asked about the demand of a POC machine by the BPKIHS, Chief Minister Sherdhan Rai said he had no knowledge about the issue.

"I haven’t been formally informed about the need for a new PCR machine and POC machine at BPKIHS. The provincial government is ready to provide the necessary support to address the issue when asked," said Rai.