Hyderabad: Just a few months ago, when Covid-19 positive cases started to get reported in the country, the community of physicians and public health officials in Telangana had little knowledge about the nature of the SARS-CoV-2 virus.
Fast forward to the end of July, the healthcare community, not only in Hyderabad, but also in the entire country is far better placed in managing Covid-19 positive cases, says Dr B Bhaskar Rao, founder and MD of Krishna Institute of Medical Sciences (KIMS) and president of Telangana Super Speciality Hospitals Association (TSSHA).
The senior cardiologist interacted with Telangana Today on the present situation in private hospitals in Hyderabad and the future challenges that have to be dealt with, not only by State-run hospitals but also by the private sector.
When Covid-19 cases started to get reported in China and later spread across the world, we felt that a lockdown was necessary. It was a decision taken out of necessity, since very little knowledge about SARS-CoV-2 was available, except for information coming out of China and later from Italy.
Evolving nature of pandemic
Lots of people criticised the Indian Council of Medical Research (ICMR) and other such organisations for frequently changing guidelines in dealing with SARS-CoV-2 virus and Covid patients. I personally feel that the criticism was unnecessary because the pandemic was evolving quickly and new information, studies and research papers were coming out on a daily basis. So, guidelines, treatment strategies and public advisories had to be changed and issued frequently. We had to learn about Covid-19 very quickly and adapt our existing medical infrastructure and manpower to tackle the pandemic.
Initially, the quarantine period was for four weeks, then it was reduced to 15 days and gradually more information and guidelines came through. The days required for a Covid-19 positive case to make a complete recovery is now 10 days. There are numerous instances where very mild positive cases are recovering within three to four days. You must have the ability to evolve quickly and open to adopt new developments during pandemics.
On drugs, the initial information available was the utility of Hydroxychloroquine and later on more drugs came into picture like anti-virals, Remdesivir and Tocilizumab. Now, we are also observing a lot of advantages from plasma therapy, which could be another good treatment modality for Covid-19 patients.
Shortage of beds in Telangana
When Covid cases started to get reported, we quickly realised that existing beds from other departments must be converted. However, let us accept that infrastructure challenges in the entire health sector in the country already existed even before Covid-19 happened.
Earlier, we used to treat all the Covid-19 positive cases in hospitals, putting a lot of pressure on the availability of beds. Later, as we learned, asymptomatic cases and mild cases can recover from home quarantine. I personally feel that the guidelines to keep mild, asymptomatic and high risk cases in home isolation and quarantine respectively reduced a lot of pressure on the healthcare system in Telangana. The State government was very quick to adopt these guidelines and it also provided a direction to private healthcare sector.
Persons who are Covid positive and are in home isolation, however, must ensure that they are monitoring their oxygen levels frequently and immediately call the doctor if there is a drop. Home isolation patients must always be in touch with a doctor (either Government or private hospital doctor) so that in an emergency, when the oxygen levels drop, the doctor will be able to allot a bed or provide some alternative way of emergency treatment.
You can’t take a risk by directly arriving to a healthcare facility with a critically ill Covid-19 patient who is struggling to get oxygen. People must realise that such patients must be stabilised and then brought to a hospital in an ambulance. For that to happen, they must be always in touch with a doctor when the patient is in home isolation. In that way, they will be able to avoid the disappointment of not getting a bed for a critical patient on time.
Experiences at KIMS
At present, there are nearly 1000 Covid-19 positive patients who are under our care in home and hotel isolation, institutional care. A majority of private hospitals roped in hotels, which started offering their rooms for isolation and quarantine purposes. We ourselves at KIMS had to innovate and convert or modify other medical sections for Covid-19 patients. Physical distancing, wearing masks and hand washing was adopted in every nook and cranny of our hospitals, which went a long way in reducing infections.
People also must realise that 90 per cent of the Covid-19 patients are recovering quickly. The remaining positive cases are also recovering but they do need some kind of medical assistance in an institutional setup. By this time, everybody is aware that people with pre-existing medical conditions must be careful. Therefore, I am very much hopeful that we can get out of this with minimum damage to lives.
What the future holds
There was the initial phobia against Covid-19, which has continued to persist to this day. But, I have observed that the phobia is now on the decline. However, people should not and never take Covid-19 lightly and at the same time there is also no need to overreact or panic.
As advancement in research continues to happen, I foresee in the near future the arrival of vaccines, which would give us some respite. Till then, however, the SARS-CoV-2 virus simply can’t vanish. It will be there and we must continue to thwart it by wearing masks, handwashing and physical distancing.
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