'Health infrastructure will not hold up if govt doesn't check spread'

A team of doctors and health workers make the rounds of Dharavi, requesting people to get themselves tested. File pic/Suresh Karkera

A group of specialist doctors from Mumbai have written to Chief Minister Uddhav Thackeray pointing out various lapses in the management of COVID-19. According to members of the Association of Medical Consultants (AMC), unless the government controls the spread of the disease, the health care infrastructure will severely challenged.

The letter, signed by Dr Deepak Baid, president of AMC and Dr Nilima Vaidya-Bhamare, the secretary, which was sent on Saturday, mentioned that there is no real-time data available about the beds in hospitals for COVID-19 patients, and doctors have not been able to guide them. They also said they were unable to guide COVID-19 affected pregnant women. In spite of the government directives, they claimed hospitals dealing with non-COVID-19 patients have often wrongly been sealed for 14 days and even the protocols for quarantine, testing of staff, government guidelines, etc are not uniformly followed by the local authorities.

Lack of unformity
The biggest problem is lack of uniformity. While there is big talk about co-ordination, things on the ground are bad, said many doctors. "The system of working and duty shifts in a COVID-19 hospital are not standardised. The ROTA system of attendance is not uniform across the corporations and hospitals, exposing our health care workers to infections," a senior doctor said, adding, "This should be fixed as soon as possible to get some method in the madness." Speaking in detail about how non-COVID-19 patients are getting affected because of the mismanagement of COVID-19, another specialist doctor affiliated to the organisation said, "The present policy towards COVID-19 testing by the government has led to confusion. Labs have been refusing to test even admitted patients. Pregnant women, chemotherapy patients and dialysis patients should be tested. Many doctors have been infected during surgeries, which is a matter of concern."

Brihanmumbai Municipal Corporation doctors test a resident in Madina Nagar, Dharavi recently. Pic/Pradeep Dhivar

Another doctor working in a high-pressure hospital said that there have been incidences of violence (at Cooper, Lilavati hospitals) in hospitals, but no satisfactory action has been taken against the people involved or against security personnel. Neither have the superintendents so far managed to register a simple FIR. "Our doctors, staff and technicians have been facing difficulties from local politicians at many places," she added.

'No caps on prices'
Another issue the doctors raised was of prices. "The government has still not capped the prices of N95 masks and PPEs and there is always a shortage of kits. There isn't any provision for testing and treatment of hospital staff and doctors. Even the high-end medicines for COVID-19 are largely unavailable," said Dr Baid. He added that while requisitioning the service of doctors, adequate care needs to be taken.

"While we have always been in the forefront and actively involved in the care of both COVID-19 as well as non-COVID-19 patients, we find that our members have been facing multiple issues" said Dr Baid.

Official speak
"The new municipal commissioner has held two meetings, on Saturday and Sunday with top officers, and ordered them to increase the number of beds in hospitals on a priority basis. He has already focused on these points raised by doctors. He even asked to improvise co-ordination between hospitals and instructed them to send the patient to other wards where beds are available," said a senior BMC officer who was present in the meetings.

Angry doctors

While the state govt has exempted senior doctors - above age 55 and with co-morbidity - from COVID-19 duty in government hospitals, many are angry with having to fill forms repeatedly for the same. The Directorate of Medical Education and Research (DMER) sent a notification to all doctors to fill up forms and send them to the civic chief's office by May 11. The DMER sent a new form on May 9. "While the letter clearly mentioned that doctors above 55 years of age are exempted from the 15 days duty for COVID-19, we are forced to fill the forms," said Dr Suhas Pingale from Mumbai. Dr Tatyarao Lahane, director of DMER, however, said "Doctors above the age of 55 need not fill the forms. We received 6,500 forms so far and 1,100 of these doctors are willing to give their service for 15 days," said Dr Lahane.

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